（禀受诸疾）凡十九门
《巢氏病源》小儿解颅候∶解颅者，其状∶小儿年大囟应合而不合，头缝开解是也。由肾气不成故也。肾主
骨髓，而脑为髓海，肾气不成则髓脑不足，不能结成，故头颅开解也。
《婴童宝鉴》∶小儿客风伤腑，即颅骨解囟。
《大万全方》小儿头病方论∶小儿有解颅候，有囟不合候，有囟陷候，此三者大同而小异也。解颅者，谓小
儿年长而头颅开解也。夫肾主骨，今骨不合，头缝开解，此肾气不成故也。其囟不合与囟陷，虽因脏腑有热，
热气上冲，致囟或不合或陷，然亦本于肾气不足也。
《玉诀》小儿骨气所伤候歌∶
解颅鹤膝腑伤风，囟肿因惊胃气攻。语涩行迟胎气促，筋拳瞪目是肝风。
此患当先行风气，利膈下涎。次和脏腑，即无误也。
《葛氏肘后方》治小儿解颅。
蟹足骨、白蔹等分，细末，乳汁和涂上，干又敷。
《千金》治小儿解颅方。
熬蛇蜕皮，末之，和猪颊车中髓，敷顶上，日三、四度。
《千金》又方
猪牙颊车髓，敷囟上瘥。
《千金》治小儿脑长解颅不合，羸瘦色黄，至四、五岁不能行。半夏熨方
半夏（汤洗七遍） 生姜 芎 （各一两） 细辛（三两） 桂心（一尺） 乌头（去皮脐，十枚）
上六味 咀，以醇苦酒五升渍之。 时，煮三沸，绞去滓，以绵一片浸药中，适寒温以熨囟上，冷更温之，
复熨如前。朝暮各三、四熨乃止，二十日愈。（《婴孺方》只五味，无生姜，又不用苦酒。）
《千金》治小儿解颅。三物细辛敷方
细辛 桂心（各半两） 干姜（炮十八铢）
上末之。以乳汁和敷颅上，干复敷之，儿面赤即愈。
《简要济众》治小儿解颅不合。
驴蹄不许多少，烧灰研，以生油和，敷于头骨缝上，以瘥为度。
《圣惠》治小儿解颅囟大，身有痼热，头汗出，腹胀咳嗽，上气肩息，胫蹇足交，三岁不行，皆
治之。钟乳丸方
钟乳粉 防风（去芦头） 熟干地黄 牛黄（细研） 甘草（炙） 漆花(《婴孺方》以此一味为豺漆，盖五加皮也。)
上各一分捣，罗为末，入研了药，更研令匀，以犬脑髓和丸如麻子大。每服以粥饮下三丸，早晨、午间。
日晚各一服。量儿大小，以意加减。
《圣惠》治小儿颅骨开。宜涂白芨散方
白芨 细辛 防风（去芦头） 柏子仁
上各一分捣，细罗为散。以乳汁调涂儿颅骨上，日再用之。
《婴孺方》治小儿脑长喜摇头，解颅。狗脑丸方
狗脑（一个） 豺漆（五加皮也） 甘草（炙） 白术 防风 钟乳石 干地黄（各一分） 牛黄（二分）
上以狗脑丸小豆大。一岁饮下二丸，日再，未知加之。又云∶儿囟常令暖，冷即病死。
《婴孺方》小儿锢囟药，使脑不长。
芍药粉
上取黄雌鸡临儿囟上，刺其冠，以血滴囟上，血上以芍药粉敷之，使血不见，一日立瘥。
《婴孺方》治小儿解颅囟大，身羸汗出，肺胀咳上气，三、五岁不行。狗脑丸方
甘草（炙） 地黄（各三分） 防风 白术（各二分） 钟乳粉 牛黄（各二铢）
上为末，狗脑丸如小豆大。二岁饮服七丸，日再稍加之。
张涣∶婴儿头骨应合而不合，头缝开解，名曰解颅。宜用玉乳丹方
钟乳粉（根据古法制炼者） 柏子仁（别研） 熟干地黄（根据法蒸焙者） 当归（洗焙干。各半两） 防
风（锉） 补骨脂（净炼炒。各一两） 或加黄 、茯苓
上件除别研者碾为细末，次入钟乳粉等拌匀，炼蜜和如黍米大。每服十粒，煎茴香汤下，乳食前。
《万全方》治小儿解颅囟大，身有痼热，头汗出，腹胀咳嗽，上气肩息，胫蹇足交，三岁不行皆治之。磁石丸
磁石（火 ，醋淬七遍，细研飞过） 防风（去芦头） 熟干地黄 牛黄（研入） 甘草（炙） 干漆
（炒令烟出。以上各一分）
上捣，罗为末，入研了药，更同研匀，以犬脑髓和丸如麻子大。每服三丸，粥饮下，早晨、午间、日晚各
一服。量儿大小以意加减。
长沙医者丁时发传治小儿解颅。虎骨方
虎骨 败龟板 不灰木 乳香（各半两）
上为末。用生猪血于手心内调，涂在头缝开处，以旧绵子包裹七日，第八日以葱汤水洗去前药，再用此药
涂之。经年者已减一分，又歇三日，方再用药涂之。又服参苓散
人参 茯苓 白附子（炮） 羌活 甘草（炙） 芍药 白术（水煮。各一分） 犀角屑 京
芎藿香（后三味减一半）
上为末。每服半钱，水一盏，用少金银同薄荷三叶煎至三分，温服，通惊气。
【背景信息】
书名：幼幼新书 作者：刘昉 朝代：宋 章节：卷第六 / 解颅第一 类别：综合
