《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》记载小儿夜啼有四种证型：一是寒证，二是热证，三是重舌口疮，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，弯腰曲背啼哭，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，仰身挺腹啼哭，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，受外邪之气冲犯而啼哭，各随其证候进行治疗。
〔曾世荣〕夜啼的原因，有惊热夜啼、心热夜啼、寒疝夜啼、误触神灵夜啼这四种，详情如下。惊热者，是因为衣被太厚，或在极暖和的地方久坐，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，用百解散（治急惊）、牛蒡汤（治咽喉病）、三解散（治潮热）主治。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，宜凉心安神，用百解散或五苓散（均治惊证）加黄芩、甘草，水煎服，其次用牛蒡汤（治咽喉病）、三解散（治潮热）及琥珀抱龙丸（治惊证）治疗。有的患儿在黄昏后到半夜时分，哭多睡少，啼声不止，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（治疝）、乌梅散（治腹痛）及冲和饮（治伤寒）加盐炒吴茱萸、小茴香，生姜水煎服，以及钓藤膏也很好。
误触神灵者，面色紫黑，气郁像发怒的样子，呼喊时好像恐惧，睡觉中惊惕，两手抱着母亲，大哭不休，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，宜用百解散（治惊），其次驱邪镇心，用苏合香丸（治客忤）、琥珀抱龙丸（治惊）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，医生仔细辨证治疗，才是好的。如果小儿啼哭，胸膛仰起突出，头向后仰，不喜欢见灯光，这是心经有热，宜疏利，服用三黄丸或洗心散加灯心草、麦门冬子疗效好。如果小儿啼哭，头低身弯，眼闭肚子紧，这是脏腑留寒，宜温之，胃风汤加黄连煎服有效。如果不识证候，只用蝉蜕十四枚完整的，去掉大脚研为末，加朱砂一字，蜂蜜调涂于嘴角，立即见效。
〔薛己〕夜啼有两种，一是脾寒，一是心热。夜晚属阴，阴气盛，则脾脏的寒气越盛，脾为至阴，喜温恶寒，寒则腹中作痛，所以弯腰曲背啼哭，其症状是面色青白，手和腹部都冷，不想吃奶，这也是胎寒，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，其症状是面红，手和腹部都暖，口中气息热，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。如果兼有吐泻食少，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，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，用蝉蜕下半截研为末，一字量，薄荷汤入少许酒调下。有人不信，将上半截研为末，前汤调下，即又啼哭，古人立方，不知其妙处。
According to *San Yin Fang*, there are four types of night crying in infants: cold, heat, double tongue with mouth sores, and external fright (Ke Wu). The cold type presents with abdominal pain and crying, cyanotic-white complexion, cold breath from the mouth, cold abdomen, and crying while bending the waist; this is the cold syndrome. The heat type presents with mental restlessness and crying, red face, dark urine, hot sensation in the mouth, warm abdomen, occasional sweating during crying, and crying while extending the body; this is the heat syndrome. If it involves double tongue or mouth sores, the infant desires to suckle but cannot, crying immediately upon lips touching the nipple, with slight fever on the body and forehead; one should urgently examine the mouth with a lamp. If no sores are found, the tongue must be double-tongued. "Ke Wu" refers to crying caused by being offended by the qi of strangers upon seeing them; treatment should follow the specific syndrome.
[Zeng Shirong] Night crying arises from four causes: 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. These four are detailed below. Fright-heat results from thick clothing or sitting too long in an extremely warm place, causing stuffiness and vexation, allowing pathogenic heat to attack the Heart. Since the Heart governs the Spirit (Shen), spirit disorder leads to fright. As the Heart and Small Intestine are exterior-interiorly related, the infant cries, weeps, and enures. The treatment method is to clear heat and calm the Heart for natural peace, using Baijie San (for acute fright), Niubang Tang (for throat conditions), or Sansanjie San (for tidal fever) as main prescriptions. Heart-heat manifests as intensified crying under light, red face, and excessive tears, with relief in darkness. Fire belongs to Yang; when Heart-heat meets fire, two Yangs clash, causing intense crying at the sight of light. Thus, the classic states: "When fire is swift and wind arises, rain follows." This illustrates the principle. Treatment should cool the Heart and calm the Spirit, using Baijie San or Wuling San (both for fright) added with Huangqin and Gancao, decocted in water. Subsequently, Niubang Tang, Sansanjie San, and Hupo Baolong Wan (for fright) may be used. 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 becomes weak, leading to curved waist, sweaty forehead, tearless eyes, white complexion with cyanotic tints, prone position crying, and symptoms resembling intestinal colic ("panchang neidiao"), named Cold Hernia. Treatment removes residual cold and warms the Lower Jiao, using Baishaoyao Tang (for hernia), Wumei San (for abdominal pain), and Chonghe Yin (for cold damage) added with salt-fried Zhuyu and Huixiang, decocted with ginger water. Diaoteng Gao is also effective.
