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Insects (parasites) are formed from the wind-wood qi of Shaoyang, generated through the stagnation and steaming of dampness and heat. Observing nature, when rain falls under the scorching sun, insects are born in the joints of grain stalks. Humans suffering from intestinal parasites (Chong Ji) often do so due to irregular eating habits, leading to Qi deficiency in the Zhongwan region, where dampness and heat fail to transform properly, thus giving rise to various worms. This is most common in children and occasionally occurs in adults. Symptoms include heartburn (Xin Cao), abdominal pain, vomiting of saliva and foam, sallow complexion, dark circles under the eyes and nose, craving for non-food items such as rice paper, tea leaves, mud, or charcoal, lethargy with a desire to sleep, and slight chills and fever. Treatment should be tailored to the specific syndrome. For instance: if there is pain in the heart and abdomen that moves up and down, occurs intermittently, and is accompanied by salivation, it is caused by worms; use Wumei Wan (Mume Pill). If there is biting pain in the epigastrium occurring at fixed times, with vomiting of saliva upon onset, use Jingui Jiutong Wan (Nine-Pain Pill from the Golden Cabinet). For those who are suspicious and easily confused, use Miaogong Wan. For dysphagia and vomiting, use Jianhong Wan. For constant heat in the abdomen, use Huachong Wan. For constant coldness in the four limbs, use Jixiao Wan. For abdominal worm accumulation, use Wanying Wan. For phlegm-dampness and worm accumulation above the diaphragm, use Yuxian Dan. For ulcers at the anus caused by worm erosion with itching and pain, use Jiao'ai Xianggui Tang, applied externally with Xionghuang Dui method; used according to symptoms, all are effective. The Qianjin Fang prescribes one pig gallbladder mixed with half a sheng of vinegar, boiled over fire until bubbling three times (three ups and three downs). When cooled to warm temperature, drink three mouthfuls on an empty stomach; the worms die and the disease cures. This treats ascariasis attacking the heart with divine efficacy. Renzhai stated: Blood entering wine becomes "wine鳖" (jié); blood coagulating with Qi becomes "Qi鳖";敗血 (stagnant blood) mixed with phlegm becomes "blood-phlegm". These worms turn their heads and tails, invade the stomach upward, eat human fatty membranes, attach to the hypochondrium and back, or hide in the chest and abdomen. Only fried and decocted Yuanqi (Corydalis Rhizome) can kill them. However, it must be combined with herbs that nourish the stomach, benefit blood, and regulate the middle jiao to effectively eliminate the worms. Using only Leizhuang (Omphalia lapidescens) or Tin Ash cannot remove the disease.

Medicines for treating worms must be taken during the summer months when dragons and snakes emerge from hibernation, for this is when they are most effective. If taken during the time when all things are dormant and hidden, even correct formulas will not work. Danxi believed that in the first half of the lunar month, the head of the worm faces upward, making it easier to treat; therefore, medication should be administered in the first half of the day. First, attract the worms using sugar, honey, meat broth, and sweet foods, then administer vermifuges. However, these must be prepared as powders (San) because the residue can enter the worm's mouth. For worms eroding the lower part in hemorrhoids and fistulas, penetrating the anus and intestine, take one green-backed toad, add one qian of Lu Hui (Aloe), insert two raw rooster leg bones filled with Yan Huang (Realgar), seal with salt mud, calcine until the original nature remains, mix into a powder. Add small amounts of Nao (Camphor), She (Musk), and Pengsha (Borax), grind extremely fine. First, boil three pig trotter hooves and seven stems of Hu Cong (Wild Onion), wash the area daily, dry with paper twists, blow the powder deep into the anal opening, cover externally with Hei Gao (Black Plaster), apply once daily until the canal heals. If facing bizarre diseases unresponsive to treatments for phlegm and blood stasis, suspect worm pathology. Assess the excess or deficiency of meridians and consult pulse and symptoms for treatment. Worms in the Liver cause fear and redness/obstruction in the eyes; in the Heart, irritability and restlessness; in the Spleen, labor-fever and swollen/tight limbs; in the Lung, cough and asthma. Physicians who fail to examine carefully may mistakenly attribute all movement syndromes to Fire or Phlegm, using cold-cooling herbs that damage the Spleen and Stomach, leading to premature death. Only experts like Yuan Shi can distinguish this. Parasitic infection in women's genitals is detailed in the Women's Diseases section.

Shiwen said: Worm diseases present many strange symptoms, often difficult to identify immediately. Ancient cases mention Leizhuang treating Ying Sheng Chong (Echoing Worm). Recently, a woman developed cough, abdominal pain, then suddenly began shouting. Initially making gasping sounds, progressing to continuous humming, changing voices unpredictably—sometimes like a hen, sometimes like a frog, sometimes like boatmen calling out. Each episode lasted dozens of sounds, occurring ten-plus times daily. Suppressing it caused chest oppression. This is called "Jiao Chong" (Calling Worm), similar to Ying Sheng Chong. Another patient, after fever and fullness, frequently felt nauseous, vomiting several shrimp-like worms that jumped incessantly. Various treatments failed. Someone advised taking Tong Lv (Malachite Green) to induce vomiting; after two or three doses, the worms never reappeared.