《圣惠》∶夫小儿囟不合者,此乃气血少弱,骨本不荣故也。皆由肾气未成,肝肺有热,壅热之气上冲于脑,
遂令头发干枯,骨髓不足,故令囟不合也。
钱乙论解颅,六年大而囟不合,肾气不成也,长必少笑。更有目白睛多, 白色瘦者,多愁少喜也。余见
肾虚。
《千金》治小儿囟门不合方。
防风(一两半) 柏子仁 白芨(各一两)
上三味末之,以乳和敷囟上。十日知,二十日愈。日一。
《婴孺方》狗脑丸 治小儿三岁不行,脑长囟大,头汗出,有热,足燥胫交方。
钟乳石 干地黄 甘草 豺漆(五加皮也) 防风(各等分)
上为末,狗脑丸如小豆大。饮下二丸,日进三服,夜二服。
《婴孺方》治小儿囟开不合方。
防风(六分) 白芨(四分) 栀子(三分)
上为末。以乳汁蜜和,涂囟上,日一度。
《婴孺方》小儿囟开令合方。
防风(六分) 白芨(二分)
上为末。乳和涂囟上,日十度,以知为度。二十日当合。
钱乙治囟开不合,鼻塞不通。
天南星大者,微炮去皮,为细末。淡醋调,涂绯帛上,贴囟上,火灸,手频熨之。
张涣∶婴儿解颅,囟不合,囟填,囟陷下不平。皆由肾经虚热。宜用对囟散方
蛇蜕皮(一两烧灰,细研) 防风 川大黄(湿纸裹火,煨存性。) 白芨(各半两)
上件碾为细末,入青黛半两,同研匀。每用半钱,以 猪胆汁调匀,用一纸囟子摊之,四边回各留少白纸,
用淡醋、生面糊贴囟上,不住以温水润动,一伏时换。
《庄氏家传方》治脑缝不合。
山茵陈(一两) 车前子 百合(各半两)
上为末,用乌牛乳汁调涂脚及脑缝上,用帛子裹头,三日一换,五上必效。
《王氏手集》封囟散方 治囟开不合,头缝开张;囟开崎陷,咳嗽鼻塞。
柏子仁 防风 天南星(各四两)
上为细末。每用一钱,以猪胆汁调匀,稀稠得所,摊在绯绢帛上,看囟子大小剪贴。一日一换,不得令干,
时时以汤润动。
《圣惠》小儿囟开不合,灸脐上、脐下各五分。二穴各三壮。灸疮未合,囟开先合,炷如小麦大。
《太平圣惠方》记载:小儿囟门不合,这是由于气血虚弱,骨骼得不到滋养的缘故。这通常是因为肾气尚未充盈,肝肺有热,壅滞的热气上冲至脑部,导致头发干枯,骨髓不足,从而造成囟门无法闭合。
钱乙论述解颅(囟门迟闭),指出若患儿六岁时囟门仍大且不合,是肾气未成的表现,长大后往往言语迟钝、少笑。如果有白睛多、面色苍白消瘦的患儿,则多表现为忧愁多于喜悦。其余情况可见于肾虚证。
《千金方》治疗小儿囟门不合的方剂。
防风(一两半) 柏子仁 白芨(各一两)
将以上三味药研成细末,用乳汁调和后敷在囟门上。十日见效,二十日痊愈。每日一次。
《婴孺方》狗脑丸,治疗小儿三岁不能行走,头骨缝宽、囟门大,头部出汗,伴有发热,足部干燥、小腿交叉的症状。
钟乳石 干地黄 甘草 豺漆(即五加皮) 防风(各等分)
将上述药物研为细末,用狗脑制成如小豆大小的丸剂。每次饮服二丸,白天服用三次,夜间服用两次。
《婴孺方》治疗小儿囟门开张不合的方剂。
防风(六分) 白芨(四分) 栀子(三分)
将上述药物研为细末。用乳汁和蜂蜜调和,涂抹在囟门上,每日一次。
《婴孺方》使小儿囟门开张得以闭合的方剂。
防风(六分) 白芨(二分)
将上述药物研为细末。用乳汁调和涂抹在囟门上,每日十次,以见效为度。二十日应当闭合。
钱乙治疗囟门开张不合,伴有鼻塞不通。
选用较大的天南星,轻微炮制后去皮,研成细末。用淡醋调匀,涂在红绢上,贴在囟门上,用火灸,并用手频繁熨烫。
张涣认为:婴儿出现解颅(囟门迟闭)、囟门不合、囟填(囟门隆起)、囟陷下不平,都是由于肾经虚热所致。适宜使用对囟散方。
蛇蜕皮(一两烧成灰,细研) 防风 川大黄(用湿纸包裹后火煨至存性) 白芨(各半两)
将上述药物碾成细末,加入青黛半两,共同研磨均匀。每次取半钱药粉,用猪胆汁调匀,摊在一层纸上,四周留出少许白纸边缘,用淡醋和生面糊贴在囟门上,不时用温水润湿保持湿润,一个时辰(两小时)更换一次。
《庄氏家传方》治疗脑缝不合。
山茵陈(一两) 车前子 百合(各半两)
将上述药物研为细末,用黑牛乳汁调和,涂抹在脚底及脑缝处,用布带裹住头部,每三天更换一次,五次之后必定见效。
《王氏手集》封囟散方,治疗囟门开张不合,头缝裂开;囟门凹陷崎岖,咳嗽鼻塞。
柏子仁 防风 天南星(各四两)
将上述药物研为细末。每次取一钱药粉,用猪胆汁调匀,浓度适中,摊在红绢帛上,根据囟门大小剪裁贴合。每日更换一次,不得令其干燥,时常以热水润湿。
《太平圣惠方》小儿囟门开张不合,可灸脐上五分、脐下五分各两个穴位。每个穴位灸三壮。若灸疮未愈合而囟门先闭合,艾炷大小如小麦粒。
Taiping Shenghui Fang records: The failure of the fontanelle to close in infants is due to the deficiency and weakness of Qi and Blood, resulting in a lack of nourishment to the bones. This is generally caused by the incomplete development of Kidney Qi and heat in the Liver and Lungs. The stagnant heat rises to the brain, leading to dry hair and insufficient marrow, thereby causing the fontanelle to remain open.