（禀受诸疾）凡十九门
《巢氏病源》关于小儿“解颅”的论述：所谓“解颅”，其症状表现为：小儿年龄增长，囟门本应闭合却未能闭合，头骨缝裂开。这是由于肾气未充盛所致。肾主司骨髓，而脑为髓之海，肾气不足则髓海空虚，无法凝结成骨，因此导致头颅骨缝裂开。
《婴童宝鉴》指出：小儿若受客风侵袭脏腑，即会出现颅骨解离、囟门不合的症状。
《大万全方》关于小儿头病的方论：小儿患有“解颅”证候的，有“囟门不合”证候的，有“囟门凹陷”证候的，这三者大同小异。“解颅”是指小儿年长后头颅骨缝裂开。肾主骨，如今骨骼不闭合，头缝裂开，这也是因为肾气未充盛所致。至于“囟门不合”与“囟门凹陷”，虽然是因为脏腑有热，热气上冲，导致囟门要么不闭合要么凹陷，但根本原因仍在于肾气不足。
《玉诀》关于小儿骨气受损的证候歌诀：
解颅、鹤膝风是腑受风邪，囟肿是因惊恐导致胃气攻冲。言语涩滞、行走迟缓是胎气急促所致，筋脉拘挛、瞪眼直视则是肝风内动。
此患应当先祛除风气，通利膈部并降下痰涎。其次调和脏腑，就不会有误治。
《葛氏肘后方》治疗小儿解颅。
蟹足骨、白蔹各等分，研成细末，用乳汁调和涂抹患处，干了再敷。
《千金方》治疗小儿解颅的方子。
将蛇蜕皮熬制，研成粉末，与猪下颌骨中间的骨髓混合，敷在头顶，每天三到四次。
《千金方》又一方
用猪牙颊车部位的骨髓，敷在囟门上，即可痊愈。
《千金方》治疗小儿脑发育异常、解颅不合，身体消瘦面色发黄，到了四五岁还不能行走。半夏熨法方
半夏（用热水洗七遍） 生姜 川芎 （各一两） 细辛（三两） 桂心（一尺） 乌头（去皮脐，十枚）
以上六味药切碎，用五升醇苦酒浸泡。煮至沸腾三次，绞去药渣，取一片绵布浸透药液，调节至适宜温度熨烫囟门处，凉了再加热，再次熨烫如前法。早晚各熨三四次为止，二十日可愈。（《婴孺方》只有五味药，没有生姜，也不用苦酒。）
《千金方》治疗小儿解颅。三物细辛敷方
细辛 桂心（各半两） 干姜（炮制十八铢）
以上研成粉末。用乳汁调和敷在颅骨上，干了再敷，直到患儿面部红润即为痊愈。
《简要济众方》治疗小儿囟门不合。
驴蹄不限数量，烧成灰研细，用生油调和，敷在头骨缝上，以痊愈为度。
《圣惠方》治疗小儿解颅、囟门过大，身体有顽固性发热，头部出汗，腹胀咳嗽，气逆喘息，小腿僵硬双脚交叉，三岁不能行走，皆可用此方治疗。钟乳丸方
钟乳粉 防风（去芦头） 熟干地黄 牛黄（细研） 甘草（炙） 漆花（《婴孺方》以此一味为豺漆，即五加皮。）
以上各一分捣碎，过筛成末，加入已研好的药物，再次研磨均匀，用犬脑髓和丸如麻子大小。每次服用三丸，用米汤送下，早晨、中午、晚上各服一次。根据患儿大小，酌情加减剂量。
《圣惠方》治疗小儿颅骨开裂。宜用涂敷白芨散方
白芨 细辛 防风（去芦头） 柏子仁
以上各一分捣碎，过筛成散剂。用乳汁调匀涂在患儿颅骨上，每天两次。
《婴孺方》治疗小儿脑部发育异常喜欢摇头、解颅。狗脑丸方
狗脑（一个） 豺漆（即五加皮） 甘草（炙） 白术 防风 钟乳石 干地黄（各一分） 牛黄（二分）
以上用狗脑和丸如小豆大小。一岁的患儿用饮液送服二丸，每天两次，若无效则增加剂量。又说：婴儿囟门常令其温暖，若寒冷则会导致病死。
《婴孺方》小儿锢囟药，使脑部不再过度生长。
芍药粉
取一只黄雌鸡，将其头靠近患儿囟门，刺破鸡冠，让血滴在囟门上，然后在血迹上敷以芍药粉，使血液不外露，一天即可立即痊愈。
《婴孺方》治疗小儿解颅、囟门过大，身体消瘦出汗，肺胀咳嗽气逆，三到五岁不能行走。狗脑丸方
甘草（炙） 地黄（各三分） 防风 白术（各二分） 钟乳粉 牛黄（各二铢）
以上研成粉末，用狗脑和丸如小豆大小。两岁的患儿用水送服七丸，每天两次，逐渐增加剂量。
张涣：婴儿头骨本应闭合却未闭合，头缝裂开，名为解颅。宜用玉乳丹方
钟乳粉（按古法制炼者） 柏子仁（另研） 熟干地黄（按法蒸焙者） 当归（洗净焙干。各半两） 防风（锉碎） 补骨脂（净炼炒。各一两） 或加黄芪、茯苓
以上除另研的药物外，其余碾成细末，再加入钟乳粉等拌匀，用炼蜜和丸如黍米大小。每次服用十粒，煎茴香汤送下，在吃奶吃饭之前服用。
