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Parasites are generated by the stagnation and steaming of damp-heat. Observing nature, when it rains during the day, parasites grow on the nodes of rice stalks; the principle is clear. Zhang Dairen's deduction is excellent: Water and Fire belong to Spring and Summer, damp Earth belongs to late summer. Water transforms through Earth, thus parasites are abundant. Human parasitic accumulation often results from irregular eating habits (overeating or fasting), excessive consumption of fish and alcohol, overeating beef and mutton, or mistakenly consuming soft-shelled turtle and amaranth. This leads to deficiency of Qi in the Zhongwan region, failure of damp-heat transformation, and the generation of various parasites such as Taenia solium (Taenia, tapeworm). Some resemble earthworms, others turtles or soft-shelled turtles. They are most common in children and occasionally seen in adults. Symptoms include epigastric discomfort and abdominal pain, vomiting of saliva, sallow complexion, bluish-black discoloration around the eyes and below the nose, reduced appetite, emaciation, lethargy and drowsiness, mild chills and fever. If not treated early, the parasites will reproduce endlessly. Ancients said: "A parasite reaching one chi can harm humans; if it penetrates through the body, death occurs rapidly."

The treatment method involves expelling parasites and removing accumulations, using Jianhong Pill (Red Scissors Pill), Zunshen Pill (Revering Spirit Pill), and Yuxian Dan (Immortal Meeting Elixir). Parasites coexist with humans but cause great harm. Their shape resembles a large horse's tail or thin fascia, residing based on the Spleen, with heads and tails, all about three chi long. There are also nine types of parasites: 1. Fu Chong (Hidden Worm), four fen long; 2. Hui Chong (Roundworm/Ascaris), one chi long; 3. Bai Chong (White Worm/Taenia), one cun long; 4. Rou Chong (Flesh Worm), resembling rotten apricot kernels; 5. Fei Chong (Lung Worm), resembling silkworms; 6. Wei Chong (Stomach Worm), resembling toads; 7. Ruo Chong (Weak Worm), resembling melon seeds; 8. Chi Chong (Red Worm), resembling raw meat; 9. Tiao Chong (Pinworm), extremely fine, resembling vegetable worms. Fu Chong is the leader of the group; Hui Chong penetrating the heart causes death; Bai Chong reproduces endlessly, increasing in number and size, mothers growing up to four or five zhang, also causing death; Rou Chong causes irritability and fullness; Fei Chong causes coughing; Wei Chong causes vomiting and belching due to rebellious Stomach Qi; Ruo Chong, also called Ge Chong (Diaphragm Worm), causes excessive salivation; Chi Chong causes borborygmus; Tiao Chong resides in the large intestine, causing hemorrhoids when numerous, or leprosy-like sores, leading to various abscesses, tinea, and scabies. Qiu Chong (Cavity Worm) acts everywhere; humans do not necessarily have all types, nor in equal numbers; some have specific types, women often have more. These worms are fierce and represent a major affliction. Bathing with Baiyan Grass (likely *Artemisia* species or similar aromatic herb), using roots and leaves, is effective as it is both an aromatic herb and feared by parasites. Before taking tonics or treating diseases, one must eliminate parasites and thoroughly clear phlegm-fluid retention and old turbidity; otherwise, medicinal efficacy will be lost. In cases of Cold Damage (Shanghan) or epidemic febrile diseases, internal heat combined with poor diet and empty intestines/stomach allows the "Three Parasites" to move seeking food, eroding the Five Viscera and lower parts. Signs include colorless teeth, white tongue coating, ulcers inside lips, heavy limbs, and drowsiness. Check for ulcers inside the upper lip. Hemoptysis and millet-grain-like ulcers inside lips indicate internal restlessness and pain, signifying erosion by parasites in the upper part. The Nine Parasites arise from deficient