虫由湿热郁蒸而生，观之日中有雨，则禾节生虫，其理明矣。善乎，张戴人推言之也，曰∶水火
属春夏，湿土属季夏，水从土化，故多虫焉。人患虫积，多由饥饱调 失宜，或过餐鱼 白酒，或多
食牛羊，或误啖鳖苋，中脘气虚，湿热失运，故生寸白诸虫，或如蚯蚓，或似龟鳖，小儿最多，大人
间有。其候心嘈腹痛，呕吐涎沫，面色痿黄，眼眶鼻下青黑，以致饮食少进，肌肉不生，沉沉默默欲
眠，微有寒热，如不早治，相生不已。古人云∶虫长一尺则能害人，虫若贯串，杀人甚急。
治法追虫取积，以剪红丸、尊神丸、遇仙丹。夫人腹中有 虫，此物与人俱生，而为人大害。 虫之
形，状似大马尾，或如薄筋，根据脾而居，乃有头尾，皆长三寸。又有九虫∶一曰伏虫，长四分；二曰
蛔虫，长一尺；三曰白虫，长一寸，四曰肉虫，状如烂杏；五曰肺虫，状如蚕；六曰胃虫，状如虾蟆；
七曰弱虫，状如瓜瓣；八曰赤虫，状如生肉；九曰蛲虫，至细微，形如菜虫状。伏虫则群虫之主也；
蛔虫贯心杀人；白虫相生，子孙转多，其母转大，长至四五丈，亦能杀人；肉虫令人烦满；肺虫令人
咳嗽；胃虫令人呕吐，胃逆喜哕；弱虫又名膈虫，令人多唾；赤虫令人肠鸣；蛲虫居胴肠之间，多则
为痔，剧则为癞，因生疮痍，即生诸痈疽、癣 疥。龋虫无所不为，人亦不必尽有，有亦不必尽多，
或偏有，或偏无类，妇人常多，其虫凶恶，人之极患也。常以白筵草沐浴隹，根叶皆可用，既是香草，
且是 虫所畏也。凡欲服补药及治诸病，皆须去诸虫，并痰饮宿 ，醒醒除尽，方可服补药。不尔，
必不得药力。凡得伤寒及天行热病，腹中有热，又人食少，肠胃空虚，三虫行作求食，蚀人五脏及下
部。若齿 无色，舌上尽白，甚者唇里有疮，四肢沉重，忽忽喜眠。当数看其上唇内有疮。唾血，唇
内如粟疮者，心内懊 痛闷，此虫在上蚀
也。九虫皆由脏腑不实，脾胃皆虚，杂食生冷、甘肥油腻、咸脏等物，节宣不时，腐败停滞，所以发
动。又有神志不舒，精魄失守，及五脏劳热，又病余毒，气血积郁而生。或食瓜果与畜兽五内，遗留
诸虫子类而生。虫之为候，呕恶吐涎，口出清沫，痛有去来，乍作乍止。寸白虫色白形褊，损人精气，
力乏腰疼。蛲虫细如菜虫，能为痔漏、疮癞、疥癣、痈疽等患。寸白、蛲、蛔是三者，皆九虫数中之
一物也。外此又有儿童疳 ，昏睡烦躁，鼻烂汁臭，齿 生疮，下利黑血。虫食下部为狐，下唇有疮；
虫食其脏为惑，上唇有疮。三虫者，谓长虫、赤虫、蛲虫也。乃有九种。而蛲虫及寸白人多病之。寸
白从食牛肉饮白酒所成，相连一尺则杀人，服药下之，须结裹溃然出尽乃佳，若断者相生未已，更宜
速治之。蛲虫多是小儿患之，大人亦有，其病令人心痛，清朝口吐汁、烦躁则是也。其余各种，皆不
利人，人胃无不有者，宜服九虫丸以除之。蛔虫者，是九虫之一也，长一尺，亦有长五六寸。或因脏
腑虚弱而动，或因食甘肥而动，其发动则腹中痛，发作种聚，行来上下，痛有
休息，亦攻心痛，腹中热，口中喜涎，及吐清水，贯伤心者则死。诊其脉，腹中痛、其脉法当沉弱弦，
今反洪而大，则蛔虫也。蛔虫，九虫之数，人腹中皆有之。小儿失乳而哺早，或食甜过多，胃虚虫动，
