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This is because the parasites lie dormant in winter and emerge in summer. Apply mashed fresh toad externally to the affected area, changing it three times a day. After three consecutive days, a small snake emerges from the ulcer; remove it with iron pincers, and the disease is cured. (From *Zhiqing Jishuo* and *Yi Shuo*.)

In the Xinwei year of Zhishun (1331), a woman in Shangbu went into the forest to dig bamboo shoots. Upon returning, she felt her hands sticky like syrup and did not have time to wash them immediately. She peeled the shoots and bit them with her teeth, thereby contracting a parasitic disease. She died giving birth to a snake, likely due to poisoning from residual toxins left by snakes. (Recorded by Kong Xingsu in *Jingzhai Zhizhi Zhiji*.)

Zhang Hezi treated Yang Zhongchen, an official in charge of wine, who suffered from qi pain upon onset of his illness. This person often enjoyed drinking alcohol. After just two or three cups, he would limp and run back and forth thirty to fifty times until the alcohol dissipated somewhat, after which he could resume his seat. When drinking up to his usual capacity, one bout of drunkenness would result in vomiting five to seven times. Until the next morning, he would vomit greenish-yellow fluid, which later developed a fishy odor for several days before recovering after six or seven days. Zhang said, "Emetic therapy is suitable." Consequently, he vomited out one worm, reddish-yellow in color, six or seven inches long, with complete mouth, eyes, and nose, and eyes covered by membranes, resembling a snake. It was dried with salt and shown to others.

Zhang Hezi said: "I once passed west of Xiayi and encountered a woman suffering from abdominal distension like a drum. Her appetite fluctuated between eating and not eating, alternating chills and fever, accompanied by frequent vomiting, for three years. Shamans and exorcists had tried everything, leaving only death as the outcome. Coincidentally, in October during the agricultural off-season, farmers gathered for hunting. A dog was killed and dismembered at the base of a large tree, leaving blood and gore on the roots. The sick woman happened to pass by the tree roots, suddenly feeling dizzy and unconscious, resting her head by the root. A worm emerged from her mouth, shaped like a snake with distinct mouth and eyes, licking the gore on the ground. The bystander, startled by the sight of a long snake, wrapped his hands in his sleeves, pressed down on the worm's head, and forcefully pulled it out. It was over two chi long and weighed nearly a jin. Upon dissecting it and showing it to the crowd, the woman recovered. The worm had no specific name. This coincides with the treatment method of Hua Yuanhua (Hua Tuo) and was merely an accidental success using emetic therapy."

Bi Lianyuan, a junior officer from Yanshi, suddenly contracted a strange disease with unbearable pain in his left thigh, groaning for days. A monk came to the door begging for food and asked about his suffering. The monk said, "This is a 'meat eel' (a type of parasite). Early treatment could save him, but now the disease has penetrated deeply." The monk then punctured his knee, extracting over ten small snakes. Holding them, the monk left; days later, more snakes emerged, and the patient eventually died. (From *Sangang Shilue*.)

Lu Xiaoyu treated Chen Shuguang, who suffered from intense hunger that could only be relieved by eating meat. Otherwise, he felt worms crawling all over his abdomen, and his body felt light as if floating in the air. Each time he ate meat, the first bite caused heart-piercing pain, which subsided only after consuming several bites. Eating little led to frequent hunger; eating too much resulted in indigestion and diarrhea. After half a year of medical treatment, he became emaciated to the point of skin-and-bones. Pulse diagnosis revealed weak pulses in all six positions, varying in depth, size, and rate. His face was yellow with blue veins. Lu said, "This is a parasitic disease, which can be cured immediately." He instructed purchasing half a jin of *Quisqualis Indica* seed flesh and half a jin of lean pork to boil together. Once the meat was thoroughly cooked, the *Quisqualis* seeds were removed, and one qian of Nifen (Calomel) was added. The patient was instructed to consume the broth and meat in one sitting. Initially, the pain felt like arrows piercing, but half a day later, the hunger ceased. By the fifth watch (early morning), he excreted a basin full of worms, some intact, some half-rotted, occasionally moving. The chronic ailment was instantly eradicated. Subsequently, he was regulated with *Shenling Baizhu San* and other formulas, forbidden from eating meat for a year, and fully recovered.

A man from Punan, when young, often caught clams by the stream. After age thirty, he suffered from intestinal pain so severe he wished to die, lasting three to four days per episode. A passing monk heard his cries, produced seven pills the size of rapeseed, and administered them with warm water. Soon after, he excreted twenty to thirty worms, red and white in color, shaped like clams, and recovered. He died two years later. (From *Yunjian Zazhi*, anonymous.)

Xue Lizhai treated a man suffering from abdominal pain, exacerbated by heat, unresponsive to various medicines. Half a year later, his abdomen swelled, and his complexion became sallow. Pulse diagnosis showed no surging or slippery qualities, ruling out abscesses. Inquiry revealed the onset followed extreme thirst and drinking from a mountain stream. Suspecting accidental ingestion of leeches, he prescribed pills made from river mud, taken with water on an empty stomach (one hundred pills). The patient indeed excreted leeches and recovered. Another son, suffering from abdominal pain after falling into a ditch and failing to respond to medicines for accumulation and fright, was treated similarly based on the previous case.

A woman used chicken feathers to clean her ears. Unbeknownst to her, a centipede had laid eggs on the feather, introducing baby centipedes into her ear canal. They burrowed into her brain, causing itching unrelieved by any medicine. In a dream, a deity transmitted a prescription: roast chicken meat hotly, place it in a vessel with a small hole, cover it, and let the patient inhale the steam through the ear. The chicken aroma attracted the centipedes onto the meat, curing the disease immediately. (From *Guang Biji*.)