viscera, weak Spleen and Stomach, mixed intake of cold/raw, sweet/greasy, and salty organ meats, irregular lifestyle, and stagnation of decay. Also caused by emotional stagnation, loss of Jing and Po, Five Viscera labor-heat, residual toxins, and Qi/Blood stagnation. Or from ingesting fruit/vegetables and animal organs containing parasite eggs. Symptoms include nausea, vomiting saliva, clear foam, intermittent abdominal pain. Taenia (Bai Chong) is white and flat, depleting Jing-Qi, causing fatigue and backache. Pinworms (Tiao Chong) are fine like vegetable worms, causing hemorrhoids, fistulas, sores, tinea, and abscesses. Taenia, Pinworm, and Ascaris are among the Nine Parasites. Additionally, children may suffer from Gan Syndrome (Pediatric Malnutrition), characterized by drowsiness, irritability, foul-smelling nasal discharge, gum ulcers, and black bloody diarrhea. Parasites eroding the lower part cause "Hu" (Fox) syndrome with lower lip ulcers; eroding viscera cause "Huo" (Confusion) syndrome with upper lip ulcers. The "Three Parasites" refer to Chang Chong (Long Worm/Ascaris), Chi Chong (Red Worm), and Tiao Chong (Pinworm). Among the nine, Pinworm and Taenia are most common. Taenia results from eating beef and drinking wine; connected strands of one chi length can kill. Medication must expel them completely wrapped in feces; if broken, they regenerate, requiring urgent treatment. Pinworms mostly affect children but also adults, causing heart pain, morning salivation, and irritability. Other parasites are generally harmful; since everyone has some in the stomach, Jiuchong Wan (Nine Parasite Pill) is suitable. Ascaris (Hui Chong) is one of the nine, one chi long, sometimes five or six cun. Activated by visceral weakness or sweet/greasy food, it causes abdominal pain, migratory masses, intermittent pain, heart pain, abdominal heat, salivation, and vomiting of clear fluid. Penetrating the heart causes death. Pulse diagnosis: abdominal pain usually presents with deep, weak, or wiry pulses; a surging and large pulse indicates Ascaris. Ascaris is present in everyone. Early weaning or excessive sweets in children cause Stomach deficiency and worm movement, leading to abdominal pain, nausea, clear fluid vomiting, and visible blue veins on the abdomen. Roasted Jiguzi (Fructus Juglandis Seed) or decoction of shells is effective. However, taking it before bed without fixed timing is often ineffective. Best taken at dawn between the 4th and 5th days of the lunar month. Parasites are expelled by noon. Follow with harmonizing and warming herbs for one or two days; do not overuse. The position of parasites changes with the lunar month: head up in the first ten days, horizontal in the middle ten, head down in the last ten. Medication fails in the middle/last ten days because it doesn't enter the mouth. Cattle/horses born in the first ten days lead; middle ten walk side-by-side; last ten follow. Cats eating mice eat top/middle/bottom sections accordingly. This is natural law.

Case from *Kezuo Xinwen*: Xia Zongyang's family practiced medicine in Jiangyin. A scholar's father had abdominal distension. Pulse was surging and large, indicating damp-heat generating parasites. Diet was normal, ruling out edema or Gu distension. Prescribed Pomegranate Peel (*Rhus chinensis* root bark? Note: Text says Shiliupi, likely *Punica granatum* peel) and Chun Tree (*Toona sinensis*) east-facing roots, plus Areca Nut (*Betel nut*), each 5 qian, decocted in flowing water, taken on an empty stomach. Soon, severe abdominal pain occurred, followed by expulsion of a long worm approx. one zhang. Cured. *Ben Shi Fang* states: Lung worms resemble silkworms, can kill, reside in lung lobes, erode lung collaterals, causing Tuberculosis (Zhai Ji), cough, hemoptysis, hoarseness. Hard to treat as drugs cannot reach. *Dao Zang Jing* records: All worms' heads point down, except from 1st to 5th day when heads point up, explaining why medication is effective then.