令人腹痛恶心，口吐清水，腹上有青筋。火煨史君子与食，以壳煎汤送下，甚妙。然世人多于临卧服
之，又无日分，多不验。唯是于月初四五间，五更服之。至日午前虫尽下，可以和胃温平药，一两日
调理之，不可多也。九虫在人腹中，月上旬头向上，中旬横之，下旬头向下，故中下旬用药即不入虫
口，所以不验也。牛马之生子，上旬生者行在母前，中旬生者并肩而行，下旬生者后随之。猫之食鼠
亦然，上旬食上段，中旬中段，下旬下段，自然之理，物皆由之而莫知之。客座新闻云∶青阳夏戚宗
阳家，素业医，任江阴训科。有儒生之父患腹胀，求其诊视，乃曰∶脉洪而大，湿热生虫之象，况饮
食如常，非水肿蛊胀之证，以石榴皮、椿树各东行根，加槟榔，三味各五钱，用长流水煎，空心顿服
之。少顷，腹作大痛，泻下长虫一丈许，遂愈。《本事方》云∶肺虫如蚕能杀人，居肺叶之内，蚀人
肺系，故成瘵疾，由是咳嗽咯血声嘶，药所不到，治之为难。《道脏经》中载∶诸虫头皆向下，唯自
初一至初五以前虫头向上，故用药多取效者此也。
又姚宽《西溪丛话》云∶五脏虫皆上行，唯有肺虫下行最难治。用獭爪为末调药，于初四、初六日治
之，此日肺虫上行也。二说小异，姑两存之，以备参考。泊宅编永州通判厅军员毛景得奇疾，每语喉
中必有物作声相应，有道人教令诵本草药名，至蓝而默然，遂取蓝捩汁而饮之，少顷，吐出肉块长一
寸余，人形悉具，自后无声。陈正敏《遁斋闲览》载∶杨 中年得异疾，每发言应答，腹中有小声效
之，数年间其声浸大，有道人见而惊曰，此应声虫也，久不治延及妻子，宜读本草，遇虫不应者，当
取服之。 如言读至雷丸，虫无声，乃顿服之，遂愈。正敏后至长沙，遇一丐者，亦有是疾，环而观
之甚众，教使服雷丸，丐者亦愈。丁志记∶齐州士曹席进孺，招所亲张彬秀才为馆舍，彬嗜酒，每夜
必置数升于床隅，一夕忘设，至夜半大渴，求之不可得，忿闷呼躁，俄顷，呕吐一物于地，旦起视之，
见床下肉块如肝而黄，上如蜂窠，犹微动，取酒沃之，唧唧有声，始悟平生酒病根本，亟投诸火中，
后遂不饮。庚志记∶赵子山字景高，寓居邵武军天王寺，苦寸白虫为挠。医者戒云∶是疾当止酒。而
以素所耽嗜，欲罢不能，一夕醉于外，舍归已夜半，口干咽燥，仓卒无汤饮，适廊庑下有瓮水，月色
下照莹然可掬，即酌而饮之，其甘如饴，连饮数酌，
乃就寝，迨晓虫出盈席，觉心腹顿宽，宿疾遂愈。一家皆惊异，验其所由，盖寺仆日织草履，浸红藤
根水也。吴少师在关外，尝得疾，数月间肌肉消瘦，每日饮食下咽少时，腹如万虫攒攻，且痒且痛，
皆以为劳瘵也。张锐是时在成都，吴遣驿骑招致锐到兴元既切脉戒云∶明日早，且忍饥，勿啖一物，
俟锐来为之计。旦而往，天方剧暑，白请选一健卒，趋往十里外，取行路黄土一银盂，而令厨人旋治
面，将午乃得食，才放箸，取土适至，于是温酒一升，投土搅其内，出药百粒，进于吴饮之，觉肠胃
掣痛，几不堪忍，急登溷，锐密使别坎一穴，便掖吴以行，须臾，暴下如倾秽恶斗许，有马蝗千余，
宛转盘结，其半已困死。吴亦惫甚，扶憩竹榻上，移时方餐粥一器，三日而平。始信去年正以夏夜出
