大全云∶妇人阴痒者，是虫蚀所为。三虫在于肠胃之间，因脏虚，三虫动作，蚀于阴内，
其虫作热，微则为痒，重者乃痛也（阴痒生虫，当与肠胃求食之虫不同。仲景曰风三虫，此当
从风木所化，故治法悉以清肝为主）。薛氏曰∶前证属肝经所化，当用龙胆泻肝汤、逍遥
散以主其内，外以桃仁研膏，和雄黄末或鸡肝纳阴中，以制其虫。一妇人胸膈不利，内热
作渴，饮食不甘，肢体倦怠，阴中闷痒，小便赤涩，此郁怒伤肝脾所致，用归脾汤加山栀而
愈。复因怒，患处并小腹胀痛，用小柴胡加山栀、芎、归、芍药，痛止，用逍遥散加山栀而愈。
又因劳役，患处肿胀，小便仍涩，用补中益气加山栀、茯苓、丹皮而痊。一妇人阴内痛痒，
不时出水，食少体倦，此肝脾气虚，湿热下注，用归脾加丹皮、山栀、芍药、甘草主之而安。
一妇人阴内痒痛，内热倦怠，饮食少思，此肝脾郁怒，元气亏损，湿热所致，用参、 、归、
术、陈皮、柴胡、炒栀、车前、升麻、芍药、丹皮、茯苓而瘥。若阴中有虫痒痛亦属肝木，以桃
仁、雄黄研，纳阴中以杀之，仍用清肝解郁之药，有以鸡肝纳之者，乃取虫之法也。一方捣
新桃叶绵裹纳阴中，日三两易。
李氏曰∶阴中生虫 如小蛆者，乃湿热甚而心气又郁，气血凝滞而生，（此又谓脾胃
湿热下流而生虫者）宜藿香养胃汤、补心汤、硫鲤丸，外用生艾汁调雄黄末，烧烟熏之，更
用雄黄锐散纳阴中。阴中生细虫，痒不可忍，食入脏腑即死，令人发寒热，与劳证相似，
先以蛇床子煎汤净拭干，后用梓树皮焙干为未，入枯矾四分之一。麝香少许敷之立效。
如下疽生虫，所下如柿汁臭秽，及心中绞痛，闷绝虚烦，甚者不治。
The *Daquan* states: Vulvar pruritus in women is caused by the erosion of parasites. Three types of worms reside between the intestines and stomach; due to deficiency of the zang organs, these three worms become active and erode the interior of the yin (vagina). These worms generate heat; when mild, it manifests as itching, and when severe, as pain. (Note: Vulvar pruritus with parasitic infection differs from common worms seeking food in the gastrointestinal tract. Zhang Zhongjing refers to them as "Wind Three Worms"; these are believed to transform from Wind-Wood qi, therefore treatment methods primarily focus on clearing the Liver.)
Xue Ji stated: The aforementioned symptoms belong to transformations of the Liver channel. Internally, one should use Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) or Xiaoyao San (Free and Easy Wanderer Powder) as the main treatment. Externally, grind Tao Ren (Peach Kernel) into a paste, mix with Xionghuang powder (Realgar), or insert a chicken liver into the vagina to control the worms.
One woman suffered from chest and diaphragm discomfort, internal heat with thirst, poor appetite, limb fatigue, stifling itching in the vagina, and red, scanty, painful urination. This was caused by depression and anger injuring the Liver and Spleen. She was cured using Guipi Tang (Restore the Spleen Decoction) with Shanzhi (Gardeniae Fructus). Later, due to renewed anger, she experienced distending pain in the affected area and lower abdomen. She was treated with Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Shanzhi, Xiong (Chuanxiong Rhizoma), Gui (Danggui Radix Angelicae Sinensis), and Shaoyao (Paeoniae Radix); after the pain ceased, she was cured with Xiaoyao San plus Shanzhi.
Subsequently, due to overwork, the affected area swelled, and urination remained difficult. She recovered using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Shanzhi, Fuling (Poria), and Danpi (Moutan Cortex).
Another woman suffered from pain and itching inside the vagina, frequent discharge, poor appetite, and body fatigue. This was due to deficiency of Liver and Spleen qi with damp-heat pouring downward. She was stabilized using Guipi Tang plus Danpi, Shanzhi, Shaoyao, and Gancao (Licorice Root).
Yet another woman suffered from itching and pain inside the vagina, internal heat, fatigue, and loss of appetite. This was caused by Liver-Spleen depression and anger, depletion of Yuanqi (Original Qi), and damp-heat. She recovered using Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Chaihu (Bupleuri Radix), fried Shanzhi, Cheqianzi (Plantaginis Semen), Shengma (Cimicifugae Rhizoma), Shaoyao, Danpi, and Fuling.
If there are worms in the vagina causing itching and pain, this also belongs to Wood (Liver) pathology. One may grind Tao Ren and Xionghuang, insert them into the vagina to kill the worms, and still use herbs that clear the Liver and resolve depression. Some used inserted chicken liver, which is a method of baiting the worms. Another prescription involves crushing fresh Tao Ye (Peach Leaf), wrapping it in cotton, and inserting it into the vagina, changing it two to three times daily.
Li Shi said: Parasites resembling small maggots appearing in the vagina arise from severe damp-heat combined with stagnation of Heart qi, leading to coagulation and stagnation of qi and blood. (This is also described as worms generated by damp-heat from the Spleen and Stomach flowing downward). Suitable treatments include Huoxiang Yangwei Tang (Agastache Decoction to Nourish the Stomach), Buxin Tang (Nourish the Heart Decoction), and Liu Li Wan (Sulfur and Leech Pill). Externally, apply raw Aiye juice mixed with Xionghuang powder and burn it to fumigate the area; additionally, insert Xionghuang Ruisan (Realgar Sharp Powder) into the vagina.
Fine worms in the vagina cause unbearable itching; if they enter the viscera, they die, causing chills and fever similar to consumptive diseases. First, wash and dry the area thoroughly with a decoction of Chuanshangzi (Cnidii Fructus). Then, apply a powder made from dried Zishu Pi (Phellodendri Cortex) roasted until dry, mixed with one-quarter part of Mingfan (Alumen) and a small amount of Moxiang (Moschus). This yields immediate results.
If ulcers in the lower jiao generate worms, with discharge resembling persimmon juice and foul odor, accompanied by colicky heart pain, suffocation, restlessness, and deficiency vexation, the condition is incurable in severe cases.