Yao Kuan's *Xixi Conghua* says: Visceral worms ascend, but Lung worms descend, making them hard to treat. Use Otter Claw powder mixed with medicine, treat on 4th and 6th days when Lung worms ascend. Two theories differ slightly; keep both for reference. *Bozhai Bian* records Mao Jing, military officer in Yongzhou, had a strange disease where his throat echoed his speech. A Daoist taught him to recite herbal names. When he reached "Lan" (Indigo), silence ensued. He drank Indigo juice and vomited a human-shaped flesh piece one cun long. Silence returned. Chen Zhengmin's *Dunzhai Xianlan* records Yang Yi had a disease where his abdomen mimicked his voice. Years later, sound grew louder. A Daoist identified it as "Echoing Worm," warned it would spread to wife/children, advised reading herbal texts until a name elicited no echo, then take that herb. Reading "Leiwang" (Walnut/Alum? Text implies Leiwang/Pill of Thunder), silence occurred. He took it and cured. Later in Changsha, a beggar had the same disease; teaching him Leiwang cured him too. *Ding Zhi* records Xi Jinru of Qizhou invited relative Zhang Bin. Zhang loved wine, kept it by the bed. One night he forgot it, woke thirsty, became angry/restless, vomited a yellow liver-like mass with honeycomb texture, still moving. Pouring wine made it squeak. Realizing the root of his wine illness, he burned it and quit drinking. *Geng Zhi* records Zhao Zishan (Jinggao) staying at Tianwang Temple in Shaowu, suffering from Taenia. Doctor advised quitting wine. He couldn't, got drunk, returned at midnight, dry-mouthed, found water in a jar under moonlight, tasted sweet, drank several cups, slept. Morning brought worms filling the mat, feeling relief, cured. Reason: Temple servant wove straw sandals soaked in Red Vine Root water.

Wu Shaoshi fell ill outside the pass, wasting away. After eating, abdominal pain/itching felt like thousands of insects attacking. Diagnosed as Consumption. Zhang Rui, in Chengdu, was summoned to Xingyuan. Pulse diagnosed damp-heat/worms. Advised fasting until arrival. Next day, hot weather. Zhang Rui sent a runner to fetch soil from the road. Noodles were prepared. Upon eating, soil arrived. Mixed warm wine and soil, extracted 100 pills, gave to Wu. Severe intestinal cramping, rushed to toilet. Zhang Rui dug a pit nearby. Wu evacuated violently, expelling斗许 (approx. a dou/volume unit) of filth, including over 1,000 leech-like worms (Ma Huang/Water Leeches?), tangled, half dead. Wu exhausted, rested on bamboo couch, ate congee after time, recovered in 3 days. Cause: Summer night campaign, thirst, drank stream water, swallowed something unnoticed. Zhang Rui explained: Worms breed in Liver/Spleen, gather at Dantian during meals to suck blood, disperse to limbs when full. Killing alone isn't enough; must sweep them out. Fasting attracted them (they like wine, lacked earth taste), allowing one dose to clear them. Wu rewarded Zhang heavily. (After evacuation, use Siwu Tang added with Huangqi/Huanglian? Text says "Huang", likely Huangqi or Huanglian depending on context, usually Huangqi for recovery or Huanglian for clearing heat, here likely Huangqi for blood generation or Huanglian for clearing remaining heat. Standard recovery is Siwu Tang + Huangqi). Cai Dingfu Kan's son Kangji suffered from Taenia. Doctor prescribed Areca Nut powder and Pomegranate East-Root decoction. Patient chewed fatty pork fat without swallowing. Theory: Worms' heads point up only before the 3rd day of the month; medication works then. Smell of meat attracts them en masse. Sensation of arrows piercing chest indicates success. Then drink medicine. Cai followed advice. Within 15 minutes, borborygmus, rushed to toilet, expelled worms like pouring, linked in strings, nearly zhang long, still moving. Thrown into stream, cured.