师，中涂躁渴，命候兵持马盂挹涧水，甫入口似有物焉，未暇吐之，则径入喉矣，自此遂得病。锐曰∶
虫入人肝脾里，势须滋生，常日遇食时则聚丹田间，吮咂精血，饱则散处四肢，苟惟知杀之而不能扫
尽，故无益也。锐是以请公枵腹以诱之，此虫喜酒，又久不得土味，乘饥毕集，故一药能洗空之耳。
吴大喜，浓赂以金帛，送之归。（泻出后，宜以四物汤加黄 煎服，生血调理）。蔡定夫戡之子康积
苦寸白为孽，医者使之碾槟榔细末，取石榴东引根煎汤调服之，
先炙肥猪肉一大脔，置口中嚼咀其津膏而勿食。云此虫惟月三日以前其头向上，可用药攻打，余日即
头向下，纵有药皆无益。虫闻肉香咂啖之意，故空群争赴之，觉胸中如万箭攻攒，是其候也。然后饮
前药。蔡悉如其戒，不两刻腹中雷鸣，急登厕，虫下如倾，命仆以杖挑拨，皆联绵成串，几长数丈，
尚蠕蠕能动，举而抛于溪流，宿患顿愈。
虫是由湿热郁结蒸腾而产生的，观察自然界可知，白天若下雨，禾苗的节间就会生虫，其中的道理是很明显的。张戴人对此推论得非常好，他说：水和火属于春夏季节，湿土属于夏末秋初（季夏），水在土中转化，所以容易滋生虫子。人患虫积，大多是因为饥饱失调，或者过量食用鱼、酒，或者多吃牛羊肉类，或者误食鳖、苋菜等，导致中脘气虚，湿热运化失常，从而生出寸白虫等各种寄生虫，有的像蚯蚓，有的像龟鳖，小儿最为多见，大人偶尔也有。其症状表现为心中嘈杂腹痛，呕吐涎沫，面色萎黄，眼眶及鼻下呈现青黑色，以致饮食减少，肌肉消瘦，精神萎靡嗜睡，伴有轻微的寒热感，如果不早点治疗，虫子会相生繁衍不止。古人说：虫子长到一尺就能害人，如果虫子贯穿身体，杀人非常迅速。
治疗方法是驱虫消积，使用剪红丸、尊神丸、遇仙丹。人腹中有虫，这种生物与人共生，却对人造成极大危害。虫的形状，状似大马尾，或像薄筋，依附于脾脏居住，有头有尾，都长三寸。又有九种虫：一是伏虫，长四分；二是蛔虫，长一尺；三是白虫，长一寸；四是肉虫，形状像烂杏；五是肺虫，形状像蚕；六是胃虫，形状像蛤蟆；七是弱虫，形状像瓜瓣；八是赤虫，形状像生肉；九是蛲虫，极其细微，形状像菜虫。伏虫是群虫的首领；蛔虫贯穿心脏可致人死亡；白虫相生，子孙越来越多，母虫变得更大，长达四五丈，也能杀人；肉虫让人烦闷胀满；肺虫让人咳嗽；胃虫让人呕吐，胃气上逆喜欢打嗝；弱虫又名膈虫，让人多唾；赤虫让人肠鸣；蛲虫居住在直肠之间，多了会长痔疮，严重了会长癞疮，因为生疮疡，进而产生各种痈疽、癣疥。龋虫无所不为，人也不一定全都有，有也不一定全很多，有的偏有，有的偏无，种类各异，妇人常较多，这种虫凶恶，是人的极大祸患。常用白筵草沐浴，根叶都可以用，它既是香草，也是虫子所畏惧的。凡是想要服用补药及治疗各种疾病，都必须先去除诸虫，并将痰饮宿垢彻底清除干净，才可以服用补药。不然，一定无法发挥药效。凡是得了伤寒及天行热病，腹中有热，加上人吃得少，肠胃空虚，三虫活动寻找食物，侵蚀人的五脏及下部。如果牙齿无色，舌苔全白，严重的嘴唇里有疮，四肢沉重，恍惚喜睡。