（有虫有积）
虫痛发作无时。随痛随止。发则面色 白。口吐涎沫。腹中痛作疙瘩。脉洪大。目
似痫。宜下之。用木香槟榔丸。苦楝根白皮煎汤送下。先翁用雄黄解毒丸下之。小儿体弱者
。不可下也。用安虫丸以渐去之。
莪术（醋煨） 木香 黄连 青皮 槟榔 使君子 白芜荑仁 白雷丸 苦楝根皮（白者
可用。赤者有毒。各等分。） 上为末。醋面丸。麻子大。白汤下。
家训云。凡欲取虫。须于每月上弦前取之。虫头向上。若望后头向下。不可取也。
王小亭子善食。尝苦虫痛。予用安神丸服之。三日后取下一虫甚异。约长一尺。身赤色
。大如鳝令人手持其两头牵之。长二三尺。形如小线。放下依旧短缩。此虫母也。
胡泮西弟蚤卒。遗子。乃泮西夫人养之。尝苦腹中虫痛。请先翁治之。再三不效。复
治之。予问先翁。曾用何药。翁曰。雄黄解毒丸。予问翁。再有别方否。翁曰。只此一方。
用之屡效。予告翁云。此虫有灵。当设法取之。择定除破日。在每月初旬取之。勿令儿知也
。隔夜煎下苦楝根汤。次日五更与其伯母议。用清油煎鸡子饼一个。先食之。后服药。故不
与食。儿闻其香味。急欲食之。腹中如有物涌上心口。取药与服之。少顷心口之物坠下。以
蛋食之不食也。巳时腹中大鸣而泻。下一虫甚异。约小指长。有头有手足。状如婴儿。予见
之惊曰。此云传痨虫也。泮西云。彼父痨死。母亦痨死。今此儿。正三传也。幸去之矣。令
一婢用铁钳夹之河中。以火焚之。有烟扑入婢口中。其婢亦病痨死。此男无恙。至今诵之。
翁曰。汝用何药。如此神效。余曰。雄黄解毒丸。恐
本县户房吏阎姓者。麻城人也。子有虫痛。黄瘦。腹中时痛。口馋。如有肉食则痛不发
日无肉。则痛发也。请先翁治之。翁命予往。见其子甚弱。不敢下。乃思一计。只用苦楝根
皮。放肉汁中煮食之。单服三日。下虫如蝌蚪者一盆。色黄黑。后以养脾丸调理而安。阎浓
谢。先翁谓先母曰。吾有子矣。往吾教他读书。医出于儒。先母闻之喜。
一儿七岁善食肉。尝病腹痛。其父问曰。积痛虫痛何如。予曰。积痛发有常处。手不可
按。恶食而口干。虫痛无常处。喜手按摩。口馋而吐清水。此儿乃虫痛也。以药取之。下虫
大者十余条而痛止。未一月又痛。予曰。不可再取矣。如不去其虫。则痛不除。积不除。则
虫又生。苟再取之。恐伤胃气不可也。乃立一方。用黄连木香槟榔去积为主。陈皮青皮三棱
莪术枳实山楂。专去其积。使君子白芜荑川楝子苦楝根皮。专去其虫。等分为末。神曲糊丸
。麻子大。米饮下。常服之。时下小虫。及下大虫如指
或问。人腹中皆有蛔虫。何儿之虫独多也。予曰。小儿食伤成积。积化为虫。尝观草腐
萤。木腐而生蠹。人脾虚而虫集。其理一也。或又问。虫之状有不同者。何也。曰。各从其
脏变化也。如心属火化为羽虫。肝属木化为毛虫。肺属金化为介虫。肾属水化为鳞虫。脾属
土化为 虫。故蛔虫 虫出于脾。为土化也。
（由虫积引起的腹痛）
蛔虫疼痛发作没有固定时间。随痛随止。发作时面色苍白。口吐涎沫。腹中疼痛伴有疙瘩感。脉象洪大。眼睛症状类似痫证。适宜使用攻下法治疗。可用木香槟榔丸。用苦楝根白皮煎汤送服。先父曾用雄黄解毒丸进行攻下。若小儿体质虚弱。则不可使用攻下法。应使用安虫丸逐渐消除虫积。
莪术（醋煨制） 木香 黄连 青皮 槟榔 使君子 白芜荑仁 白雷丸 苦楝根皮（白色者可用。红色者有毒。各等分。）以上药材研为细末。用醋和面制成丸剂。大小如麻子。用白开水送服。
家训记载：凡欲驱虫。须在每月初一前（上弦日前）进行。此时虫头向上。若过了十五（望日后）虫头向下。则不可驱虫。
王小亭之子善于进食。曾受虫痛之苦。我使用安神丸给他服用。三日后排出了一条非常奇特的虫。约长一尺。身体赤色。粗如鳝鱼。让人手持其两头拉扯。可拉长至二三尺。形状如小线。放下后依旧短缩。这是母虫。
胡泮西的弟弟早逝。留下一个儿子。由泮西夫人抚养。曾受腹中虫痛之苦。请求先父治疗。反复治疗多次无效。再次求治。我问先父。曾用过什么药？先父说：雄黄解毒丸。我问先父。还有别的方子吗？先父说：只有这一个方子。使用多次都有效。我告诉先父：此虫有灵性。应当设法取出。选定除破日。在每月初旬驱虫。不要让患儿知道。前一天晚上煎好苦楝根汤。第二天五更天与其伯母商议。用清油煎一个鸡蛋饼。先让患儿吃下去。然后再服药。所以不给其他食物。孩子闻到香味。急于想吃。腹中如有物涌上心口。给药服用。不久心口处的东西坠下。因为吃了蛋所以不吐食了。巳时腹中大鸣并腹泻。排出一条非常奇特的虫。约小指长。有头有手足。形状像婴儿。我见到它惊讶地说：这是云传痨虫。泮西说：他的父亲因痨病而死。母亲也因痨病而死。现在这个孩子。正是第三传感染。幸好去除了。让一个婢女用铁钳夹住扔进河里。用火焚烧。烟雾扑入婢女口中。那个婢女也得了痨病死去了。这个男孩安然无恙。至今还在讲述这件事。
先父问：你用什么药？如此神效。我说：雄黄解毒丸。恐怕……
本县户房吏阎姓者。是麻城人。他的儿子有虫痛。面色萎黄消瘦。腹中时常疼痛。嘴馋。如果有肉食则疼痛不发。若无肉。则疼痛发作。请求先父治疗。先父命我去。见其子身体很弱。不敢攻下。于是想出一个计策。只用苦楝根皮。放在肉汁中煮给患儿吃。单独服用三天。排出一盆如蝌蚪般的虫。颜色黄黑。后来用养脾丸调理而痊愈。阎浓道谢。先父对先母说：我有儿子了。以前我教他读书。医学源于儒家学问。先母听了很高兴。
