《三因》小儿夜啼有四证，一曰寒，二曰热，三曰重舌口疮，四曰客忤。寒则腹
痛而啼，面青白，口有冷气，腹亦冷，曲腰而啼，此寒证也。热则心躁而啼，面赤，
小便赤，口中热，腹暖，啼时或有汗，仰身而啼，此热也。若重舌口疮，要吮乳不
得，口到乳上即啼，身额皆微热，急取灯照口，若无疮，舌必重也。客忤者，见生
人，气忤犯而啼也，各随证治之。
〔曾〕夜啼者，有惊热夜啼，有心热夜啼，有寒疝夜啼，有误触神只夜啼，此四
者，详具于后。惊热者，为衣衾太浓，或抱于极暖处久坐，致生烦闷，邪热攻心，
心主神，神乱则惊，心与小肠为表里，故啼泣而遗溺者是也。治法，退热镇心则自
安矣，用百解散（急惊）牛蒡汤（咽喉）三解散（潮热）主之。心热者，见灯愈啼，面红多泪，
无灯则稍息，盖火者阳物也，心热遇火，两阳相搏，才有灯而啼甚，故经曰∶火疾
风生乃能雨，此其义也，宜凉心安神，用百解散或五苓散（俱惊）加黄芩、甘草，水煎服，
次牛蒡汤（咽喉）、三解散（潮热）及琥珀抱龙丸（惊）为治。有遇黄昏后至更尽时，哭多睡少，
有啼声不已，直到天明，乃胎中受寒，遇夜则阴胜而阳微，故腰曲额汗，眼中无泪，
面莹白而夹青，伏卧而啼，入盘肠内吊之证，名为寒疝。治法，去宿冷，温下焦，
白芍药汤（疝）、乌梅散（腹痛）及冲和饮（伤寒）加盐炒茱萸、茴香，水姜煎服，及钓藤膏亦佳。
误触神只者，面色紫黑，气郁如怒，呼时若有恐惧，及睡中惊惕，两手抱母，大哭
不休，此误触禁忌神只而得，或因恶祟所侵，盖婴孩目有所睹，口不能言，但惊哭
无时，指纹俱隐，故《玉环集》云∶忽然两手形无见，定知唐突恶神灵。治法，先
解其表，宜百解散（惊）次驱邪镇心，用苏合香丸（客忤）、琥珀抱龙丸（惊）投之自效。〔演山〕
王氏举水镜先生云∶天苍苍，地王王，小儿夜啼疏客堂。又云∶啼而不哭是烦，哭
而不啼是躁。《无辜赋》云∶夜多啼而似祟。凡初生儿日夜烦啼如有祟，或谓热在心，
惊药与疏利，或谓寒停脏腑，与服温暖，医者察而治之，乃善也。若儿啼哭，胸堂
仰突，首反张，不喜见灯者，心经有热，宜疏利，服三黄丸或洗心散加灯心、
麦门冬子良。若儿啼哭，头低身曲，眼闭肚紧者，脏腑留寒，宜与温之，胃风汤加
黄煎效。若不识证候，但以蝉蜕二七枚全者，去大脚为末，加朱砂一字，蜜调
涂于吻，立效。〔薛〕夜啼有二，曰脾寒，曰心热也，夜属阴，阴胜，则脾脏之寒
愈盛，脾为至阴，喜温而恶寒，寒则腹中作痛，故曲腰而啼，其候面青白，手
腹俱冷，不思乳食是也，亦曰胎寒，用钓藤散。若见灯愈啼者，心热也，心属火，
见灯则烦热内生，两阳相搏，故仰身而啼，其候面赤，手腹俱暖，口中气热是也，
用导赤散。若面色白，黑睛少，属肾气不足，至夜阴虚而啼也，宜用六味丸。若兼
泄泻不乳，脾肾虚弱也，用六神散。若兼吐泻少食，脾胃虚寒也，用六君、炮木香。
大便不化，食少腹胀，脾气虚弱也，用异功散。心血不足者，秘旨安神丸。木火相
搏者，柴胡栀子散。肝血不足者，地黄丸。大抵此证或因吐泻内亡津液，或禀赋肾
阴不足、不能滋养肝木，或乳母恚怒、肝火侮金，当用六君子汤补脾土以生肺金，地
黄丸壮肾水以滋肝木。若乳母郁闷而致者，用加味归脾汤。乳母暴怒者，加味小柴
胡汤。乳母心肝热搏，柴胡栀子散。仍宜参客忤惊啼览之。
《心鉴》治小儿一百二十日内夜啼，用蝉蜕四十九个，去前截，用后截，为末，分四服，
钓藤汤调灌之。
《普济》蝉花散 治小儿夜啼不止，状若鬼祟，用蝉蜕下半截为末、一字，薄荷汤入
酒少许调下。或者不信，将上半截为末，前汤调下，即复啼也，古人立方，莫知其妙。
《三因方》中记载小儿夜啼有四种证型：一是寒证，二是热证，三是重舌或口疮，四是客忤。寒证表现为腹痛而啼哭，面色青白，口中呼出冷气，腹部发凉，弯腰屈体啼哭，这是寒证。热证表现为心中烦躁而啼哭，面色红赤，小便颜色深黄，口中发热，腹部温暖，啼哭时有时出汗，仰身伸展啼哭，这是热证。如果是重舌或口疮，患儿想要吮吸乳汁却做不到，嘴唇碰到乳头就啼哭，身体和额头都微微发热，应立即取灯照看口腔，如果没有疮疡，舌头必定是重舌。所谓客忤，是指见到陌生人，被外邪之气冲犯而啼哭，治疗应随证候不同分别施治。
曾氏认为：夜啼有惊热夜啼、心热夜啼、寒疝夜啼、误触神灵夜啼这四种情况，详细论述如下。惊热者，是因为衣被太厚，或在极暖处久坐，导致烦闷，邪热攻心，心主神明，神志紊乱则受惊，心与小肠互为表里，所以啼哭流泪并遗尿。治疗方法，退热镇心自然安宁，使用百解散（主治急惊）、牛蒡汤（主治咽喉病）、三解散（主治潮热）来治疗。心热者，见灯光啼哭更甚，面红多泪，没有灯光则稍息，因为火属阳物，心热遇火，两阳相搏，一有灯光就啼哭加剧，所以经书说：“火疾风生乃能雨”，就是这个道理，宜用凉心安神法，用百解散或五苓散（均主治惊证）加黄芩、甘草，水煎服，再用牛蒡汤（咽喉）、三解散（潮热）及琥珀抱龙丸（惊证）治疗。有的患儿在黄昏后到半夜时分，哭多睡少，啼声不停，直到天明，这是胎中受寒，遇到夜晚阴气胜而阳气微，所以腰部弯曲、额头出汗，眼中无泪，面色莹白而夹青色，伏卧啼哭，出现盘肠内吊的证候，名为寒疝。治疗方法，去除宿冷，温补下焦，用白芍药汤（疝证）、乌梅散（腹痛）及冲和饮（伤寒）加盐炒吴茱萸、小茴香，生姜水煎服，以及钓藤膏也疗效好。