应当经常查看其上唇内是否有疮。吐血的，嘴唇内有如粟米大小的疮的，心里懊恼痛闷，这是虫在上部侵蚀所致。九虫都是由脏腑不实，脾胃虚弱，杂食生冷、甘肥油腻、咸味内脏等物，生活起居不规律，腐败停滞，所以引发。又有神志不舒，精魄失守，以及五脏劳热，还有病后余毒，气血积郁而生。或者吃瓜果与畜兽的内脏，遗留诸虫卵类而生。虫的症状，呕恶吐涎，口出清沫，疼痛时去时来，忽作忽止。寸白虫色白形扁，损耗人的精气，使人乏力腰痛。蛲虫细如菜虫，能引起痔漏、疮癞、疥癣、痈疽等病患。寸白、蛲、蛔这三种，都是九虫中的一种。除此之外又有儿童疳积，昏睡烦躁，鼻子腐烂流臭汁，牙龈生疮，下利黑血。虫侵蚀下部为狐惑病的“狐”，下唇有疮；虫侵蚀内脏为“惑”，上唇有疮。三虫，指的是长虫、赤虫、蛲虫。共有九种。而蛲虫及寸白虫人多患病。寸白虫因吃牛肉喝白酒而成，相连一尺则杀人，服药驱虫，必须包裹溃烂排出干净才好，如果断开则相生未已，更应速治。蛲虫多是小儿患病，大人也有，其病让人心痛，清晨口吐汁液、烦躁就是此症。其余各种虫都不利于人，人胃无不有者，宜服九虫丸以除去它们。蛔虫，是九虫之一，长一尺，也有长五六寸的。或因脏腑虚弱而动，或因吃甘肥而动，其发作时腹中痛，发作时聚集成团，上下移动，疼痛有时休息，也攻心痛，腹中热，口中喜欢流涎，以及吐清水，贯穿伤心者则死。诊察其脉象，腹中痛，脉法应当沉弱弦，现在反而洪大而，则是蛔虫。蛔虫，属九虫之数，人腹中皆有之。小儿断奶过早或喂食甜食过多，胃虚虫动，让人腹痛恶心，口吐清水，腹部有青筋。用火煨使君子给患者吃，或用壳煎汤送下，效果很好。然而世人多在临睡前服用，又没有固定日期，大多无效。唯有在月初四五之间，五更时分服用。到日午前虫子全部排下，可以配合和胃温平的药物，调理一两日，不可多用。九虫在人腹中，月上旬头向上，中旬横卧，下旬头向下，所以下中旬用药即不入虫口，所以无效。牛马生子，月上旬生的走在母前，中旬生的并肩而行，下旬生的跟随在后。猫吃老鼠也是这样，月上旬吃上段，中旬中段，下旬下段，这是自然之理，万物皆由之而无人知晓。《客座新闻》记载：青阳夏戚宗阳家，世代行医，担任江阴训科。有一儒生的父亲患腹胀，求其诊治，他说：脉象洪大而，是湿热生虫的迹象，况且饮食如常，不是水肿蛊胀的病证，用石榴皮、椿树各东向生长的根，加槟榔，三味药各五钱，用长流水煎煮，空腹顿服。不久，腹部剧烈疼痛，泻下一条长约一丈的大虫，于是痊愈。《本事方》说：肺虫像蚕能杀人，居住在肺叶之内，侵蚀人的肺系，所以形成瘵疾，由此咳嗽咯血声嘶，药物难以到达，治疗很困难。《道藏经》中记载：诸虫头皆向下，唯独从初一至初五以前虫头向上，所以用药多有效的原因就在这里。