一个七岁儿童善于吃肉。曾患腹痛。他的父亲问：积痛和虫痛有什么区别？我说：积痛发作有固定部位。手不能按压。厌恶进食且口干。虫痛发作无固定部位。喜欢用手按摩。嘴馋且吐清水。这个孩子是虫痛。用药驱虫。排出大虫十余条后疼痛停止。不到一个月又痛。我说：不可再攻下了。如果不去除虫积。疼痛就不会消除。积滞不去。虫又会滋生。如果再攻下。恐怕损伤胃气。不可以这样做。于是立一方。用黄连、木香、槟榔去除积滞为主。陈皮、青皮、三棱、莪术、枳实、山楂。专门去除积滞。使君子、白芜荑、川楝子、苦楝根皮。专门去除虫积。等分为末。神曲糊丸。大小如麻子。米饮送服。常服之。时下小虫。及下大虫如指头粗细。
有人问：人腹中都有蛔虫。为什么这个孩子的虫特别多？我说：小儿饮食损伤形成积滞。积滞化为虫。曾观察草木腐烂生萤。木头腐烂生蠹。人脾虚则虫聚集。道理是一样的。又有人问：虫的形状为何不同？回答说：各自随所属脏腑变化。如心属火化为羽虫。肝属木化为毛虫。肺属金化为介虫。肾属水化为鳞虫。脾属土化为蛲虫。所以蛔虫、蛲虫出于脾。是土化的结果。
(Intestinal Colic due to Parasites and Accumulation)
Parasitic colic occurs at irregular intervals, ceasing as soon as the pain subsides. During an attack, the complexion is pale, saliva is vomited, abdominal pain is accompanied by a sensation of lumps, the pulse is surging (Hong), and the eyes resemble those in epilepsy. Purging (Xia Fa) is indicated. Use Muxiang Binglang Wan (Aucklandia and Areca Pill). Administer with decoction of Cortex Ailanthi Radicis Albus (Ku Lian Gen Bai Pi). My late father used Xionghuang Jiedu Wan (Realgar Detoxification Pill) for purging. However, if the child's constitution is weak, purging should not be used. Instead, An Chong Wan (Parasite-Anchoring Pill) should be used to gradually eliminate the parasites.
Curcumae Rhizoma (Osmorhiza Rhizome prepared with vinegar) (E Zhu, 莪术 - Vinegar-fried) Aquifolii Fructus (Mu Xiang, 木香) Coptidis Rhizoma (Huang Lian, 黄连) Aurantii Fructus Immaturus (Qing Pi, 青皮) Arecae Semen (Bing Lang, 槟榔) Quisqualis Fructus (Shi Jun Zi, 使君子) Galini Semen Album (Bai Wu Yi Ren, 白芜荑仁) Polyporus (Bai Lei Wan, 白雷丸) Cortex Ailanthi Radicis (Ku Lian Gen Pi, 苦楝根皮 - White variety is usable; red variety is toxic. Equal parts.) Grind all into powder. Form pills with vinegar and flour, size of hemp seeds. Administer with warm water.
Family instructions state: To expel parasites, it must be done before the first quarter moon (Shangxian). At this time, the parasite heads face upward. After the full moon (Wang), when heads face downward, expulsion should not be attempted.
