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Chao Yuanfang stated: Ascaris lumbricoides (Hui Chong, 蛔虫) is one of the nine types of parasites. It is approximately one chi long, or five to six cun long. Its movement is triggered by the weakness of the Zang-Fu organs and the consumption of sweet and fatty foods. When active, it causes attacking pain in the abdomen, which comes and goes intermittently, accompanied by salivation. If the worm penetrates the heart region, death ensues. Treatment should involve using formulas such as Shijunzi Wan (Scholar's Bean Pill) to expel the parasite. Qian Yi (Qian Zhongyang) stated: Vomiting clear fluid without heart pain indicates Cold of the Stomach; vomiting foam with heart pain indicates Parasite Pain. This condition resembles Epilepsy (Xian Bing, 痫), but differs in that there is no deviation of the eyes or convulsions of the hands and feet. An Chong San (Parasite-Calming Powder) is the primary treatment. Tian Shi stated: Symptoms of Parasite Pain include crying, twisting the body forward and backward, restlessness in sitting and lying down, self-pressing of the heart and abdomen, frequent loud shouting, a complexion that is greenish-yellow, pale lips, lackluster eyes, and salivation. If vomiting is caused by Stomach Cold, Lizhong Tang (Regulate the Middle Decoction) can be used with five fried Sichuan peppercorns (Chuan Chuanjiao, 川椒) and two fen of Areca Seed (Binglang, 槟榔) decocted, followed by administration of Wumei Wan (Mume Pill). Ancient texts state: If worms erode the upper part, white spots appear on the upper lip; if they erode the lower part, white spots appear on the lower lip. Regarding various worms in the abdomen, their heads point upward before the full moon and downward after the full moon. To administer medication, first roast pork liver oil until fragrant and let the child smell it to make the worms' heads point upward, making them easier to subdue by the medicine. If the Middle Qi is deficient causing the worms to be restless, simply regulating and tonifying the Spleen and Stomach will settle them. Master Zhu Danxi stated: Vomiting worms in winter is mostly due to Deficiency-Cold of Stomach Qi. Qian's Baizhu San (Atractylodes Macrocephala Powder) with two cloves (Dingxiang, 丁香) is indicated.

Clinical Cases:
One child suffered from heart pain due to moving parasites. After taking Da Wutai Tang (Greater Wormwood and Melia Decoction) to expel turbidity, he developed vomiting and reduced appetite. His right cheek and nasal tip were white with a yellowish tint, indicating Deficiency of Spleen and Lung Qi. Two doses of Yigong San (Extraordinary Power Powder) showed slight improvement, and adding Pao Jiang (Fried Ginger) resulted in stabilization after one dose.
Another child, whose vomiting and diarrhea were nearly cured, experienced heart pain, vomiting of water, and coldness in both hands and feet. He suddenly pressed his heart and abdomen with his hands. This was identified as Deficiency-Cold of Stomach Qi, resembling Parasite Pain, and was cured using Yihuang San (Yellow Regulating Powder).
A third child vomited clear fluid and had pain in the heart region after an illness. I diagnosed this as Deficiency-Cold of Stomach Qi and treated him with Wuwei Yigong San (Five-Ingredient Extraordinary Power Powder), resulting in a cure. Later, whenever he vomited, refused food during illness, and had cold extremities leading to vomiting and heart pain, I added Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to the previous powder, achieving recovery. Conversely, when vermifuge agents were used, the previous symptoms worsened, accompanied by severe abdominal pain and a bearing-down sensation. I treated this with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Pao Jiang, resulting in a cure.

Shijunzi Wan (Scholar's Bean Pill): Treats the five types of Gan syndrome (malnutrition in children), disharmony of the Spleen and Stomach, abdominal distension and fullness, intermittent pain, anorexia, and gradual emaciation. It is suitable for all these conditions.
Ingredients: Shijunzi Rou (Scholar's Bean Flesh, 1 liang), Houpo (Magnoliae Officinalis Cortex, processed), Juhong (Citri Reticulatae Pericarpium Rubrum), Shaoyao (Paeoniae Radix Alba), Gancao (Licorice Root, fried), Chuanxiong (Ligusticum Chuanxiong Rhizome) (each 1 qian).
Preparation and Administration: Grind the above into powder, form pills with honey the size of soap beans. Take one pill per dose, dissolved in aged rice water.

An Chong San (Parasite-Calming Powder): Treats Parasite Pain.
Ingredients: Hufen (Lead White, fried), Leshi (Chrysanthemi Indici Flos, fried), Chuanlianzi (Toosendan Fructus), Binglang (Areca Seed) (each 2 qian), Baifan (Alumen, calcined, 2.5 qian).
Preparation and Administration: Grind the above into powder. Take 3-5 fen per dose, mixed with rice water.

Wumei Wan (Mume Pill): Treats Reversal due to Ascaris (Hui Jue, 蛔厥) where vomiting of worms is expected but absent, replaced by quietness followed by irritability, due to Internal Cold causing worms to ascend into the diaphragm, stopping temporarily, then returning with eating-induced vomiting and irritability. The worms naturally vomit upon smelling odors. Also treats chronic dysentery. (Formula details see "Wind-Cold Cough")

Lizhong Tang (Regulate the Middle Decoction) (See "Cold Diarrhea")
Da Wutai Tang (Greater Wormwood and Melia Decoction) (See "Gan Syndrome")
Yigong San (Extraordinary Power Powder) (See "Internal Hook")
Baizhu San (Atractylodes Macrocephala Powder) (See "Accumulation Pain")
Yihuang San (Yellow Regulating Powder) (See "Spleen Organ")