小儿禀赋不充盈，肌肉削瘦少峥嵘，膝骨外露如鹤膝，多缘肾弱髓难生，
血脉不荣筋挛缩，膝贮风涎时作疼，大防风汤宜先服，地黄继进莫从容。
【注】
小儿鹤膝风，多因禀赋不足，血气不荣，肌肉削瘦，
遂致骨节外露，筋脉挛缩，股渐细小，而膝愈大，
腰皆肾虚不能生精髓之故也，
须先服大防风汤，继以补肾地黄丸治之，庶气血充而证自愈矣。
（大防风汤）
人参 白术土炒 茯苓 甘草炙 熟地黄 当归身 白芍药炒
川芎 黄耆蜜炙 羌活 防风 附子制 杜仲 牛膝 引用姜枣水煎服。
（方歌）
大防风汤八珍耆，羌防附子杜仲移，荣筋更有川牛膝，虚风鹤膝最相宜。
（补肾地黄丸）方见五软
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杂证门
小儿解颅最堪怜，先天有损脑髓干，面色□白形瘦弱，二目多白若愁烦，
补肾地黄丸堪服，补阳扶元散为先，更有封□散极效，临时摊贴保安然。
【注】
解颅者，乃□大骨缝不合也，
盖肾生髓，脑为髓海，肾气有亏，脑髓不足，亦如花木无根，
现证面色□白，形体瘦弱，目多白睛，悲愁少笑，治宜补养肾气为主，
先以补肾地黄丸滋补其阴，再以扶元散补养其气，
外用封□散摊贴之，则精血稍充，或可转危为安也。
（补肾地黄丸）（扶元散）俱见五软。
（封□散）
柏子仁 防风 天南星各四两 以上为细末，每用一钱，以猪胆汁调匀，
摊在绯绢帛上，看□大小剪贴，一日一换，不得令干，时时以汤润动。
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杂证门
小儿先天禀赋不充足，肌肉消瘦缺乏丰盈之态，膝部骨骼外露形似鹤膝，多因肾气虚弱导致骨髓难以化生，
血脉无法濡养致使筋脉拘挛收缩，膝关节处积聚风邪与痰涎时而疼痛，应当先服用大防风汤，随后继服补肾地黄丸不可迟缓。
【注】
小儿鹤膝风，多因先天禀赋不足，气血不能濡养，肌肉消瘦，
从而导致骨节外露，筋脉拘挛收缩，大腿逐渐变细，而膝盖反而更大，
这都是因为腰部肾脏肾虚，不能生化精髓的缘故，
必须先服用大防风汤，接着用补肾地黄丸治疗，这样气血充盛病症自然痊愈。
（大防风汤）
人参、土炒白术、茯苓、炙甘草、熟地黄、当归身、炒白芍药、川芎、蜜炙黄耆、羌活、防风、制附子、杜仲、牛膝，引用生姜和大枣煎水服用。
（方歌）
大防风汤包含八珍汤及黄耆，加入羌活、防风、附子、杜仲，
更有川牛膝以荣养筋脉，对于虚风引起的鹤膝风最为适宜。
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杂证门
小儿解颅症最令人怜悯，先天受损导致脑髓干枯，面色苍白形体瘦弱，双眼眼白多露神情愁苦烦闷，
可以服用补肾地黄丸，先服用补阳扶元散，还有封囟散效果极佳，临时摊贴可保平安。
【注】
解颅，是指囟门宽大骨缝不合，
肾主生髓，脑为髓海，肾气亏损，脑髓不足，就像花木没有根基一样，
现症见面色苍白，形体瘦弱，眼睛多露白睛，悲伤愁苦少笑，治疗应以补养肾气为主，
先用补肾地黄丸滋补其阴，再用扶元散补养其气，
外用封囟散摊贴，则精血稍充，或许能转危为安。
（封囟散）
柏子仁、防风、天南星各四两，以上药物研为细末，每次取一钱，用猪胆汁调匀，
摊在红色丝绢上，根据囟门大小剪裁贴敷，一日更换一次，不得使其干燥，时时用汤水润湿。
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杂证门
Pediatric patients with insufficient congenital endowment exhibit emaciated muscles lacking plumpness, and the knee bones protrude resembling a crane's knee. This condition often stems from weak Kidney Qi, which hinders the generation of marrow. When blood vessels fail to nourish the sinews, spasms and contractions occur; wind-phlegm accumulates in the knees causing intermittent pain. Dafangfeng Tang (Great Wind-Expelling Decoction) should be administered first, followed promptly by Dihuang Wan (Rehmannia Pill).
