陈（七岁） 湿伤。脾胃失调。下注小肠。虫从溺窍而出。粪溏完谷。不可温补。（湿热）
黄柏 茯苓 猪苓 槐米 泽泻 萆
又 虫自小便而出。经月泻皆粘腻及不化食物。此非虚寒。皆湿 内蕴。运化失司。当苦药胜
湿兼理幼稚疳积。
黄连 黄柏 茅术 浓朴 泽泻 槐角子 木通 使君子 淡竹叶 三服后续进肥儿丸
龚（七岁） 湿热生虫。腹痛便溏。恶食。
川连 胡连 生白芍 乌梅 枳实 川椒 炒楂 青皮 水法丸。
许 肠有湿热生 虫。用苦寒引导小肠。
苦楝皮 北秦皮 槐角子 胡粉 黄柏 牡蛎 生研末。猪肚肠一条漂洁。煮丸。
张（十三） 丹溪云。小儿盗汗不须医。以体属纯阳。汗乃阳泄故也。至于疮多。湿热浮肿胀满。得攻
下而消。此六腑以通为补也。其少腹痛屡发。亦由湿热生虫生积。当以酸苦泄热。
川连 胡连 生白芍 鸡肫皮 炒楂肉 芦荟 枳实 苦楝皮 乌梅肉捣丸。
汪（十六） 肛漏时肿。泻过白虫。手足阳明热甚。（阳明热）
槐角子 黄柏 榧子肉 生茅术 樗根白皮 小川连
茯苓 炒地榆 蒸饼为丸。
虫类虽多。其源皆由饮食停滞。湿热郁蒸。变化而成者也。凡面色痿黄。饮食不为肌肤。起
伏作痛。聚散不定。痛止即能饮食者。皆有虫积。或从呕。或从小便。或从大便而出。治法当
观其微甚。若虫势骤急者。当用攻逐之剂。如黑丑槟榔大黄胡粉山棱莪术之类。虫去则
调其脾胃。缓者用酸苦泄热燥湿。兼以相制相畏之品。如川连胡连芦荟苦楝乌梅川椒
雷丸芜荑使君榧肉之类。脾弱者兼运其脾。胃滞者兼消其滞。虫症治法。大略如此。（陆履安）
徐评 治虫有缓治之法。其病势甚轻。而日久当用膏丸等药。兼补兼消之。若病势危急者。必
另有峻厉之方。并奇药秘方。可杀虫去积。否则元气消乏。不可补救矣。
陈（七岁）：湿气损伤身体。脾胃功能失调，湿邪下注于小肠，导致寄生虫从尿道口排出。大便稀溏且含有未消化的食物残渣，此时不可使用温补法。（病机为湿热）
处方：黄柏、茯苓、猪苓、槐米、泽泻、萆薢。
又诊：寄生虫从小便排出，持续一个月腹泻，粪便粘腻且含有未消化的食物。这并非虚寒证，而是湿气内蕴，运化功能失常。应当用苦味药物胜湿，同时调理小儿疳积。
处方：黄连、黄柏、苍术、厚朴、泽泻、槐角子、木通、使君子、淡竹叶。服用三剂后，后续进服肥儿丸。
龚（七岁）：湿热滋生寄生虫，腹痛，大便稀溏，厌恶进食。
处方：川黄连、胡黄连、生白芍、乌梅、枳实、川椒、炒山楂、青皮。制成水泛丸。
许：肠道内有湿热滋生寄生虫。用苦寒药物引导药力入小肠。
处方：苦楝皮、北秦皮、槐角子、胡粉、黄柏、牡蛎。研成细末。取一条猪大肠漂洗干净，煮烂后与药末混合制丸。
张（十三岁）：朱丹溪曾说，小儿盗汗不需要治疗，因为小儿体质属纯阳，汗液是阳气外泄的表现。至于疮疡较多，湿热浮盛导致肿胀满闷，通过攻下法即可消除。这就是六腑以通畅为补益的道理。其少腹部疼痛屡次发作，也是由湿热滋生寄生虫和食积所致。应当用酸苦之法泄热。
处方：川黄连、胡黄连、生白芍、鸡肫皮、炒山楂肉、芦荟、枳实、苦楝皮、乌梅肉。捣碎后制成丸剂。
汪（十六岁）：肛漏时常肿胀，腹泻时排出白色寄生虫。手足阳明经热势很盛。（病机为阳明热）
处方：槐角子、黄柏、榧子肉、生苍术、樗根白皮、小川黄连。
另配：茯苓、炒地榆。用蒸饼糊作为粘合剂制成丸剂。
虫类虽然种类繁多，但其根源都在于饮食停滞，湿热郁结蒸腾，变化而成。凡是面色萎黄，饮食不能转化为肌肉气血，腹部疼痛起伏不定，聚散无常，疼痛停止后就能正常进食的，都有虫积。寄生虫或从呕吐物中排出，或从小便排出，或从大便排出。治疗方法应当观察病情的轻重。如果虫势突然急迫，应当使用攻逐的方剂，如黑丑、槟榔、大黄、胡粉、三棱、莪术之类。虫去之后，再调理脾胃。病情较缓的，用酸苦之法泄热燥湿，兼用相互制约、相互畏惧的药物，如川黄连、胡黄连、芦荟、苦楝、乌梅、川椒、雷丸、芜荑、使君子、榧子肉之类。脾虚弱的兼以运脾，胃滞涩的兼以消滞。虫症的治疗方法，大致如此。（陆履安记录）
徐评：治疗虫病有缓治的方法。如果病势很轻，但病程日久，应当使用膏剂、丸剂等药物，兼用补益和消导之法。如果病势危急，必定另有峻猛的方剂，以及奇药秘方，可以杀虫去积。否则元气消耗衰竭，就无法补救了。
