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Infant crying, abbreviated as "er ti" (儿啼), refers to excessive crying in newborns or infants due to various reasons, commonly seen in infants under six months old.

This condition includes "yan ti" (躽啼) from Zhubing Yuanhou Lun, "night crying," "jing ti" (惊啼) from Luxin Jing, "wei ti" (胃啼) from Xiao'er Yaozheng Zhijue, and "ao ku" (拗哭) from Youyou Jicheng, among others.

Since crying is an instinctive response in newborns and infants, they often use crying to express needs or discomfort. Therefore, crying caused by improper feeding or inadequate care (such as crying that stops after breastfeeding, drinking water, changing wet diapers or clothes, being held, or resuming usual habits, with consistent crying tones and no abnormalities upon detailed examination) should be excluded from this discussion. For crying caused by conditions such as carcinoma of the tongue, newborn gingival cyst, mantis seed (螳螂子), aphtha, cold abdominal colic, epilepsy, etc., please refer to the relevant entries.

bubble_chart Pattern Analysis

1. Deficiency-Cold of the Spleen Meridian︰Crying incessantly at night, or crying with a bent waist, crying without tears, the crying sound fluctuating in pitch, prolonged and weak, preferring to lie prone, with a bluish complexion, cold hands and abdomen, reduced food intake, loose stool, pale lips and tongue, pulse manifestation of deep and thin, and pale red, deep and sluggish finger venules. It is often caused by improper care, cold in the middle of the abdomen, and internal invasion of cold pathogens, leading to spleen cold, hence the bent-waist crying; yin exuberance at night, reaching its peak and causing restlessness, cold pathogens stagnating, qi movement obstructed, hence abdominal pain and crying at night, often accompanied by a pale complexion, cold hands, reduced food intake, loose stool, pale lips and tongue, pulse manifestation of deep and thin, and deep, sluggish, pale finger venules. Treatment involves warming the spleen and dispelling cold, and Uncaria Decoction can be used.
2. Heart Channel Heat Accumulation︰Crying at night with strong crying sounds, prefers lying on the back, crying worsens when seeing lights, dysphoria, short and reddish urine, severe constipation, red face and lips, red tongue tip, thin coating, rapid and forceful pulse, purple finger venules. Often caused by the nursing mother or infant consuming spicy and dry-heat foods that stir fire or taking excessive warm-natured medications, leading to fire stagnation and accumulated heat flaring upward. The heart governs fire and belongs to yang. At night, yin becomes exuberant while yang declines, making it unable to contend with pathogenic heat. When upright qi fails to overcome pathogenic factors, pathogenic heat invades the heart, disturbing the spirit and causing nighttime crying. This is often accompanied by dysphoria and restlessness, worsened crying upon seeing lights, red face and lips, body heat, reddish urine, severe constipation, red tongue tip, thin coating, rapid and forceful pulse, and stagnant purple finger venules. Due to differences in the mechanism of disease, the treatment principles also vary. The treatment focuses on clearing the heart and downbearing heat, commonly using Redness-Removing Powder.
3. Heart Deficiency and Constitutional Weakness︰Night crying with weak, low, and faint sounds, accompanied by restlessness, emaciation, low-grade fever, a pale red or cherry-red tongue, a red tongue tip with little or no coating, a weak and rapid pulse, and faint red finger venation. This is due to blood deficiency failing to nourish the heart spirit, commonly seen in children with post-illness weakness or congenital insufficiency, accompanied by restlessness, insomnia, pallor, pale lips and tongue, and little or no coating. If accompanied by deficient fire, symptoms such as cherry-red lips, a red tongue tip, and a weak, rapid pulse may appear. Treatment should focus on nourishing blood and calming the spirit, and Anshen Wan (Spirit-Calming Pill) can be used. Crying due to heart deficiency and constitutional weakness versus crying due to fright and fear: Although both may present with palpitations and a rapid pulse, crying due to fright and fear is characterized by daytime fear, nighttime restlessness, sudden startled cries, pronounced palpitations due to fright, tearful crying, clinging to the mother at the slightest sound, startled jumps, a complexion that alternates between bluish and pale, an intermittently rapid pulse, and generally normal lips and tongue. Treatment should focus on calming the heart and mind, often using Zhusha Anshen Wan (Cinnabar Spirit-Calming Pill).
4. Fright and Fear︰Crying at night, excessive tears, fright and vigilance during sleep, easily startled, restless, sudden crying, frothing at the mouth, lips and complexion alternating between bluish and pale, clinging tightly to the mother's arms, greenish stool, tongue coating often without obvious abnormalities, pulse manifestation at night may appear wiry, rapid, and frequent, with bluish-purple finger veins. Due to fear when awake, fright and vigilance while sleeping, restlessness, sudden fright-induced cries, palpitations due to fright being particularly prominent, along with tearful crying, clinging tightly to the mother's arms or startling at the slightest sound, complexion alternating between bluish and pale, pulse sometimes rapid and sometimes not, while lips and tongue often show no abnormalities. Treatment should focus on settling the heart and calming the mind, commonly using Cinnabar Sedative Pills.
5. Milk Stagnation and Food Accumulation︰The crying is loud, intermittent, with abdominal pain and refusal to be touched, vomiting of milk curds, reluctance to suckle, and either constipation or diarrhea containing sour, foul-smelling, undigested milk. The tongue is pale red with a thick white coating, and the finger veins appear purple and sluggish. This is due to milk and food stagnation, which injures the spleen and stomach, leading to spleen-stomach disharmony and disturbance of qi movement, resulting in abdominal pain and crying. Hence, the crying is loud, fluctuating in intensity, intermittent, and occurs even during the day, accompanied by symptoms of milk indigestion. Treatment should focus on dispersing milk stagnation and promoting digestion, using Xiao Ru Wan (Milk-Dispersing Pill). Once the stagnation is resolved and digestion improves, the pain will cease, and the crying will stop.