误触神灵者，面色紫黑，气郁像发怒一样，呼喊时好像恐惧，睡眠中惊惕，两手抱着母亲，大哭不止，这是误触禁忌神灵所致，或因恶祟侵扰，因为婴儿眼睛看到了什么，嘴巴不能说话，只是惊恐啼哭没完没了，指纹隐伏，所以《玉环集》说：“忽然两手形无见，定知唐突恶神灵。”治疗方法，先解表邪，宜用百解散（惊证），再驱邪镇心，用苏合香丸（客忤）、琥珀抱龙丸（惊证）投服自有效验。
演山王氏引用水镜先生的话：“天苍苍，地王王，小儿夜啼疏客堂。”又说：“啼而不哭是烦，哭而不啼是躁。”《无辜赋》说：“夜多啼而似祟。”凡是初生儿日夜烦啼好像有鬼祟，有人说热在心，用惊药与疏利药；有人说寒停脏腑，给服用温暖药，医生观察后治疗，才是好的。如果儿啼哭，胸膛仰突，头向后仰，不喜欢见灯光的，是心经有热，宜用疏利法，服用三黄丸或洗心散加灯心草、麦门冬子效果好。如果儿啼哭，头低身曲，眼闭肚子紧的，是脏腑留寒，宜用温法，胃风汤加黄连煎服有效。如果不识别证候，只用蝉蜕十四枚完整的，去掉大脚研为末，加朱砂一字，蜂蜜调涂于嘴唇上，立即见效。
薛己认为：夜啼有两种，即脾寒和心热。夜间属阴，阴气胜，则脾脏之寒更盛，脾为至阴，喜温恶寒，寒则腹中作痛，所以弯腰啼哭，其症状见面色青白，手脚和腹部都冷，不想吃乳食，这也叫胎寒，用钓藤散。如果见灯光啼哭更甚，是心热，心属火，见灯则烦热内生，两阳相搏，所以仰身啼哭，其症状见面色红赤，手脚和腹部都暖，口中气热，用导赤散。如果面色白，黑睛少，属于肾气不足，到了夜晚阴虚而啼哭，宜用六味丸。如果兼有泄泻不吃奶，是脾肾虚弱，用六神散。如果兼有吐泻少吃，是脾胃虚寒，用六君子汤、炮木香。大便不消化，食少腹胀，是脾气虚弱，用异功散。心血不足者，用秘旨安神丸。木火相搏者，用柴胡栀子散。肝血不足者，用地黄丸。大抵此证或因吐泻体内亡失津液，或禀赋肾阴不足，不能滋养肝木，或乳母愤怒，肝火侮金，应当用六君子汤补脾土以生肺金，地黄丸壮肾水以滋肝木。如果是乳母郁闷导致的，用加味归脾汤。乳母暴怒的，用加味小柴胡汤。乳母心肝热搏的，用柴胡栀子散。仍宜参考客忤惊啼的内容阅读。
《心鉴》治疗小儿一百二十日内夜啼，用蝉蜕四十九个，去掉前截，用后截，研为末，分四次服用，用钓藤汤调灌。
《普济本事方》蝉花散：治疗小儿夜啼不止，状若鬼祟，用蝉蜕下半截为末，一字量，薄荷汤入少许酒调下。有人不信，将上半截为末，前汤调下，就会再次啼哭，古人立方，不知其妙处。
According to *San Yin Fang*, there are four patterns of night crying in infants: one is cold, two is heat, three is double tongue or mouth sores, and four is Ke Wu (sudden fright from strange influences). In the cold pattern, the infant cries due to abdominal pain, with a cyan-white complexion, cold breath, a cold abdomen, and cries while bending the waist; this is the cold pattern. In the heat pattern, the infant cries with mental restlessness, a red face, dark urine, hot breath, a warm abdomen, sometimes sweating during crying, and cries while extending the body backward; this is the heat pattern. If it is double tongue or mouth sores, the infant wants to suckle but cannot, crying as soon as the lips touch the nipple, with slight fever on the body and forehead; one should immediately examine the mouth with a lamp. If there are no sores, the tongue must be double. Ke Wu refers to crying triggered by seeing strangers, where external pathogenic qi offends the body; treatment should follow the specific pattern.