Chen (7 years old): Dampness has injured the body. The Spleen and Stomach functions are disordered, with dampness sinking into the Small Intestine, causing parasites to exit from the urethral orifice. Stool is loose and contains undigested food residues; warming and tonification methods must not be used at this time. (Pathogenesis: Damp-Heat)
Prescription: Phellodendri Cortex (Huangbai), Poria (Fuling), Polyporus (Zhuling), Sophorae Flos (Huaimi), Alismatis Rhizoma (Zexie), Dioscoreae Hypoglaucae Rhizoma (Bixie).
Second visit: Parasites are exiting via urine. Diarrhea has persisted for a month, with sticky stools containing undigested food. This is not a Deficiency-Cold syndrome, but rather dampness accumulating internally with impaired transformation and transportation. Bitter medicines should be used to overcome dampness, while simultaneously addressing pediatric malnutrition (Gan accumulation).
Prescription: Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Atractylodis Rhizoma (Cangzhu), Magnoliae Officinalis Cortex (Houpo), Alismatis Rhizoma (Zexie), Sophorae Fructus (Huaijiaozhi), Akebiae Caulis (Mutong), Quisqualis Fructus (Shijunzi), Lophatheri Herba (Dan Zhuye). After three doses, subsequently administer Fei'er Wan (Fat-Nourishing Pill).
Gong (7 years old): Damp-heat generates parasites, causing abdominal pain, loose stools, and aversion to food.
Prescription: Coptidis Rhizoma (Chuanlian), Phellodendri Cortex (Hulian), Raw Paeoniae Radix Alba (Baishao), Mume Fructus (Wumei), Aurantii Fructus Immaturus (Zhishi), Zanthoxyli Pericarpium (Chuanjiao), Fried Crataegi Fructus (Chaozha), Citri Reticulatae Pericarpium (Qingpi). Prepared as water-habit pills.
Xu: Damp-heat in the intestines generates parasites. Use bitter-cold medicines to guide the action into the Small Intestine.
