小便白如米泔者，内乳哺失节，有伤于脾，致令清白不分而色白也，久则成疳，此亦心膈伏热兼而得之，茯苓散主
之可也。
又云小便白如米泔者，乃脾胃受寒而得，脾属阴，脾遇寒则饮食愈积滞而不化，胃气愈乖戾而不和，致使传送失常，
水火不济，故色白也。
〔附方〕
茯苓散 三棱 莪术 砂仁 赤茯苓 青皮 陈皮 滑石 甘草
总括 虫虽湿热感而生，亦因伤积借成形；九种虫名宜认晓，追安二字可详行。
脉法 虫脉当沉细而弦，今反洪大即知蛔虫甚也，脉沉实者生，虚大者死。
《内经》曰∶肠胃为市，无物不受，无物不包。又曰∶饮食自倍，肠胃乃伤。夫饮食不能谨节，则早损暮伤，自伤
成积，积久成热，湿热相生，而诸般奇形之虫，各从五行之气而化生矣，若腐草为萤是也。其虫或脏腑虚弱而动，或食
肥甘而动，或胃冷而动，或胃热而动。动则往来上下，腹痛攻心，绞痛叫哭，仰身挥手，心神闷乱，吐涎味沫，或吐清
水，腹上青筋是其候也。
巢氏曰∶蛔虫，九虫之一也，生生不息，多则贯心，便能杀人，以追虫丸、安虫散主之。
九虫形症∶一曰伏虫，长四寸许，为诸虫之主；二曰蛔虫；三曰白虫，长四五寸许，母子相生，其形转大而长，亦能杀
人；四曰内虫，状如烂杏，生之令人心烦；五曰肺虫，其状如蚕，令人咳嗽；六曰 虫，状如虾蟆，令人呕吐咳逆；七
曰弱虫，又名膈虫，状如瓜瓣，令人多睡；八曰赤虫，状如生肉，令人肠鸣；九曰蛲虫，状如菜虫，形至微细，居广肠，
多则为痔，剧则为癞。因人疮处以生，又如鼷鼠、应声虫之类，未易悉举。（批∶上唇有疮曰惑，虫食其脏；下唇有疮曰
狐，虫食其肛。）
〔附方〕
追虫丸 槟榔 芜荑 雷丸 定粉 鹤虱 使君子肉
安虫丸 鹤虱 槟榔 胡粉 白矾 川楝根 半生半熟，食前米饮调服。
小便颜色白如米泔水，是因为哺乳喂养不当，损伤了脾胃，导致清浊不分而呈现白色。若病程长久，会发展为疳积病证。这也是心膈间伏热兼夹此症所致，可用茯苓散主治。
另一种说法认为，小便白如米泔，是由于脾胃受寒所致。脾属阴脏，脾遇寒邪则饮食更加积滞不化，胃气更加乖戾不和，致使传导功能失常，水火不能既济，所以小便色白。
〔附方〕
茯苓散：三棱、莪术、砂仁、赤茯苓、青皮、陈皮、滑石、甘草。
总括：虫证虽由湿热感受而生，但也因伤食积滞借以成形；九种虫的名称应当认清，追安（指追虫丸和安虫散）二字可以详细施行。
脉法：虫证的脉象应当沉细而弦，如果反而洪大，就知道是蛔虫病严重。脉象沉实的预后良好（生），脉象虚大的预后不良（死）。
《黄帝内经》说：肠胃如同集市，没有东西不接受，没有东西不包容。又说：饮食过量一倍，肠胃就会受伤。如果饮食不能谨慎节制，就会早晚受损，自我伤害形成积滞，积滞久了产生热邪，湿热相生，各种奇形怪状的虫子，便随着五行之气而化生，就像腐草化为萤火虫一样。这些虫子或因脏腑虚弱而发动，或因食用肥甘厚味而发动，或因胃冷而发动，或因胃热而发动。虫子发动时，上下往来窜动，腹痛攻心，绞痛难忍甚至叫哭，仰身挥手，心神烦闷混乱，吐涎沫或清水，腹部出现青筋，这些都是其征候。
巢元方说：蛔虫是九虫之一，生生不息，数量多时会贯穿心脏，便能致人死亡，应用追虫丸、安虫散主治。
九虫的形态与症状：一是伏虫，长约四寸左右，是各种虫的主帅；二是蛔虫；三是白虫，长约四五寸左右，母子相生，形状逐渐变大变长，也能致人死命；四是内虫，形状像烂杏，生出它使人感到心烦；五是肺虫，形状像蚕，使人咳嗽；六是蛲虫（原文缺字，据上下文及常见九虫论推测为“肉虫”或类似，此处依原文留空或通假，但根据后文“状如虾蟆”通常指肉虫或类似的描述，此处按原文转录为“虫”），形状像蛤蟆，使人呕吐咳逆；七是弱虫，又名膈虫，形状像瓜瓣，使人嗜睡；八是赤虫，形状像生肉，使人肠鸣；九是蛲虫，形状像菜虫，形体极其微小，居住在广肠（大肠末端），多了会导致痔疮，严重时会导致癞病。它们因人体疮疡部位而生，又如鼷鼠、应声虫之类，难以一一列举。（批注：上唇有疮称为惑，是虫蚀内脏；下唇有疮称为狐，是虫蚀肛门。）
〔附方〕
追虫丸：槟榔、芜荑、雷丸、定粉、鹤虱、使君子肉。
安虫丸：鹤虱、槟榔、胡粉、白矾、川楝根。半生半熟，饭前用米汤调服。
If the urine is white like rice washings, it is due to irregular breastfeeding or feeding, which damages the Spleen and Stomach, causing the clear and turbid to fail to separate, resulting in a white color. If prolonged, it may develop into *Gan* disease (infantile malnutrition syndrome). This condition can also be caused by latent heat in the Heart and Diaphragm combined with this symptom; it can be treated with *Fuling San*.