《万全方》治疗小儿解颅、囟门过大，身体有顽固性发热，头部出汗，腹胀咳嗽，气逆喘息，小腿僵硬双脚交叉，三岁不能行走，皆可用此方治疗。磁石丸
磁石（火煅，醋淬七遍，细研过筛） 防风（去芦头） 熟干地黄 牛黄（研入） 甘草（炙） 干漆
（炒至冒烟。以上各一分）
以上捣碎，过筛成末，加入已研好的药物，再次共同研磨均匀，用犬脑髓和丸如麻子大小。每次服用三丸，用米汤送下，早晨、中午、晚上各服一次。根据患儿大小，酌情加减剂量。
长沙医生丁时发传授治疗小儿解颅。虎骨方
虎骨 败龟板 不灰木 乳香（各半两）
以上研成粉末。用生猪血在手心内调和，涂在头骨裂缝处，用旧棉絮包裹七天，第八天用葱汤水洗去前药，再用此药涂抹。患病一年的已经减轻一分，又休息三天，才再次用药涂抹。另外服用参苓散
人参 茯苓 白附子（炮） 羌活 甘草（炙） 芍药 白术（水煮。各一分） 犀角屑 京芎藿香（后三味减半）
以上研成粉末。每次服用半钱，水一盏，加少许金银同薄荷三叶煎至三分之一，温服，以通惊气。
[Background Information]
Book: *Youyou Xinshu* (New Book for Infants and Children)
Author: Liu Fang
Dynasty: Song Dynasty
Chapter: Volume 6 / Jie Lu (Split Skull) Part 1
Category: Comprehensive
(Disorders Inherited from Conception) Total of Nineteen Sections
**On the Syndrome of "Jie Lu" in Children from *Chao Shi Bing Yuan*:**
The term "Jie Lu" refers to a condition where, as the child grows older, the fontanelle should have closed but remains open, and the cranial sutures are split. This is caused by the insufficiency of Kidney Qi. The Kidneys govern the bone marrow, and the brain is the sea of marrow. When Kidney Qi is insufficient, the marrow and brain are deficient and cannot consolidate into bone, resulting in the splitting of the cranial sutures.
**From *Ying Tong Bao Jian*:**
If children are injured by external wind pathogens affecting the fu organs, it leads to the separation of cranial bones and an unclosed fontanelle.
**On Formulas for Pediatric Head Diseases from *Da Wan Quan Fang*:**
Children may present with the syndrome of "Jie Lu," the syndrome of an unclosed fontanelle, or the syndrome of a depressed fontanelle. These three conditions are largely similar with minor differences. "Jie Lu" refers to the splitting of cranial sutures in older children. Since the Kidneys govern