囟陷者,有因脏腑有热,多饮水浆致成泻痢,久则气血弱,不能上充髓脑,故下陷
如坑,此乃胃虚脾弱之极,宜急扶元。若与枕骨并陷者,百难救一。亦有父精有损,母
血虚衰,禀元不足,是以形容枯瘦,阴阳两亏,无时温壮而囟陷者。有因蓄热不除,渐
至身羸发落,脚缩手拳,皮焦鹤膝,血绝筋衰而囟陷者。宜各随症调治。枕陷尤重于囟
陷,不独小儿也。盖耳后方圆二寸,皆属于肾,陷则肾元败矣。
治禀受不足,颅囱开解,肌肉消瘦,齿语行迟。
山药(一钱) 人参 白茯苓 茯神 白术 白芍 当归 黄 (蜜炙) 熟地黄(各五
分) 川芎 甘草(炙,各六分) 石菖蒲(四分) 姜 枣 水煎服。
治婴孩颅囟开解。此乃肾气不成,肾主骨髓,脑为髓海,肾气不盛,所以脑水不
足,故不合。
人参(二钱) 熟地黄(四钱) 鹿茸酒 山药 白茯苓 牡丹皮 山茱萸(去核,各三钱)
为末,蜜丸,芡实大,参汤调化,食远服,神效。
治解颅。
山茵陈 车前子 百合(各五钱) 为末,乌牛乳汁调,涂足心及头缝开处,帛
裹,三日一换。
又方
驴头骨不拘多少,烧灰研细,以清油调敷头缝中。
一方
用狗头骨、炙黄,为末,鸡子清调涂。
治感热囟门忽肿。
天麻 蝉脱 防风 羌活 远志肉(各五分) 甘草(一分) 川芎 桔梗(各四分)
牛蒡子(炒,三分) 灯心水煎服。
囟门凹陷,有的是因为脏腑有热,大量饮水导致腹泻痢疾,时间久了气血虚弱,不能向上充养髓海和脑窍,所以囟门向下凹陷像坑一样,这是胃虚脾弱到了极点,应当紧急扶助元气。如果囟门与枕骨同时凹陷的,一百个病人中难救活一个。也有的是因为父亲精气受损,母亲血液虚衰,先天禀赋不足,因此形体枯瘦,阴阳两亏,没有定时发热而囟门凹陷的。有的是因为蓄积的热邪不除,逐渐导致身体消瘦、头发脱落、脚缩手拳、皮肤焦枯、鹤膝风(膝盖肿大如鹤膝),血竭筋衰而导致囟门凹陷的。应当各自根据症状进行调治。枕骨凹陷比囟门凹陷更为严重,不仅限于小儿如此。因为耳后方圆二寸的区域,都归属于肾,凹陷说明肾元败坏了。
治疗先天禀受不足,颅囟开解不合,肌肉消瘦,出牙、说话、行走迟缓。
山药(一钱) 人参 白茯苓 茯神 白术 白芍 当归 黄芪(蜜炙) 熟地黄(各五分) 川芎 甘草(炙,各六分) 石菖蒲(四分) 生姜 大枣 水煎服。
治疗婴儿颅囟开解不合。这是由于肾气未成,肾主骨髓,脑为髓海,肾气不旺盛,所以脑髓之水不足,因此囟门不能闭合。
人参(二钱) 熟地黄(四钱) 鹿茸酒 山药 白茯苓 牡丹皮 山茱萸(去核,各三钱)
研为细末,用蜂蜜制成丸药,大小如芡实,用人参汤送服化开,饭后服用,效果神奇。
治疗解颅(囟门迟闭)。
山茵陈 车前子 百合(各五钱)
研为细末,用乌牛乳汁调和,涂抹于足心及头缝开裂处,用布包裹,三天更换一次。
又一方
驴头骨不拘多少量,烧成灰后研细,用清油调和敷在头缝中。
另一方
用狗头骨,炙黄后研为细末,用鸡蛋清调和涂抹。
治疗感受热邪导致囟门突然肿胀。
天麻 蝉蜕 防风 羌活 远志肉(各五分) 甘草(一分) 川芎 桔梗(各四分) 牛蒡子(炒,三分) 灯心草 水煎服。
Fontanelle depression may be caused by heat in the zang-fu organs, excessive drinking of water leading to diarrhea and dysentery. Over time, Qi and Blood become weak and fail to ascend to nourish the Marrow Sea and brain, causing the fontanelle to sink like a pit. This indicates extreme deficiency of Stomach Qi and Spleen Qi; it is urgent to support the Primordial Qi. If both the fontanelle and the occipital bone are depressed, one out of a hundred cases is difficult to save. There are also cases due to damage to the father's essence or deficiency and decline of the mother's blood, resulting in insufficient congenital endowment. The child appears withered and emaciated, with both Yin and Yang deficient, experiencing no periodic fever but having a depressed fontanelle. In other cases, accumulated heat remains unresolved, gradually leading to emaciation, hair loss, flexed legs and fists, scorched skin, "crane knee" deformity (swollen knees resembling a crane's knee), exhaustion of Blood, and decline of Sinews, resulting in a depressed fontanelle. Treatment should follow each specific syndrome. Depression of the occipital bone is more serious than that of the fontanelle and is not limited to children. The area two cun in diameter behind the ear belongs to the Kidney; depression here indicates failure of Kidney Primordial Qi.