Qian Guobin treated the son of the Zhou family, a scholar aged twenty, who constantly had swollen feet with dozens of yellow blisters that healed upon draining fluid, and suffered from recurrent syncope. During a family banquet, he suddenly collapsed. Upon examination, the pulses in most meridians were unresponsive, except for the Kidney pulse, which was soggy and rapid, sometimes chaotic, sometimes quiet. Qian reasoned: Soggy indicates dampness; rapid indicates heat; chaotic indicates worm activity; quiet indicates worm dormancy; sores on the sole belong to the Kidney meridian. Thus, damp-heat in the Kidney meridian generated worms, whose qi attacked upward causing syncope. He prescribed Xionghuang Wan: 5 fen each of Radix Curcumae Longae (Yujin), Rhubarb (Dahuang), and Croton Seed Husk (Bashuang), pill-sized as mung beans, coated with Realgar. Administered with ginger decoction (15 pills), followed by more ginger decoction. The worms dissolved into black, glue-like fluid and were excreted in piles outdoors. Later, cold rice soup was used to tonify. To prevent recurrence, he consumed 1–2 sheng of Torreya seeds, and the condition did not return.

An eighteen-year-old daughter of a shopkeeper in Jining suffered from consumption-like symptoms for three years, becoming emaciated and delirious, with worsening condition. Her spirit was haggard, eyes bright, and pulses chaotic. Detailed inquiry revealed constant dull abdominal pain and a craving for sweets. Observing white spots on her face, Lu deduced it was a parasitic disease, not consumption. He gave ten Xionghuang Wan pills, administered with Betel Nut Decoction. No movement occurred by noon, so five more pills were urged. Loud rumbling ensued, followed by the excretion of over a hundred worms resembling ground beetles, with fish scales on top, black mouths below, and movable legs. The girl remained unconscious for half a day before waking. She drank thin porridge and took a formula containing Ginseng Root, Angelica Sinensis Root, Betel Nut, Perilla Leaf, Poria, Cinnamon Bud, and Mume Fruit to eradicate the root of the parasites. She was discharged with a regulating formula. (Case of Qian.)

Tang Guoxue, a student from Baoxing, aged eighteen, was tall and bony with lack of muscle, pale face with visible blue veins, and slight pain near the lower abdomen and hypochondrium. Physicians could not diagnose the pattern. Pulses alternated between long and short, indicative of parasites. Visible blue veins indicated Liver pathology. The location near the lower abdomen and hypochondrium corresponds to the Liver. Thus, damp-heat in the Liver generated worms, eroding the body for a long time. He prescribed one liang of preserved soap and one qian of Aloe Vera, ground into fine powder, taken daily with sugar water (one qian). The worms, affected by the medicine, were excreted daily in piles outdoors, turning into thick green slime. After twenty-five days, all worms were gone. Recovery was completed with Ginseng, Astragalus, Angelica, and Atractylodes. Within two months, his physique greatly strengthened. (Same source.)

Jiang Zhongfang stated: Yao Yizhi's wife, in her twenties, suffered from bone-steaming tidal fever, dry cough, and dry mouth, unresponsive to various treatments. A practitioner suggested, "There are worms in the lungs. Since it is midsummer, they can be drawn out." One young rooster was plucked, cleaned, boiled, and placed in a lacquer tray. The lid was half-open. While the patient slept, the open part was placed near her nose. Upon waking, the lid was closed tightly. At dawn, a large bucket of water was placed under the tray. Upon inspection, hundreds of winged small insects were found on the chicken, which were poured into running water. On the second night, another chicken drew out seventy to eighty more insects. The disease was cured, and she remains healthy today. My interpretation is that chickens like eating worms, so worms also like eating chicken, similar to the enmity between centipedes and chickens. Boiling releases fragrance; in midsummer, worms scatter; while sleeping and immobile, worms follow the scent easily. Pouring into running water ensures they leave and do not return. This method proved effective on others, but crucially, the patient must not know beforehand, lest the worms sense it and avoid it.

Wang Yutai said: Wang Zhongjia told me, "Do you know why Wang Jiezhai died?" I replied, "No." Wang said, "When Jiezhai served as Vice Commissioner of Sichuan, he developed heart and abdominal pain. Medical treatments failed, and the condition worsened daily. Hearing of a Daoist adept skilled in medicine on Mount Emei, whom he could not visit easily, Jiezhai went personally, dismissing his carriage and attendants, walking on foot. The adept saw him and exclaimed, 'The disease is deep.' Sitting down, the adept asked, 'Have you ingested any raw animal products that were not thoroughly roasted or processed?' Jiezhai replied, 'Yes, I have taken Buyin Wan for decades.' It contained turtle shell, prepared with wine frying. The adept said, 'That is it. You must return home immediately.' Counting on his fingers, he said, 'You will make it home.' Jiezhai hastily submitted his resignation and returned. Upon reaching Wuchang, he defecated countless tiny red turtles and died that night on the boat. Wang commented: Materia Medica states that Turtle Shell primarily treats masses, malaria, hemorrhoids, genital ulcers, and leukorrhea with blood/purulence, not tonifying Heart and Kidney. Taking it causes harm instead. (From *Yixia Zhiyan*, Cheng Yunlai. Xiong notes: Turtle and softshell turtle shells should only be used in decoctions. If used in pills, they must be boiled into gelatin to replace honey, to avoid adverse effects.)