Zeng stated that night crying includes night crying due to fright-heat, night crying due to heart-heat, night crying due to cold hernia, and night crying due to accidentally offending spiritual entities, detailed as follows. Fright-heat arises from thick clothing or sitting too long in a very warm place, causing stuffiness and vexation, allowing pathogenic heat to attack the Heart. The Heart governs the Spirit; when the Spirit is disordered, fright occurs. Since the Heart and Small Intestine are exterior-interior partners, the infant cries, weeps, and enures. The treatment method is to reduce heat and calm the Heart to restore peace, using Bai Jie San (for acute fright), Niubang Tang (for throat conditions), or San Jie San (for tidal fever). Heart-heat manifests as intensified crying under light, a red face, and excessive tears, with relief in darkness. Fire belongs to Yang; when Heart-heat meets fire, two Yangs clash, causing intense crying upon seeing light. As the classics state, "Rapid fire generates wind, which brings rain," illustrating this principle. One should cool the Heart and calm the Spirit, using Bai Jie San or Wu Ling San (both for fright) plus Huangqin (Scutellariae Radix) and Gancao (Glycyrrhizae Radix et Rhizoma), decocted in water. Subsequently, treat with Niubang Tang, San Jie San, and Hupo Baolong Wan (for fright). Some infants cry excessively and sleep little from dusk until midnight, continuing until dawn. This is cold contracted in the womb; at night, Yin prevails and Yang is weak, leading to a curved waist, sweating on the forehead, tearless eyes, a bright white complexion with cyan tinges, prone crying, and symptoms resembling Pan Chang Nei Diao (intestines coiling inward), named Cold Hernia. The treatment is to eliminate old cold and warm the Lower Jiao, using Baishao Yao Tang (for hernia), Wumei San (for abdominal pain), and Chonghe Yin (for cold damage) plus salt-fried Zhuyu (Euodiae Fructus) and Huixiang (Foeniculi Fructus), decocted with ginger and water. Diaoteng Gao is also effective.
