(第十二)
蛔虫者,九虫内之一虫也,长一尺,亦长五、六寸者,盖因脏腑虚弱而动。或因食肥甘
而动。其动则腹中痛发作,肿聚行束上下,痛有休止,亦攻心痛,口喜吐涎及清水,贯肠心者
即死。论其脉,腹中痛,其脉发
当沉弱而弦,今反脉大即是蛔虫也。此痛因食物太早受甜,怕痛时便高声啼叫,只看人中上
鼻头、唇口一时黑色即是。
此证当服使君子丸、槟榔散、化虫丸,取下便无事。仲景云∶蛔厥者,其人当吐蛔,
今病者静前后烦,此五脏寒,乌梅丸主之。其蛔虫穿者,用薏苡根煎服即安。
使君子丸 治小儿五疳,脾胃不和,心腹胀,时或疼痛,不进乳食,渐至羸瘦。
浓朴 陈皮(各一两) 使君子肉(一两,汤泡去黑皮) 甘草 川芎(各二钱半)
加芍药
上未,炼蜜丸,芡实子大。每服一丸,空心米饮下。
化虫丸 治小儿虫咬心痛,来去不定,不思乳食。
鹤虱 槟榔 胡粉 苦楝根(各半两) 明矾(三钱五分,半生半枯)
上末,面糊丸,绿豆大。三岁服三十丸,熟水入香油二滴吞下。食前如有小虫,皆
化为水,大虫自利下,初服甚效。
乌梅丸 治蛔虫上入其膈,故须臾复上,得食而呕又烦者,咽闻食臭,服此当自吐蛔,又治
久痢。
乌梅(二十三枚) 干姜(两二钱,炮) 黄连(二两) 川椒 当归(各半两) 细辛
附子(炮去皮脐) 人参 桂枝 黄 (各七钱)
上为末,用酒浸乌梅肉一宿,去核,蒸饭杵成泥,和药匀丸如麻子大。食后服十丸,
日三服,忌生冷物。
(12)
Ascaris lumbricoides (Hui Chong) is one of the nine types of intestinal parasites. Its length may be one chi, or five to six cun, generally triggered by weakness of the Zang-Fu organs. It may also be induced by consuming rich and sweet foods. When active, it causes abdominal pain attacks, with swelling and aggregation that move up and down; the pain has intervals. It may also attack the heart region, accompanied by a tendency to salivate and vomit clear water. If the worm penetrates the heart, death ensues. Regarding the pulse: in cases of abdominal pain, the pulse should be deep, weak, and wiry; if it is instead large, it indicates Ascaris infection. This pain is caused by consuming overly sweet food too early. The child cries loudly due to fear of pain; diagnosis can be confirmed if the area above the philtrum to the nose tip and lips suddenly turns black.
This condition should be treated with Shijunzi Wan (Quince Seed Pill), Binglang San (Betel Nut Powder), or Huachong Wan (Worm-Dissolving Pill). Once the worms are expelled, the patient will recover. Zhang Zhongjing stated: "In cases of Hui Jue (Ascaris Cold Reversal), the patient typically vomits worms. Now, if the patient alternates between quietness and restlessness, this indicates cold in the Five Zang organs, and Wumei Wan (Mume Pill) should be primarily used." For severe cases where worms perforate the intestines, decocting and taking Yiyi Gen (Coix Root) brings relief.
Shijunzi Wan (Quince Seed Pill): Treats pediatric five kinds of Gan syndrome (malnutrition due to parasitic infection), disharmony of the Spleen and Stomach, abdominal distension and fullness, occasional pain, refusal of milk and food, leading gradually to emaciation.
Ingredients: Houpo (Magnolia Bark), Chenpi (Aged Tangerine Peel) (each 1 liang); Shijunzi Rou (Quince Seed Meat) (1 liang, soaked in hot water to remove black skin); Gancao (Licorice Root), Chuanxiong (Sichuan Lovage Rhizome) (each 2.5 qian); add Shaoyao (Peony Root).
Preparation and Administration: Grind the above ingredients into fine powder, mix with refined honey to form pills the size of Euryale Seed (Qianshi Zi). Take one pill per dose, swallowed with rice water on an empty stomach.
Huachong Wan (Worm-Dissolving Pill): Treats pediatric heart pain caused by worm bites, with unpredictable onset and cessation, and loss of appetite for milk and food.
Ingredients: Leshe (Chrysanthemum Seed), Binglang (Areca Nut), Hufen (Lead White), Kulian Gen (Melia Root Bark) (each 0.5 liang); Mingfan (Alum) (3.5 qian, half raw and half calcined).
Preparation and Administration: Grind into fine powder, bind with wheat paste to form pills the size of Mung Bean. For three-year-olds, administer thirty pills, swallowed with warm water mixed with two drops of sesame oil. If taken before meals, small worms dissolve into water, and large worms are naturally excreted. Initial administration is very effective.
Wumei Wan (Mume Pill): Treats Ascaris disturbing the diaphragm, causing recurrent upward movement; vomiting and restlessness after eating, and aversion to the smell of food. Taking this pill should induce vomiting of worms. It also treats chronic dysentery.
Ingredients: Wumei (Mume Fruit) (23 pieces); Ganjiang (Dried Ginger) (2 qian, processed), Huanglian (Coptis Rhizome) (2 liang); Chuanjiao (Sichuan Pepper), Danggui (Angelica Sinensis) (each 0.5 liang); Xixin (Asarum), Fuzi (Processed Aconite Root, peeled and de-navel), Renshen (Ginseng), Guizhi (Cinnamon Twig), Huang [missing character, likely Huangqi] (each 7 qian).
Preparation and Administration: Grind the above ingredients into powder. Soak Wumei meat in wine overnight, remove pits, steam until cooked, pound into a paste, and mix uniformly with the powder to form pills the size of Hemp Seed. Take ten pills after meals, three times daily. Avoid raw and cold foods.