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Worms are generated by the stagnation and steaming of damp-heat. (This can also result from miscellaneous consumption of cold and raw foods, or the retention of rich and greasy flavors, or internal heat due to five zang organs' overwork, or qi and blood accumulation after illness. Any factor that causes damp-heat can generate worms; it is not necessary to have overconsumed fish sashimi and white wine, or mistakenly eaten softshell turtle, amaranth, or leeches for this to occur.) Observing that rain in the sun leads to worms growing on rice stalk joints illustrates this principle. *Xuanzhu* states: "Worms are born when they receive the qi of wind and wood, and transform when they receive the qi of rain." Since the qi of wind and wood is warm, and the qi of rain is damp, their generation from damp-heat is unquestionable. *Qianjin Yaofang* states: There are nine types of worms, all capable of consuming the human viscera. The first is called Fuchong (Hidden Worm), measuring four fen, which is the leader of the swarm. The second is Hui Chong (Roundworm), measuring one chi or five to six cun; if numerous, it can pierce the heart and cause death. The third is Bai Chong (White Worm), measuring one cun (hence also called Cunbai Chong); its offspring multiply continuously, with the mother worm growing larger, reaching lengths of four to five zhang (*Zhunsuo* records them as connected, one zhang long), capable of causing death. (Zihehe stated: They have a smaller head, caused by drinking white wine, eating beef roasted on mulberry branches, eating raw millet, or drinking milk/cheese immediately after eating raw fish. When activated, they damage the body's essence and qi, causing lower back and leg pain.) The fourth is Rou Chong (Flesh Worm), resembling rotten apricots, causing irritability and fullness. The fifth is Fei Chong (Lung Worm), resembling silkworms, causing coughing. The sixth is Wei Chong (Stomach Worm), resembling a toad, causing vomiting and stomach qi rebellion with belching. The seventh is Ruo Chong (Weak Worm), also known as Ge Chong (Diaphragm Worm), resembling melon seeds, causing excessive salivation. The eighth is Chi Chong (Red Worm), resembling raw meat, causing borborygmus. The ninth is Tiao Chong (Pinworm), extremely minute, resembling vegetable worms, residing in the Guangchang (large intestine), capable of causing hemorrhoids, fistulas, sores, scabies, and tinea. Not everyone has worms, and those who do may not have many. *Benshi Fang* states: The Heart worm is Hui (Roundworm); the Spleen worm is Cunbai; the Kidney worm resembles cut silk threads (Pinworm); the Liver worm resembles rotten apricots; the Lung worm resembles silkworms; all can cause death. Lung worms reside within the lung lobes, eroding the lung system, leading to consumptive disease with hemoptysis and hoarseness; medicines cannot easily reach them, making treatment difficult. There is also Shichong (Corpse Worm), born with humans, resembling a horse's tail or thin tendons, residing attached to the Spleen, having heads and tails, all three cun long.

Worm syndromes present with epigastric discomfort and abdominal pain, or upward attacking pain feeling like biting in the heart region. (When worms move, the heart becomes flustered and restless, causing epigastric discomfort. When worms crawl and bite, abdominal pain occurs.) Vomiting of saliva, clear water, or green/yellow fluid. (Worms often reside in the stomach; stomach qi disturbed by worms causes fluids to overflow with qi. *Neijing* states: "When worms move, the stomach relaxes; when the stomach relaxes, the Lianquan acupoint opens, causing drooling." This means stomach qi is stagnant due to worms, unable to transport fluids, so they overflow upwards from the Lianquan acupoint.) Withered yellow complexion. (The Stomach meridian ascends to the face; weakness of the Stomach due to worms manifests as a withered yellow color on the face.) Or sudden changes in complexion to red, white, blue-black. (Blue-black indicates pain; white indicates lack of blood color; red indicates fire. Worm movement is unpredictable; severe pain causes blue-black complexion; qi and blood stagnating internally fail to ascend, resulting in pale face; prolonged stagnation suddenly clearing allows fire to rise, resulting in redness.) Or white spots on the face. (Erosion marks in the stomach correspond to spots on the face, like a shadow mimicking form.) Lips often red. (Spleen blood stagnates due to heat, manifesting color on the lips.) Or sores appearing like millet grains. (*Zhunsuo* states: Erosion of the lower part is Hu, with sores on the lower lip; erosion of the upper part is Huo, with sores on the upper lip. According to *Jinkui*, Huo refers to erosion of the throat with hoarseness; Hu refers to erosion of the lower part with dry throat. *Yizong Jinjian* states: Hu corresponds to chancre, eroding the anus and genitals; Huo corresponds to noma, eroding the pharynx, rotting gums, loosening teeth, perforating cheeks, and breaking lips. Noma and chancre are both damp-heat diseases.) Or silence and desire to sleep, restlessness in lying down and rising, loss of appetite, aversion to the smell of food. (Worms move upon smelling food, causing mental distress, hence loss of appetite and aversion to food smells.) Pain when hungry, worsening after eating. (Hunger causes worms to move seeking food, and competition for food causes chaotic movement.) Relief when full. (Worms stop moving when full.) Intermittent pain relieved by percussion. (A case of cardiac-abdominal pain unresponsive to drugs was relieved only by beating, as vibration startles and stops the worms; removing the worms cured it.) Prominent blue veins on the abdomen, or palpable masses rising in the abdomen, passage of black blood. (In children, gan heat generates worms; earth failure and wood overacting lead to visible blue veins on the abdomen; blood degradation leads to black stool.) Alternating chills and fever. (Qi stagnating internally causes chills; prolonged stagnation suddenly extending outward causes fever.) Surging and large pulse. (Abdominal pain typically presents with deep and weak pulses; surging and large pulses here indicate damp-heat generating worms.) These are all signs of worm syndromes.

