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，而膝盖愈大，要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 （蜜炙） 羌
活防风 杜仲 附子（制） 牛膝
引用姜、枣，水煎服。
【方歌】大防风汤八珍 ，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）
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，更有封囟散极效，临时摊贴保安然。
【注】解颅者，乃囟大骨缝不合也。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，外用封囟散摊贴之，则精血稍充，或可转危为安也。
补肾地黄丸 扶元散（俱见五软）
封囟散
柏子仁 防风 天南星（各四两）
为细末，每用一钱，以猪胆汁调匀，摊在绯绢帛上，看囟大小剪贴，一日一换，不得令干，时时以汤润动。
小儿先天禀赋不足，导致肌肉消瘦、形体不壮，膝盖骨骼外露形状像鹤的膝盖，这大多是因为肾气虚弱，骨髓难以化生，血脉不能滋养筋脉导致筋脉拘挛收缩，膝盖处积聚风邪与痰涎从而时常疼痛。治疗时应先服用大防风汤，随后继服补肾地黄丸，不可拖延。
【注】小儿鹤膝风，多因先天禀赋不足，气血无法濡养身体，肌肉消瘦，从而导致骨节外露，筋脉拘挛收缩，大腿逐渐变细，而膝盖部位却越来越大，这都是因为肾虚不能生成精髓的缘故。必须先用大防风汤治疗，接着用补肾地黄丸调理，这样气血充盈后病症自然痊愈。
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、黄芪（蜜炙）、羌活、防风、杜仲、附子（制）、牛膝。
引用生姜、大枣，加水煎煮后服用。
【方歌】大防风汤由八珍汤加减而来，加入羌活、防风、附子、杜仲，其中川牛膝能荣养筋脉，最适合治疗虚风引起的鹤膝风。
补肾地黄丸（方剂见“五软”章节）
小儿解颅症最为可怜，这是由于先天受损导致脑髓干枯，面色苍白，形体瘦弱，双眼眼白部分显露多，神情显得忧愁烦恼。治疗可服用补肾地黄丸，但需先服用补阳扶元散，此外还有封囟散效果极佳，临时外敷贴于囟门处可保平安。
【注】解颅，是指囟门宽大、头骨骨缝不合。因为肾主生髓，脑为髓海，肾气亏损会导致脑髓不足，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，悲伤愁闷少笑，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，外用封囟散敷贴，这样精血稍微充盈，或许可以转危为安。
补肾地黄丸、扶元散（均见“五软”章节）
封囟散
柏子仁、防风、天南星（各四两）。
研成细末，每次取一钱，用猪胆汁调匀，涂在红色丝绢上，根据囟门大小剪裁贴合，每天更换一次，不能让药膏变干，经常用热水润湿保持湿润。
The child's congenital endowment is insufficient, leading to emaciated muscles and a lack of robustness. The knee bones protrude resembling the knee of a crane (He Xi Feng, 鹤膝风). This is mostly due to weak Kidney Qi, making it difficult for marrow to generate. When blood vessels fail to nourish the sinews, they contract and spasm; wind pathogens and phlegm accumulate in the knees, causing frequent pain. Da Fang Feng Tang (Great Wind-Expelling Decoction) should be taken first, followed by Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill); treatment must not be delayed.
[Note] Pediatric He Xi Feng (Crane Knee Deformity) is mostly caused by insufficient congenital endowment, where Qi and Blood fail to nourish the body. Muscles become emaciated, causing joints to protrude and sinews to contract. The thighs gradually become thin while the knees enlarge. All these stem from Kidney deficiency failing to generate essence and marrow. One must first administer Da Fang Feng Tang (Great Wind-Expelling Decoction), then treat with Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill). Thus, when Qi and Blood are充盈 (abundant), the condition will heal naturally.
Da Fang Feng Tang (Great Wind-Expelling Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Fu Ling (Poria), Zhi Gan Cao (Prepared Licorice Root), Shu Di Huang (Prepared Rehmanniae Radix), Dang Gui Shen (Dong Quai Root Stem), Chao Bai Shao Yao (Stir-fried White Peony Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Mi Zhi Huang Qi (Honey-fried Astragali Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Du Zhong (Eucommiae Cortex), Zhi Fu Zi (Prepared Aconiti Lateralis Radix), Niu Xi (Achyranthis Bidentatae Radix).
Add fresh ginger and Chinese jujube, decoct in water, and take orally.
[Fang Ge - Formula Song] Da Fang Feng Tang (Great Wind-Expelling Decoction) is derived from Ba Zhen Tang (Eight-Treasure Decoction), adding Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), and Du Zhong (Eucommiae Cortex). Chuan Niu Xi (Achyranthis Bidentatae Radix) further nourishes the sinews, making this formula most suitable for Crane Knee deformity caused by deficient wind.
Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill) (See "Wu Ruan" / Five Flaccidity section for formula details).
Pediatric Jie Lu (Split Skull) is truly pitiable; congenital damage leads to dry brain marrow. The complexion is pale, the physique is thin and weak, and the eyes show excessive whites, reflecting sorrow and vexation. Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill) can be taken, but Bu Yang Fu Yuan San (Tonify-Yang Restore-Origin Powder) should be administered first. Additionally, Feng Xin San (Fontanelle-Sealing Powder) is extremely effective; applying it externally to the fontanelle temporarily ensures safety.
[Note] Jie Lu (Split Skull) refers to an enlarged fontanelle and unclosed cranial sutures. 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. Presenting with a pale complexion, emaciation, exposed sclera, and a demeanor of sorrowful reluctance to smile, treatment should primarily focus on nourishing Kidney Qi. First, use Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill) to tonify Yin, then use Fu Yuan San (Restore-Origin Powder) to tonify Qi. Externally apply Feng Xin San (Fontanelle-Sealing Powder). With slight replenishment of essence and blood, the critical condition may turn into recovery.
Bu Shen Di Huang Wan (Kidney-Nourishing Rehmannia Pill) and Fu Yuan San (Restore-Origin Powder) (Both see "Wu Ruan" / Five Flaccidity section).
Feng Xin San (Fontanelle-Sealing Powder)
Bai Zi Ren (Biota Seed), Fang Feng (Saposhnikoviae Radix), Tian Nan Xing (Arisaema Cum Bile, each four liang).
Grind into fine powder. For each dose, take one qian, mix evenly with pig bile, spread onto red silk fabric, cut to fit the size of the fontanelle, change once daily, ensure it does not dry out, and moisten occasionally with warm water.