Qian Yi discusses Jielu (delayed closure of the fontanelle), stating that if the fontanelle remains large and unclosed at six years of age, it indicates incomplete Kidney Qi development; such children will likely speak little and smile less when grown. Those with prominent whites of the eyes, pale complexion, and emaciation often exhibit more sorrow than joy. These conditions are also seen in Kidney Deficiency patterns.
Qianjin Fang formula for treating unclosed fontanelles in infants.
Fangfeng (Radix Saposhnikoviae, 1.5 liang) Baiziren (Semen Platycladi, 1 liang) Baiji (Rhizoma Bletillae, 1 liang)
Grind the above three herbs into fine powder. Mix with breast milk and apply to the fontanelle. Improvement is seen within ten days, and cure is achieved within twenty days. Apply once daily.
Yingru Fang Gounao Wan, used to treat infants who cannot walk by age three, have wide cranial sutures and large fontanelles, sweating on the head, fever, dry feet, and crossed shins.
Zhongrushí (Stalactitum, equal parts) Sheng Dihuang (Radix Rehmanniae Preparata, equal parts) Gancao (Radix Glycyrrhizae, equal parts) Chaqi (Cortex Acanthopanacis Senticosi / Wujiapi, equal parts) Fangfeng (Radix Saposhnikoviae, equal parts)
Grind the above ingredients into powder. Form pills using dog brain, sized like small beans. Take two pills with water. Administer three times during the day and twice at night.
Yingru Fang formula for treating open and unclosed fontanelles in infants.
Fangfeng (Radix Saposhnikoviae, 6 fen) Baiji (Rhizoma Bletillae, 4 fen) Zhizi (Fructus Gardeniae, 3 fen)
Grind the above ingredients into powder. Mix with breast milk and honey, and apply to the fontanelle once daily.
Yingru Fang formula to close open fontanelles in infants.
Fangfeng (Radix Saposhnikoviae, 6 fen) Baiji (Rhizoma Bletillae, 2 fen)
Grind the above ingredients into powder. Mix with breast milk and apply to the fontanelle ten times daily, until improvement is observed. It should close within twenty days.
Qian Yi treats open and unclosed fontanelles accompanied by nasal congestion.
Select large Tiannanxing (Rhizoma Arisaematis). Lightly process, remove skin, and grind into fine powder. Mix with light vinegar, spread on red silk, and apply to the fontanelle. Perform moxibustion and frequently warm-massage with hands.
Zhang Huan states: Infants presenting with Jielu (delayed closure of fontanelle), unclosed fontanelles, fullness of the fontanelle, or sunken/uneven fontanelles are all caused by deficient heat in the Kidney Meridian. The Duixi San formula is appropriate.
Shetui (Periostracum Serpentinum, 1 liang, burned to ash and finely ground) Fangfeng (Radix Saposhnikoviae, half liang) Chu Dahuang (Radix et Rhizoma Rhei, wrapped in wet paper and roasted until charred on the outside but raw inside, half liang) Baiji (Rhizoma Bletillae, half liang)
Pulverize the above ingredients into fine powder. Add Qingdai (Indigo Naturalis, half liang) and mix uniformly. Use half a qian of powder per application. Mix with pig bile to form a paste. Spread onto a piece of paper, leaving a white border around the edges. Apply to the fontanelle using light vinegar and raw flour paste. Keep moist with warm water continuously. Change every four hours (one fushi).
Zhuang Family Prescribed Formula for unclosed cranial sutures.
Shanyinchen (Herba Artemisiae Scopariae, 1 liang) Cheqianzi (Semen Plantaginis, half liang) Baihe (Bulbus Lilii, half liang)
Grind the above ingredients into powder. Mix with black ox milk and apply to the soles of the feet and cranial sutures. Wrap the head with cloth. Change every three days. Efficacy is expected after five applications.
Wang Shi Shouji Fengxin San formula for treating open and unclosed fontanelles, splitting cranial sutures; sunken and uneven fontanelles, cough, and nasal congestion.
Baiziren (Semen Platycladi, 4 liang) Fangfeng (Radix Saposhnikoviae, 4 liang) Tiannanxing (Rhizoma Arisaematis, 4 liang)
Grind the above ingredients into fine powder. Use one qian per application. Mix with pig bile to achieve appropriate consistency. Spread on red silk, cut to fit the size of the fontanelle. Change once daily. Do not let it dry out; keep moist with hot water periodically.
Taiping Shenghui Fang: For infants with open and unclosed fontanelles, moxa points located five fen above and below the umbilicus. Three moxa cones per point. If the moxa sore has not healed but the fontanelle closes first, use moxa cones the size of wheat grains.