Prescription: Meliae Cortex (Kulianpi), Fraxini Cortex (Beiqinpi), Sophorae Fructus (Huaijiaozhi), Plumbum Subacetatum (Hufen), Phellodendri Cortex (Huangbai), Ostrea Concha (Muli). Pulverized. Take one pig large intestine, clean thoroughly, boil until soft, and mix with the powder to make pills.
Zhang (13 years old): Zhu Danxi stated that nocturnal sweating in children does not require treatment, as children's constitutions are purely Yang, and sweat is the leakage of Yang Qi. Regarding numerous sores, floating and swelling fullness caused by damp-heat can be resolved through purgation. This illustrates the principle that the Six Fu organs benefit from unobstructed flow. Recurrent lower abdominal pain is also due to damp-heat generating parasites and food stagnation. Acid and bitter methods should be used to drain heat.
Prescription: Coptidis Rhizoma (Chuanlian), Phellodendri Cortex (Hulian), Raw Paeoniae Radix Alba (Baishao), Gavis Corneus (Jizhenpi), Fried Crataegi Fructus (Chaozharon), Aloe (Luhui), Aurantii Fructus Immaturus (Zhishi), Meliae Cortex (Kulianpi), Mume Fructus (Wumeirou). Pounded and made into pills.
Wang (16 years old): Anal fistula swells intermittently; white worms are passed during diarrhea. Heat is excessive in the Hand and Foot Yangming meridians. (Pathogenesis: Yangming Heat)
Prescription: Sophorae Fructus (Huaijiaozhi), Phellodendri Cortex (Huangbai), Torreyae Semen (Feizirou), Raw Atractylodis Rhizoma (Cangzhu), Akebiae Caulis (Chugenbaipi), Minor Coptidis Rhizoma (Xiaochuanlian).
Additional: Poria (Fuling), Fried Sanguisorbae Radix (Chaodiyu). Made into pills using steamed wheat bun paste as a binder.
Although there are many types of parasites, their source lies in food stagnation, where damp-heat accumulates and steams, transforming into parasites. Whenever the complexion is sallow, food fails to nourish the muscles, abdominal pain fluctuates irregularly, masses gather and scatter unpredictably, and appetite returns immediately after pain subsides, these indicate parasite accumulation. Parasites may be expelled via vomiting, urine, or stool. Treatment methods should observe the severity. If the parasitic condition is sudden and urgent, purgative agents such as Strychni Semen (Heiqiu), Arecae Semen (Binglang), Rheomi Radix et Rhizoma (Dahuang), Plumbum Subacetatum (Hufen), Bupleuri Radix (Sanleng), and Curcumae Longae Rhizoma (Ezhu) should be used. After the parasites are eliminated, regulate the Spleen and Stomach. For milder cases, use acid and bitter methods to drain heat and dry dampness, combined with mutually restraining or fearing herbs such as Coptidis Rhizoma (Chuanlian), Phellodendri Cortex (Hulian), Aloe (Luhui), Meliae Cortex (Kulian), Mume Fructus (Wumei), Zanthoxyli Pericarpium (Chuanjiao), Wollemiae Semen (Leiwang), Chrysanthemi Indici Flos (Wuyi), Quisqualis Fructus (Shijunzi), and Torreyae Semen (Feirou). For weak Spleens, promote Spleen transportation; for stagnant Stomachs, eliminate stagnation. The general principles for treating parasitic diseases are as above. (Recorded by Lu Lv'an)
Commentary by Xu: There is a slow-treatment method for parasitic diseases. If the pathogenic force is mild but the disease persists for a long time, pastes and pills should be used, combining tonification and elimination. If the pathogenic force is critical, there must be separate potent prescriptions, including miraculous drugs and secret formulas, capable of killing parasites and removing accumulation. Otherwise, the Yuan Qi (Primary Qi) will be depleted and exhausted, making recovery impossible.