the bones, the failure of bones to close and the splitting of head sutures is due to insufficient Kidney Qi. Although the unclosed or depressed fontanelle is caused by heat in the zang-fu organs rising upward, the root cause remains insufficient Kidney Qi.
**Song on Syndromes of Bone-Qi Injury in Children from *Yu Jue*:**
Jie Lu and crane-knee deformity indicate wind pathogen injury to the fu organs; swollen fontanelle results from fright attacking the Stomach Qi. Slurred speech and delayed walking stem from rushed fetal qi; convulsed tendons and staring eyes signify Liver Wind.
This condition should first be treated by dispelling wind and phlegm from the diaphragm. Subsequently, harmonizing the zang-fu organs will ensure no error in treatment.
**Treatment for Pediatric Jie Lu from *Ge Shi Zhou Hou Fang*:**
Mix crab claw bone and Bai Lian (*Ampelopsis japonica*) in equal parts, grind into fine powder, mix with milk, and apply topically. Reapply when dry.
**Formula for Pediatric Jie Lu from *Qian Jin*:**
Roast snake skin, grind into powder, mix with marrow from the pig's jawbone, and apply to the vertex. Apply three to four times daily.
**Another Formula from *Qian Jin*:**
Apply marrow from the pig's jawbone to the fontanelle until healed.
**Banxia Ironing Method for Pediatric Brain Development Abnormalities, Jie Lu, Emaciation, Yellowish Complexion, and Inability to Walk at Four or Five Years Old from *Qian Jin*:**
Ban Xia (*Pinelliae Rhizoma*, washed seven times in hot water), Sheng Jiang (*Zingiberis Rhizoma Recens*), Xiong Diao (*Ligusticum striatum*), Xi Xin (*Asari Radix et Rhizoma*, 3 liang), Gui Xin (*Cinnamomi Ramulus*), Wu Tou (*Aconiti Radix*, ten pieces, peeled and navel removed).