Mr. Wang Xiaoting’s son had a good appetite but suffered from parasitic colic. I administered An Shen Wan (Spirit-Calming Pill). Three days later, he expelled a very unusual worm, approximately one chi long, reddish in color, as thick as an eel. When held by both ends and pulled, it could stretch to two or three chi, resembling a thin thread. Upon release, it would shrink back to its original length. This was the mother worm.
Brother Hu Panxi passed away early, leaving a son who was raised by Madam Panxi. He suffered from abdominal parasitic colic and requested treatment from my late father. Repeated treatments were ineffective. Upon seeking further treatment, I asked my late father what medicines had been used. He replied, "Xionghuang Jiedu Wan." I asked if there were other prescriptions. He said, "Only this one, which has been effective repeatedly." I told my late father, "This worm is sentient; we must devise a plan to extract it." We selected a day for expulsion in the early part of the month and ensured the child was unaware. The night before, we decocted Cortex Ailanthi Radicis. At dawn on the second day, we consulted with his aunt. We fried an egg pancake in clear oil and had the child eat it first, followed by the medicine. Since no other food was given, upon smelling the fragrance, the child eagerly wanted to eat. A sensation rose from the abdomen to the heart region. The medicine was administered. Soon, the substance in the heart region descended. Because he had eaten the egg, he did not vomit. At Si hour (9-11 AM), loud borborygmus occurred in the abdomen followed by diarrhea. A very unusual worm was expelled, about the length of a little finger, with a head, hands, and feet, resembling an infant. Seeing it, I exclaimed in surprise, "This is the Yun Chuan Lao Worm (Tuberculosis-transmitting worm)." Panxi said, "His father died of tuberculosis, and his mother also died of tuberculosis. This child is now in the third generation of transmission. Fortunately, it has been removed." A maid was instructed to clamp the worm with iron tongs and throw it into the river, then burn it. Smoke entered the maid's mouth, and she subsequently died of tuberculosis. The boy remained healthy and still recounts this story today.
