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[Spider Powder Formula]
Scorpion (roasted) 14 pieces, Cinnamon Twig (Guizhi) half tael.
The above two ingredients are ground into a powder. Take one "bi" (a spoon-shaped measure of approximately 8 fen) mixed with warm water for oral administration, twice daily. It may also be taken as honey pills.

[Ji Jie - Collected Explanations]
You Yi stated: Scorpions are toxic; ingestion can induce diarrhea. Combined with the acrid-warm nature of Cinnamon Twig, it enters the Yin aspect to expel cold-dampness qi.

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Question: If a patient suffers from abdominal pain due to parasites, how should the pulse be differentiated? The Master said: In cases of abdominal pain, the pulse should typically be deep or wiry. If it is instead surging and large, it indicates the presence of Ascaris lumbricoides (roundworm).

[An Yu - Commentary]
Differentiating parasitic abdominal pain solely by a surging pulse is unclear; there must be missing text in the original source, so no explanation is provided here.

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Disease caused by Ascaris lumbricoides leads to salivation, cardiac pain, and intermittent episodes. When standard antiparasitic drugs fail, Gancao Fenmi Tang (Licorice, Lead Powder, and Honey Decoction) is the primary treatment.

[Zhu - Annotation]
Ascaris lumbricoides is what modern people call roundworms. The disease caused by these worms occurs intermittently. During an episode, it causes salivation and severe cardiac pain. Even if purgative or toxic antiparasitic drugs are administered, the pain persists because it is not caused by food stagnation but by worm agitation. Gancao Fenmi Tang is used because the worms ascend when encountering sweet flavors and are killed by lead powder. This is a method of treating according to the parasite's nature.

[Ji Zhu - Collected Annotations]
Xu Bin stated: "Intermittent episodes" means the pain is not constant, distinguishing it from the continuous pain of deficiency-cold. Since antiparasitic drugs are ineffective, treatments targeting qi, blood, cold, or stagnation will also fail. Therefore, Gancao Fenmi Tang is used. White powder (lead powder) kills parasites, while Licorice and Honey harmonize the Stomach and lure the worms.
Li [Name Missing] stated: The *Ling Shu* records that when Ascaris moves, the Stomach qi becomes lax; when Stomach qi is lax, the Lianquan acupoint opens, causing saliva flow and spitting. When Ascaris ascends to the diaphragm, and since the Heart is located above the diaphragm, cardiac pain occurs. When the worms descend below the diaphragm after a moment, the pain stops, hence the intermittent nature. Lianquan is an acupoint of the Ren Mai (Conception Vessel), located at the midpoint of the mandible.

Licorice (Gancao) 2 taels, Powder (Fen) 1 tael, Honey (Mi) 4 taels.
Take the above three ingredients with 3 sheng of water. First decoct the Licorice until 2 sheng remains, then remove the dregs. Add the powder and honey, stir well, and simmer until it resembles thin porridge. Take 1 sheng warm. Discontinue use once the illness resolves.

[Ji Jie - Collected Explanations]
Li [Name Missing] stated: Ascaris becomes active upon encountering sweetness, which is its nature. Hu Fen (basic lead carbonate/lead powder) is toxic and kills parasites. Placing the powder in the Licorice-Honey decoction serves to lure the worms into ingesting it.

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Patients with Hui Jue (Roundworm Cold Syndrome) typically vomit roundworms. Currently, the patient is quiet but experiences occasional irritability. This is due to internal cold, where Ascaris ascends to the diaphragm, causing irritability, which subsides after a moment. If eating triggers vomiting and irritability again, it is because the worms emerge upon smelling food odor, and the person will likely vomit roundworms spontaneously. For Hui Jue, Wumei Wan (Mume Pill) is the primary treatment.

[An Yu - Commentary]
The character "ci" (this) in "this is internal cold" should likely be "fei" (not). If it were "this," it would indicate Zang Jue (Visceral Cold Syndrome), which does not align with the differentiation of Hui Jue.

[Zhu - Annotation]
Hui Jue refers to cold extremities accompanied by pain due to Ascaris. If the cold extremities and pain were due to pure visceral cold, roundworms would not be vomited; this distinguishes Hui Jue from visceral cold. Quietness with occasional irritability indicates Ascaris ascending to the diaphragm. Eating triggers vomiting and irritability again because the worms respond to food odors. Wumei Wan is used because Ascaris calms with sour flavors, subdues with acrid flavors, and descends with bitter flavors. The prominent sour, acrid, and bitter properties in this formula make it a crucial agent for treating parasitic diseases.