There are many reasons for a child's crying, varying in severity, and sometimes it can be an early reflection of a serious illness. As stated in "You Ke Shi Mi": "Observe the situation carefully, investigate each case thoroughly, do not dismiss it as a common occurrence, and let the tears flow." However, in clinical practice, when the cause is unclear and difficult to identify, one might try administering Cicada Slough and Chrysanthemum Flower Powder, or Licorice, Wheat and Jujube Decoction.

Crying due to heat accumulation in the heart meridian and crying due to heart deficiency and weak constitution, although both involve the heart, the heart stores the spirit, and a calm spirit leads to harmony in the organs. Therefore, a child who is calm during the day can sleep peacefully at night. If the heart qi is not harmonious, or if the heart is not nourished, it can lead to crying due to a restless spirit. However, crying due to heat accumulation in the heart meridian is caused by real heat disturbing the heart, while crying due to heart deficiency and weak constitution is due to insufficient blood nourishing the heart spirit, often seen in children who are weak after illness or have a deficient constitution, accompanied by symptoms such as insomnia, fright and vigilance, pale complexion, pale lips and tongue, and little or no coating. If there is also deficient fire, symptoms such as cherry-red lips, red tongue tip, and weak rapid pulse may appear. Treatment should focus on nourishing blood and calming the spirit, and An Shen Wan can be used.

bubble_chart Documentation

1. Rumen Shiqin．A child crying incessantly: "A child crying incessantly, not stopping for days, with both hands' pulses being wiry and tight. Dai Ren said: The heart fire is severe and overcomes the lungs, the lungs cannot bear the oppression, hence the crying. The lungs govern sorrow, Wang Taipu said: When the heart is scorched, the pain is severe, hence severe scorching leads to severe sorrow. Let the child bathe in warm water, soaking the body to induce sweating. The lungs govern the skin and body hair, sweating will disperse the lung heat. After the bath, the crying stops, then prescribe Diaphragm-Cooling Powder, add Chinese Angelica, Platycodon Root, and decoct with Bamboo Leaf, Fresh Ginger Rhizome, and mirabilite to take, to purge the pathogenic heat in the diaphragm."
2. Yixue Rumen．Fetal fright night crying: "Night crying in the upper part of the night is mostly due to phlegm heat, with the body lying on its back, sweating, and red cheeks; in the lower part of the night, bending the waist must be due to deficiency cold, severe cases may involve convulsions with visceral colic and hand and foot spasms, infantile fright attack of noxious factor crying at dusk; crying while nursing may lead to a sore mouth and tongue."
3. 《The Mystery of Pediatrics．The Causes and Treatment of Crying》: "When a child cries, it is only appropriate to gently hold and support, allowing them to cry and stop on their own, absolutely do not forcibly restrain or let them suckle to stop. If there are no other illnesses, it is also not necessary to administer medicine."