For congenital insufficiency, open fontanelles, emaciated muscles, and delayed dentition, speech, and walking:
Shan Yao (Dioscoreae Rhizoma) (1 qian), Ren Shen (Ginseng Radix et Rhizoma), Bai Fu Ling (Poria), Fu Shen (Poria cum Pinellia), Bai Zhu (Atractylodis Rhizoma), Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix, honey-fried), Shu Di Huang (Rehmanniae Radix Praeparata) (each 5 fen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma, fried, each 6 fen), Shi Chang Pu (Acori Tatarinowii Rhizoma) (4 fen), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus). Decoct in water and take orally.
For infant open fontanelles. This is due to incomplete formation of Kidney Qi. The Kidney governs the Marrow, and the Brain is the Sea of Marrow. When Kidney Qi is not robust, the fluid of the Brain Marrow is insufficient, so the fontanelle fails to close.
Ren Shen (Ginseng Radix et Rhizoma) (2 qian), Shu Di Huang (Rehmanniae Radix Praeparata) (4 qian), Lu Rong Jiu (Deer Antler Wine), Shan Yao (Dioscoreae Rhizoma), Bai Fu Ling (Poria), Mu Dan Pi (Moutan Cortex), Shan Zhu Yu (Corni Fructus, pitted, each 3 qian). Grind into fine powder, make into pills with honey, size equivalent to Euryales Semen (Qian Shi). Take with Ginseng decoction after meals for miraculous effect.
For Jie Lu (delayed closure of fontanelles):
Shan Yin Chen (Artemisiae Scopariae Herba), Che Qian Zi (Plantaginis Semen), Bai He (Lilii Bulbus) (each 5 qian). Grind into fine powder, mix with milk from a black cow, apply to the center of the sole and the open cranial sutures, wrap with cloth, and change every three days.
Another prescription:
Donkey skull bone, any amount, burn to ash, grind finely, mix with clear sesame oil, and apply to the cranial sutures.
Another prescription:
Dog skull bone, roast until yellow, grind into powder, mix with egg white, and apply.
For sudden swelling of the fontanelle due to contracted Heat:
Tian Ma (Gastrodiae Rhizoma), Chan Tui (Cicadae Periostracum), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Yuan Zhi Rou (Polygalae Radix flesh, each 5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 fen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix) (each 4 fen), Niu Bang Zi (Arctii Fructus, stir-fried, 3 fen), Deng Xin Cao (Junci Medulla). Decoct in water and take orally.