Accidentally offending spiritual entities presents with purple-black complexion, Qi stagnation resembling anger, fearful tone when calling, startle during sleep, holding the mother tightly, and incessant loud crying. This results from offending taboo spirits or invasion by malevolent influences. Infants see things but cannot speak, only crying in fright endlessly, with hidden fingerprint patterns. Thus, *Yuhuan Ji* states: "Suddenly hands appear formless, surely known as offending evil spirits." Treatment first releases the exterior, using Baijie San (for fright), then expels evil and calms the Heart using Suhexiang Wan (for Ke Wu) and Hupo Baolong Wan (for fright), which yields efficacy.
[Wang Shi citing Mr. Shuijing] "Heaven is vast, Earth is royal, clear the hall of guests for the crying infant." Also: "Crying without wailing is vexation; wailing without crying is agitation." *Wugu Fu* says: "Night crying resembles possession." For newborns crying day and night as if possessed, some say heat in the Heart, treating with calming and purgative herbs; others say cold stagnating in Zang-Fu, treating with warming herbs. Physicians must observe and treat accordingly. If the infant cries with chest protruding, head retracted backward, and aversion to light, it indicates Heat in the Heart Meridian, suitable for purgation, using Sanhuang Wan or Xixin San added with Dengxincao and Maidongzhi. If the infant cries with head low, body curved, eyes closed, and tight abdomen, it indicates Cold retained in Zang-Fu, suitable for warming, using Weifeng Tang added with Huanglian. If the syndrome is unrecognized, use fourteen whole Cicada Sloughs (Chantui), remove large legs, powder them, add one *zi* of Cinnabar (Zhusha), mix with honey, and apply to the corners of the mouth for immediate effect.
[Xue Ji] Night crying has two types: Spleen-Cold and Heart-Heat. Night belongs to Yin; when Yin prevails, Spleen-Cold intensifies. The Spleen is Extreme Yin, preferring warmth and disliking cold. Cold causes abdominal pain, hence crying with bent waist. Symptoms include cyanotic-white complexion, cold hands and abdomen, and refusal to suckle; this is also called Fetal Cold, treated with Diaoteng San. Intensified crying under light indicates Heart-Heat. The Heart belongs to Fire; light generates internal heat, two Yangs clash, causing crying with extended body. Symptoms include red face, warm hands and abdomen, and hot breath, treated with Daochi San. Pale complexion with small black pupils indicates Kidney-Qi deficiency, crying at night due to Yin deficiency, treated with Liuwei Wan. Diarrhea and refusal to suckle indicate Spleen-Kidney deficiency, treated with Liushen San. Vomiting, diarrhea, and poor appetite indicate Spleen-Stomach deficiency-cold, treated with Liujun Zi Tang and Pao Muxiang. Undigested stool, poor appetite, and abdominal distension indicate Spleen-Qi deficiency, treated with Yigong San. Heart-Blood deficiency uses Mizhi Anshen Wan. Wood-Fire conflict uses Chaihu Zhizi San. Liver-Blood deficiency uses Dihuang Wan. Generally, this condition arises from fluid loss due to vomiting/diarrhea, congenital Kidney-Yin insufficiency failing to nourish Liver-Wood, or maternal anger causing Liver-Fire insulting Metal. 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 rage, 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 using 49 Cicada Sloughs, removing the anterior segment, using the posterior segment powdered, divided into four doses, administered with Diaoteng Tang.
*Puji Ben Shi Fang* Chanhua San treats incessant night crying resembling possession. Use the lower half of Cicada Slough powdered, one *zi* dose, taken with Bohe Tang mixed with a little wine. Skeptics who use the upper half powdered with the same liquid find crying resumes, unaware of the ancients' prescription subtleties.