My late father asked, "What medicine did you use? It is so miraculous." I replied, "Xionghuang Jiedu Wan. Perhaps..."
The clerk Yan from the Household Office of the county magistrate, originally from Macheng, had a son with parasitic colic. The son was sallow and emaciated, with intermittent abdominal pain and cravings. Pain did not occur if meat was consumed; however, if no meat was available, pain would arise. He requested treatment from my late father. My late father sent me. Observing the son's weak constitution, I dared not use purgatives. Thus, I devised a strategy: using only Cortex Ailanthi Radicis, boiled in meat broth for consumption. Taken alone for three days, a basin full of tadpole-like worms were expelled, yellowish-black in color. Subsequently, Yang Pi Wan (Spleen-Nourishing Pill) was used for regulation, leading to recovery. Yan Nong expressed gratitude. My late father said to my late mother, "I have gained a son [in terms of medical lineage/apprenticeship]. Previously, I taught him to read. Medicine originates from Confucian scholarship." My late mother was delighted.
A seven-year-old boy with a strong preference for meat suffered from abdominal pain. His father asked, "How do accumulation colic and parasitic colic differ?" I said, "Accumulation colic occurs at fixed locations, cannot be pressed, involves aversion to food, and dry mouth. Parasitic colic occurs at variable locations, prefers massage, involves cravings, and vomiting of clear fluid. This child has parasitic colic." Medication was used to expel parasites. Over ten large worms were expelled, and the pain ceased. Within a month, pain recurred. I said, "Purging should not be repeated. If the parasite accumulation is not removed, the pain will not cease. If the accumulation is not cleared, new parasites will generate. Further purging might damage Stomach Qi, which is inadvisable." Therefore, a prescription was formulated: Huang Lian (Coptidis Rhizoma), Mu Xiang (Aquifolii Fructus), and Bing Lang (Arecae Semen) to primarily remove accumulation. Chen Pi (Citri Reticulatae Pericarpium), Qing Pi (Aurantii Fructus Immaturus), San Leng (Sparganii Rhizoma), E Zhu (Curcumae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), and Shan Zha (Crataegi Fructus) specifically target accumulation. Shi Jun Zi (Quisqualis Fructus), Bai Wu Yi (Galini Semen Album), Chuan Lian Zi (Toosendan Fructus), and Ku Lian Gen Pi (Cortex Ailanthi Radicis) specifically target parasites. Equal parts were ground into powder, formed into pills with Shen Qu (Medicated Leaven paste), size of hemp seeds, and administered with rice drink. Regular use results in the gradual expulsion of small worms, and occasionally large worms the thickness of a finger.
Someone asked, "All humans have Ascaris lumbricoides in their intestines. Why does this child have so many?" I said, "Childhood dietary injury leads to accumulation, which transforms into parasites. I have observed that rotting grass produces fireflies, and rotting wood produces termites. Similarly, when the Spleen is deficient, parasites gather. The principle is the same." Another asked, "Why do the shapes of parasites differ?" I answered, "They transform according to their associated Zang organs. Heart belongs to Fire and transforms into feathered parasites; Liver belongs to Wood and transforms into hairy parasites; Lung belongs to Metal and transforms into shelled parasites; Kidney belongs to Water and transforms into scaled parasites; Spleen belongs to Earth and transforms into earthworm-like parasites. Therefore, Ascaris and Enterobius originate from the Spleen, resulting from Earth transformation."