Accidentally offending spiritual entities presents with a purple-black complexion, Qi stagnation resembling anger, fearful cries, startles during sleep, holding the mother tightly, and incessant loud crying. This results from offending taboo spirits or being invaded by evil influences. Infants see things but cannot speak, only crying in fright without end, with hidden finger veins. Thus, *Yuhuan Ji* states: "Suddenly the hands appear formless, surely knowing the evil spirit was offended." The treatment first releases the exterior, using Bai Jie San (for fright), then expels evil and calms the Heart, using Suhexiang Wan (for Ke Wu) and Hupo Baolong Wan (for fright), which will be effective.
Wang Yanshan quoted Master Shuijing: "The sky is vast, the earth is great, clear the hall to dispel the infant's night crying." He also said: "Crying without wailing is vexation; wailing without crying is agitation." *Wugu Fu* says: "Crying much at night resembles possession." For newborns crying day and night as if possessed, some say heat is in the Heart, treating with anticonvulsants and purgatives; others say cold stays in the Zang-Fu, treating with warming agents. Physicians should observe and treat accordingly. If the infant cries with a protruding chest, head retracted backward, and aversion to light, it indicates Heat in the Heart Meridian, suitable for purgation, treating with Sanhuang Wan or Xixin San plus Dengxincao (Junci Medulla) and Maidongzi (Ophiopogonis Semen). If the infant cries with the head down, body curved, eyes closed, and tight abdomen, it indicates Cold retained in the Zang-Fu, suitable for warming, treating with Weifeng Tang plus Huanglian (Coptidis Rhizoma) decocted, which is effective. If the pattern is unrecognized, use fourteen intact Cicada Sloughs (Chan Tui), remove the large legs, powder them, add one zi of Zhusha (Cinnabar), mix with honey, and apply to the lips for immediate effect.
Xue Ji stated that night crying has two types: Spleen-Cold and Heart-Heat. Night belongs to Yin; when Yin prevails, Spleen-Cold intensifies. The Spleen is Supreme Yin, preferring warmth and detesting cold. Cold causes abdominal pain, leading to crying with a bent waist. Symptoms include a cyan-white complexion, cold hands/abdomen, and anorexia; this is also called Fetal Cold, treated with Diaoteng San. If crying intensifies under light, it is Heart-Heat. The Heart belongs to Fire; seeing light generates internal vexation-heat, two Yangs clash, leading to backward-extending crying. Symptoms include a red face, warm hands/abdomen, and hot breath, treated with Daochi San. If the complexion is white with small black pupils, it indicates Kidney-Qi deficiency, crying at night due to Yin deficiency, treated with Liuwei Wan. If accompanied by diarrhea and refusal to nurse, it is Spleen-Kidney deficiency, treated with Liushen San. If accompanied by vomiting, diarrhea, and poor appetite, it is Spleen-Stomach deficiency-cold, treated with Liujun Zi Tang and Pao Muxiang (Aucklandiae Radix). If stool is undigested with poor appetite and abdominal distension, it is Spleen-Qi deficiency, treated with Yigong San. For Heart-Blood deficiency, use Mizhi Anshen Wan. For Wood-Fire conflict, use Chaihu Zhizi San. For Liver-Blood deficiency, use Dihuang Wan. Generally, this condition may result from fluid loss due to vomiting/diarrhea, congenital Kidney-Yin insufficiency failing to nourish Liver-Wood, or maternal anger causing Liver-Fire insulting Metal. One should use Liujun Zi Tang to tonify Spleen-Earth to generate Lung-Metal, and Dihuang Wan to strengthen Kidney-Water to nourish Liver-Wood. If caused by maternal depression, use Jiawei Guipi Tang. If caused by maternal sudden anger, use Jiawei Xiaochaihu Tang. If maternal Heart-Liver heat conflicts, use Chaihu Zhizi San. Refer also to discussions on Ke Wu and fright crying.
*Xin Jian* treats night crying in infants within 120 days after birth using 49 Cicada Sloughs, removing the anterior segment, using the posterior segment, powdering it, dividing into four doses, and administering with Diaoteng Tang.
*Puji Ben Shi Fang* Chan Hua San treats incessant night crying in infants, resembling ghost possession. Use the lower half of Cicada Slough as powder, one zi dose, mixed with Bohe Tang (Menthae Haplocalycis Herba Decoction) and a little wine. Those who do not believe may use the upper half powder mixed with the same decoction, which will cause crying to resume. The ancients' prescription methods hold mysteries unknown to us.