To treat various worms, bathing with Baiyan Cao (Artemisia argyi) is beneficial; both roots and leaves can be used. The herb is fragrant and feared by corpse worms. Regarding the position of worms in the abdomen: in the first ten days of the lunar month, the head points up; in the middle ten days, it is horizontal; in the last ten days, it points down. Observing cattle and horses giving birth: those born in the first ten days walk ahead of the mother; those in the middle ten days walk alongside; those in the last ten days follow behind. Cats eating mice: in the first ten days they eat the upper segment; in the middle ten days, the middle segment; in the last ten days, the lower segment. This is natural law. Therefore, anti-worm medication should be administered in the first ten days of the month. (One theory says: 1st to 5th day, head up. Another says: 1st to 3rd day. Another says: For Lung worms, only on the 4th and 6th days is the head up; use dried otter claw powder mixed with medicine.) If urgent waiting is impossible, fast for one day to starve the worms. At Wu Geng (3-5 AM), chew roasted pork, swallow saliva but do not eat the meat, enticing the worms to raise their heads towards the fragrance, then administer anti-worm medicine. (Alternatively, mix drug powder into fried eggs.) Most anti-worm herbs are bitter; only Feizi (Persimmon Seed) and Shijunzi (Quinine Seed) are sweet. For pediatric gan worms, roast Shijunzi for consumption, or decoct its shell for administration, which is excellent. Leser, Leiwan, Wuyi, Kulian Gen (Melia Root), Binglang (Areca Nut), Xihui (Tin Ash), etc., are all anti-worm agents, with Tin Ash being the most potent.

Mao Jing suffered from a strange disease where his throat echoed every word he spoke. A Daoist priest instructed him to recite materia medica names until he fell silent at "Lan" (Isatis). He then drank juice extracted from Isatis, shortly thereafter vomiting out a piece of flesh over one cun long, complete with human features, after which the echoing ceased. Chen Zhengmin read in his study about Yang De's異病 (abnormal illness): whenever he spoke or answered, a small voice in his abdomen imitated him. Over several years, the voice grew louder. A Daoist priest saw this and exclaimed, "This is an Echoing Worm. Untreated, it will spread to his wife and children." He instructed him to read the materia medica; when he reached "Leiwan," the worm became silent. He took it immediately and recovered. Zhao Zishan suffered from Cunbai worms. His doctor advised abstaining from alcohol, but due to his addiction, he could not quit. One night, returning drunk past midnight, he had dry mouth and throat. Lacking tea, he found a jar of water in the corridor, clear under the moonlight, and drank it. It tasted sweet as syrup. After several cups, he slept. By morning, worms covered the mat, his chest and abdomen felt relaxed, and the chronic ailment was cured. Inspection revealed the water was from soaking Hongteng Gen (Sargentodoxa Root) used by straw sandal weavers. Minister Wu Shaoshi once fell ill, wasting away over months. Shortly after swallowing food, his abdomen felt attacked by thousands of worms, itching and painful. Zhang Rui diagnosed the pulse and warned: "Fast tomorrow morning, consume nothing." Zhang Rui took a bowl of yellow soil, added one sheng of warm wine, stirred in the soil, and extracted a hundred pills. Upon ingestion, intestinal cramping pain was unbearable, followed by violent diarrhea, expelling foul matter and over a thousand leech-like worms coiled together. Zhang Rui said, "Worms entering the liver and spleen inevitably multiply. These worms prefer wine and have been deprived of earth flavor for long. Starving them gathers them all, so one dose can cleanse them." Cai Dingfu's son suffered from Cunbai worms transforming into roundworms. The doctor instructed him to grind Binglang fine, decoct the eastern root of Pomegranate bark, and take with the powder. First, chew a large piece of fatty roasted pork, extracting saliva without swallowing, to attract the worms. The doctor explained, "These worms only have heads pointing up before the 3rd day of the lunar month; otherwise, heads point down, rendering medicine useless. Smelling pork fat, they swarm towards it. Feeling like arrows piercing the chest indicates success." Then drink the medicine. Cai followed instructions strictly. Within two quarters of an hour, borborygmus sounded, and he rushed to the toilet, expelling worms profusely. Servants prodded them with sticks; they formed continuous strands nearly several zhang long, still wriggling. Thrown into a stream, the chronic ailment was instantly cured. For patients with this condition, even if emaciated, worms must be expelled first, followed by harmonizing tonics. (This serves as an example for treating deficiency with excess: attack first, tonify later.) Ignorant practitioners use only tonification, or absurdly claim worms are born from cold viscera, recklessly adding hot herbs, which is laughable.