Another view states that urine white like rice washings results from Cold invading the Spleen and Stomach. The Spleen belongs to Yin; when affected by Cold, food and drink become more stagnant and fail to transform, while Stomach Qi becomes rebellious and disharmonious. This leads to abnormal transportation and transformation, failure of Water and Fire to interact, and thus white-colored urine.
[Attached Formula]
*Fuling San* (Poria Decoction): *Sanleng* (Sparganii Rhizoma), *Ezhu* (Curcumae Rhizoma), *Sharen* (Amomi Fructus), *Chifuling* (Poria cum Ligno Rubrum), *Qingpi* (Aurantii Fructus Immaturus Pericarpium), *Chenpi* (Citri Reticulatae Pericarpium), *Huashi* (Talcum), *Gancao* (Glycyrrhizae Radix et Rhizoma).
Summary: Although worms are generated by Damp-Heat, they also take form by borrowing from food stagnation. The names of the nine types of worms should be clearly recognized; "Zhui An" (referring to *Zhui Chong Wan* and *An Chong San*) can be applied in detail.
Pulse Diagnosis: The pulse for worm conditions should be deep, fine, and wiry. If it is instead surging and large, it indicates severe roundworm (*Hui Chong*) infestation. A deep and solid pulse indicates survival, while a deficient and large pulse indicates death.
The *Neijing* (Inner Canon) states: The intestines and stomach are like a market, accepting and containing all things. It also states: If food intake doubles, the intestines and stomach will be injured. If dietary habits are not cautious, damage occurs morning and night, leading to self-inflicted accumulation. Prolonged accumulation generates Heat; Dampness and Heat generate each other, and various worms with strange shapes are born according to the Qi of the Five Phases, just as decaying grass transforms into fireflies. These worms may move due to deficiency of the Zang-Fu organs, consumption of rich and sweet foods, Cold in the Stomach, or Heat in the Stomach. When active, they move up and down, causing abdominal pain attacking the heart, colicky pain with crying, arching the back and waving hands, mental confusion, spitting saliva or foam, or vomiting clear water. Green veins on the abdomen are signs of this condition.
Chao Yuanfang stated: Roundworms (*Hui Chong*) are one of the nine worms, reproducing endlessly. If numerous, they can pierce the heart and cause death; they should be treated with *Zhui Chong Wan* and *An Chong San*.
Forms and Symptoms of the Nine Worms:
1. *Fu Chong* (Hidden Worm): About four cun long, it is the leader of all worms.
2. *Hui Chong* (Roundworm).
3. *Bai Chong* (White Worm): About four to five cun long, mother and son reproduce mutually, growing larger and longer, and can also cause death.
4. *Nei Chong* (Internal Worm): Resembles rotten apricot kernels, causing irritability.
5. *Fei Chong* (Lung Worm): Resembles a silkworm, causing coughing.
6. [Text missing character, likely referring to a specific worm type]: Resembles a toad, causing vomiting and coughing with reverse flow of Qi.
7. *Ruo Chong* (Weak Worm), also known as *Ge Chong*: Resembles melon seeds, causing excessive sleepiness.
8. *Chi Chong* (Red Worm): Resembles raw meat, causing borborygmus (intestinal rumbling).
9. *Tao Chong* (Pinworm): Resembles vegetable worms, extremely minute in shape, residing in the *Guang Chang* (large intestine/rectum). Numerous cases lead to hemorrhoids; severe cases lead to leprosy-like diseases. They arise from sores in the body, such as mice or echoing worms, which are difficult to list completely. (Commentary: Sores on the upper lip are called *Huo*, indicating worms eating the viscera; sores on the lower lip are called *Hu*, indicating worms eating the anus.)
[Attached Formulas]
*Zhui Chong Wan* (Worm-Chasing Pill): *Binglang* (Arecae Semen), *Wuyi* (Euodiae Fructus), *Leiyuan* (Ovum Ascaris), *Dingfen* (Lead Oxide), *Heshi* (Chrysanthemi Indici Flos), *Shijunzi Rou* (Quisqualis Semen).
*An Chong Wan* (Worm-Calming Pill): *Heshi* (Chrysanthemi Indici Flos), *Binglang* (Arecae Semen), *Hufen* (Lead Carbonate), *Baifan* (Alumen), *Chuanliangen* (Meliae Radicis Cortex). Half raw, half roasted; taken before meals mixed with rice water.