Chop the above six herbs, soak in five sheng of strong vinegar. Boil three times, strain to remove dregs. Soak a piece of cotton in the medicinal liquid, adjust to a suitable temperature, and iron the fontanelle. Reheat when cool and repeat. Iron three to four times morning and evening until finished; cure within twenty days. (*Ying Ru Fang* contains only five herbs, without Sheng Jiang, and does not use vinegar.)
**Sanwu Xi Xin Powder for Pediatric Jie Lu from *Qian Jin*:**
Xi Xin (*Asari Radix et Rhizoma*), Gui Xin (*Cinnamomi Ramulus*, half liang each), Gan Jiang (*Zingiberis Rhizoma*, roasted, 18 zhu).
Grind into powder. Mix with milk and apply to the skull. Reapply when dry. The child's face turning red indicates healing.
**Treatment for Unclosed Fontanelle in Children from *Jian Yao Ji Zhong Fang*:**
Burn donkey hooves to ash regardless of quantity, grind finely, mix with raw oil, and apply to the cranial sutures. Continue until healed.
**Zhongru Pill for Large Fontanelle, Persistent Fever, Head Sweating, Abdominal Distension, Cough, Dyspnea, Leg Stiffness, Crossed Feet, and Inability to Walk at Three Years Old from *Sheng Hui Fang*:**
Zhong Ru Fen (*Gypsum Fibrosum Pulveratum*), Fang Feng (*Saposhnikoviae Radix*, de-rhizome), Shu Di Huang (*Rehmanniae Radix Preparata*), Niu Huang (*Bovis Calculus*, finely ground), Zhi Gan Cao (*Glycyrrhizae Radix et Rhizoma Preparata*), Qi Hua (*Eleutherococcus senticosus*, also known as Chai Qi in *Ying Ru Fang*).
Grind each ingredient separately into powder, sieve, mix with the already-ground ingredients, and further grind uniformly. Mix with dog brain marrow to form pills the size of hemp seeds. Administer three pills per dose with millet broth, taken in the morning, noon, and evening. Adjust dosage according to the child's age and size.
**Bai Ji Powder for Split Cranial Bones from *Sheng Hui Fang*:**
Bai Ji (*Bletillae Rhizoma*), Xi Xin (*Asari Radix et Rhizoma*), Fang Feng (*Saposhnikoviae Radix*, de-rhizome), Bai Zi Ren (*Platycladi Semen*).
Grind each ingredient separately into powder, sieve finely. Mix with milk and apply to the infant's skull. Apply twice daily.
**Gou Nao Pill for Head Shaking and Jie Lu Due to Brain Development Issues from *Ying Ru Fang*:**
Gou Nao (*Canis Cerebrum*, one), Chai Qi (*Eleutherococcus senticosus*), Zhi Gan Cao (*Glycyrrhizae Radix et Rhizoma Preparata*), Bai Zhu (*Atractylodis Macrocephalae Rhizoma*), Fang Feng (*Saposhnikoviae Radix*), Zhong Ru Shi (*Gypsum Fibrosum*), Gan Di Huang (*Rehmanniae Radix*, one fen each), Niu Huang (*Bovis Calculus*, two fen).
Mix with dog brain to form pills the size of adzuki beans. For one-year-olds, administer two pills with drink, twice daily. Increase if ineffective. It is also stated that the infant's fontanelle should always be kept warm; coldness leads to death.
**Medicine to Seal the Fontanelle and Prevent Excessive Brain Growth from *Ying Ru Fang*:**
Shao Yao Fen (*Paeoniae Radix Alba Pulveratum*).
Take a yellow hen, hold its head near the infant's fontanelle, pierce the comb, let blood drip onto the fontanelle, and cover the blood with Shao Yao powder to prevent exposure. Cure occurs immediately within one day.