另外姚宽《西溪丛话》说：五脏虫都上行，唯有肺虫下行最难治。用獭爪研末调药，在初四、初六日治疗，这两天肺虫上行。两种说法略有不同，暂且并存，以备参考。《泊宅编》记载永州通判厅军员毛景得奇疾，每次说话喉咙中必有物体发声相应，有道教人士教他诵读本草药名，读到“蓝”字时沉默无声，于是取蓝草榨汁饮用，不久，吐出一块长一寸多的人形肉块，从此不再有声。陈正敏《遁斋闲览》记载：杨亿中年得异疾，每次发言应答，腹中有小声模仿，几年间声音逐渐变大，有道教人士见而惊曰，这是应声虫，久不治会延及妻子，宜读本草，遇到虫不应声的，应当取来服用。杨亿照言读至雷丸，虫无声，于是顿服，遂愈。正敏后到长沙，遇到一个乞丐，也有此病，围观者甚众，教其服用雷丸，乞丐也痊愈。丁志记载：齐州士曹席进孺，邀请亲戚张彬秀才做馆舍客，张彬嗜酒，每晚必放数升酒在床角，一晚忘记放置，半夜大渴，找不到酒，愤怒焦躁，片刻，呕吐一物在地上，早晨起来看，见床下肉块像肝一样黄，上面像蜂巢，还在微微蠕动，取酒浇在上面，发出唧唧声，才明白平生酒病的根本，急忙投入火中，此后便不再饮酒。庚志记载：赵子山字景高，寓居邵武军天王寺，苦于寸白虫骚扰。医生告诫说：此病应当戒酒。但他平时沉迷其中，想戒不能，一晚在外醉归，到家已是半夜，口干咽燥，匆忙无汤饮，恰逢廊庑下有瓮水，月光下照得晶莹可掬，就舀来饮用，甘甜如饴，连喝几口，就去睡觉，等到天亮虫子出来铺满席子，觉得心腹顿时宽松，宿疾遂愈。全家都惊异，验证其原因，原来是寺里仆人每天编织草鞋，浸泡红藤根水所致。吴少师在关外，曾得病，几个月间肌肉消瘦，每天饮食下咽少许，腹中如万虫攒攻，又痒又痛，大家都认为是劳瘵病。张锐当时在成都，吴派驿骑招致张锐到兴元，切脉后告诫说：明天早上，暂且忍饥，不要吃任何东西，等我来了再想办法。早晨前往，天气正炎热，张锐请选一名健卒，快去十里外，取行路黄土一银盂，并让厨人现做面条，将近中午才吃到饭，刚放下筷子，取土刚好送到，于是温酒一升，投入黄土搅动其中，取出药百粒，给吴饮用，感觉肠胃牵拉疼痛，几乎难以忍受，急忙上厕所，张锐秘密让人挖一个坑，搀扶吴过去，片刻，暴泻如倾，污秽斗许，有马蝗千余条，宛转盘结，一半已经困死。吴也非常疲惫，扶靠在竹榻上休息，过了一会儿才吃了一碗粥，三天才平复。这才相信去年夏天夜间出兵，中途烦躁口渴，命令候兵持马盂舀涧水，刚入口似乎有东西，没来得及吐出，就直接进入喉中，从此便得病。张锐说：虫进入人肝脾里，势必滋生，平日遇到进食时则聚集在丹田田间，吮吸精血，吃饱则散处四肢，如果只知道杀而不能扫尽，所以无益。张锐因此请求空腹以引诱它们，这些虫喜欢酒，又久不得土味，乘饥毕集，所以一药能洗空它们。吴大喜，重金贿赂，送他回去。（泻出后，宜以四物汤加黄芩煎服，生血调理）。蔡定夫戡之子康积苦于寸白虫为害，医生让他碾槟榔细末，取石榴东引根煎汤调服，先烤一大块肥肉，放在口中咀嚼其津膏而不吞食。说此虫只在月初三日以前头向上，可用药攻打，其余日子即头向下，纵有药也无益。虫闻到肉香咂啖之意，故空群争赴之，感觉胸中如万箭攒射，是其征兆。然后饮前药。蔡完全听从告诫，不到一刻钟腹中雷鸣，急登厕所，虫下如倾，命仆人以杖挑拨，都连绵成串，几乎长数丈，还蠕蠕能动，举起抛入溪流，宿患顿愈。
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.