[Annotation]
Pediatric Crane’s Knee Disease (He Xi Feng) is mostly due to insufficient congenital endowment, where Qi and Blood fail to nourish the body, leading to muscle emaciation. Consequently, bone joints become exposed, sinews contract, the thighs gradually thin while the knees enlarge. This is fundamentally caused by Kidney deficiency in the lower back, unable to generate essence and marrow. One must first administer Dafangfeng Tang (Great Wind-Expelling Decoction), then treat with Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill), so that Qi and Blood become abundant and the condition resolves spontaneously.
(Dafangfeng Tang / Great Wind-Expelling Decoction)
Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma, stir-fried with soil), Fuling (Poria), Zhigancao (Licorice Root, honey-roasted), Shudihuang (Rehmanniae Radix Praeparata), Dangguishen (Angelicae Sinensis Radix, root body), Chaibaishaoyao (White Peony Root, stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma), Mijihuangqi (Astragali Radix, honey-roasted), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Zhi Fuzi (Aconiti Lateralis Radix Praeparata), Duzhong (Eucommiae Cortex), Niuxi (Achyranthis Bidentatae Radix). Decoct with fresh ginger and jujube as guides.
(Formula Song)
Dafangfeng Tang contains the Eight Treasures plus Huangqi, along with Qianghuo, Fangfeng, Fuzi, and Duzhong.
Chuan Niuxi further nourishes the sinews, making it most suitable for Crane’s Knee caused by deficient wind.
(Bushen Dihuang Wan / Kidney-Nourishing Rehmannia Pill) See section on "Five Softnesses".
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Miscellaneous Diseases Department
The pediatric condition of Jie Lu (Split Cranium) is most pitiable; congenital damage leads to dry brain marrow. The complexion is pale white, the physique is thin and weak, and the eyes show excessive whites, reflecting sorrow and vexation. Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill) is suitable for consumption, preceded by Buyang Fuyuan San (Yang-Supporting Yuan-Nourishing Powder). Additionally, Fengxin San (Fontanel-Sealing Powder) is extremely effective; applying it temporarily ensures safety.
[Annotation]
Jie Lu (Split Cranium) refers to the fontanelle being wide and the cranial sutures failing to close.
Since the Kidney generates marrow and the Brain is the Sea of Marrow, a deficiency in Kidney Qi results in insufficient brain marrow, akin to plants lacking roots.
Current symptoms include a pale white complexion, emaciated physique, prominent whites in the eyes, and a demeanor of sorrowful melancholy with little laughter. Treatment should primarily focus on nourishing Kidney Qi.
First, use Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill) to tonify Yin, then use Fuyuan San (Yuan-Nourishing Powder) to tonify Qi.
Externally apply Fengxin San (Fontanel-Sealing Powder); if essence and blood are slightly replenished, the critical condition may turn to safety.
(Bushen Dihuang Wan / Kidney-Nourishing Rehmannia Pill) and (Fuyuan San / Yuan-Nourishing Powder) both see section on "Five Softnesses".
(Fengxin San / Fontanel-Sealing Powder)
Baiziren (Biota Seed), Fangfeng (Saposhnikoviae Radix), Tiannanxing (Arisaematis Rhizoma), each 4 liang. Grind all into fine powder. Use 1 qian per application, mix evenly with pig bile, spread onto red silk fabric, cut according to the size of the fontanelle, and apply. Change once daily, ensuring it does not dry out; moisten occasionally with warm water.
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Miscellaneous Diseases Department