**Gou Nao Pill for Large Fontanelle, Emaciation, Sweating, Lung Distension, Cough, Dyspnea, and Inability to Walk at Three to Five Years Old from *Ying Ru Fang*:**
Zhi Gan Cao (*Glycyrrhizae Radix et Rhizoma Preparata*), Di Huang (*Rehmanniae Radix*, three fen each), Fang Feng (*Saposhnikoviae Radix*), Bai Zhu (*Atractylodis Macrocephalae Rhizoma*, two fen each), Zhong Ru Fen (*Gypsum Fibrosum Pulveratum*), Niu Huang (*Bovis Calculus*, two zhu each).
Grind into powder, mix with dog brain to form pills the size of adzuki beans. For two-year-olds, administer seven pills with water, twice daily, gradually increasing the dose.
**Yuru Dan Prescribed by Zhang Huan for Unclosed Cranial Sutures:**
Zhong Ru Fen (*Gypsum Fibrosum Pulveratum*, prepared by ancient methods), Bai Zi Ren (*Platycladi Semen*, ground separately), Shu Di Huang (*Rehmanniae Radix Preparata*, steamed and baked), Dang Gui (*Angelicae Sinensis Radix*, washed and dried, half liang each), Fang Feng (*Saposhnikoviae Radix*, chopped), Bu Gu Zhi (*Psoraleae Fructus*, refined and fried, one liang each). Optionally add Huang Qi (*Astragali Radix*) and Fu Ling (*Poria*).
Grind all ingredients except those ground separately into fine powder, mix with Zhong Ru Fen, and bind with refined honey to form pills the size of millet seeds. Administer ten pills per dose with fennel decoction, before nursing or eating.
**Ci Shi Pill for Large Fontanelle, Persistent Fever, Head Sweating, Abdominal Distension, Cough, Dyspnea, Leg Stiffness, Crossed Feet, and Inability to Walk at Three Years Old from *Wan Quan Fang*:**
Ci Shi (*Magnetitum*, calcined, quenched in vinegar seven times, finely ground and sieved), Fang Feng (*Saposhnikoviae Radix*, de-rhizome), Shu Di Huang (*Rehmanniae Radix Preparata*), Niu Huang (*Bovis Calculus*, ground), Zhi Gan Cao (*Glycyrrhizae Radix et Rhizoma Preparata*), Gan Qi (*Rhei Radix et Rhizoma*, stir-fried until smoke appears, one fen each).
Grind and sieve into powder, mix with pre-ground ingredients, and grind uniformly. Mix with dog brain marrow to form pills the size of hemp seeds. Administer three pills per dose with millet broth, taken in the morning, noon, and evening. Adjust dosage according to the child's age and size.
**Hu Gu Formula Transmitted by Ding Shifa, a Physician from Changsha, for Pediatric Jie Lu:**
Hu Gu (*Pantheris Os*), Bai Gui Ban (*Testudinis Carapax et Plastrum*), Bu Hui Mu (*Travertine*), Ru Xiang (*Olibanum*, half liang each).
Grind into powder. Mix with fresh pig blood in the palm, apply to the split cranial suture, wrap with old cotton for seven days. On the eighth day, wash off the previous medicine with scallion water, then reapply this medicine. For cases lasting a year, reduce severity by one part, rest for three days, then reapply. Additionally, administer Shen Ling San:
Ren Shen (*Ginseng Radix*), Fu Ling (*Poria*), Bai Fu Zi (*Typhonii Rhizoma*, processed), Qiang Huo (*Notopterygii Rhizoma et Radix*), Zhi Gan Cao (*Glycyrrhizae Radix et Rhizoma Preparata*), Shao Yao (*Paeoniae Radix*), Bai Zhu (*Atractylodis Macrocephalae Rhizoma*, boiled, one fen each), Xi Jiao Xie (*Rhinocerotis Cornu Fragmenta*), Jing Xiong (*Ligusticum striatum*), Huo Xiang (*Pogostemonis Herba* - last three ingredients halved).
Grind into powder. Administer half qian per dose with one sheng of water, add a small amount of gold and silver, boil with three mint leaves until reduced to one-third, take warm to dispel shock qi.