蛔虫者，厥阴肝木之病也。木以水火中气，湮于湿土，不得上下调济，由是寒热相逼，温气中郁
，生意盘塞，腐蠹朽烂，而蛔虫生焉。其证为下寒上热，以乌梅丸主之。
乌梅丸
乌梅（百枚不蒸，捣膏） 人参（二两） 桂枝（二两） 干姜（二两） 附子（二两） 川椒
（二两去目，炒） 当归（二两） 茯苓（三两） 炼蜜同乌梅膏丸，梧子大，每服三十丸，日二次。
若虫积繁盛者，加大黄二两，巴霜二钱，下尽为佳。如线白虫证，是肝木陷于大肠，木郁不达，是以肛门
作痒，虫生大肠之位，从庚金化形，故其色白。而木陷之根，总由土湿，当于燥土疏木之中，重用杏仁、
橘皮以泄大肠滞气，佐以升麻，升提手阳明经之坠陷也。
颠狂者，即惊悸之重病也。凡人一藏之气偏盛，则一藏之志偏见，而一藏之声偏发。颠病者，安静而
多悲恐，肺肾之气旺也。狂病者，躁动而多喜怒，肝心之气旺也。肺肾为阴，肝心为阳。《难经》曰∶重阴
者颠，重阳者狂，正此义也。然金水之阴旺，因于阳明之湿寒，木火之阳盛，因于太阴之湿热，湿寒动
则寝食皆废，悲恐惧作，面目黄瘦，腿膝清凉，身静而神迷，便坚而溺涩，此皆金水之旺也。湿热动则眠食
皆善，喜怒兼生，面目红肥，臂肘温暖，身动而神慧，便调而水利，此皆木火之旺也。颠原于阴旺，狂原
于阳旺，阴阳各判，本不同气。而颠者历时而小狂，狂者积日而微颠。阳胜则狂生，阴复则颠作。胜复相
乘，而颠狂迭见，此阴阳之俱偏者也。如颠病悲恐失正者，以苓甘姜桂龙骨汤主之。如狂病喜怒乖常者，
以丹皮柴胡
犀角汤主之，如有宿痰胶固宜吐者，以瓜蒂散主之。
苓甘姜桂龙骨汤
半夏（三钱） 甘草（二钱） 生姜（三钱） 桂枝（三钱） 茯苓（三钱） 白芍（三钱）
龙骨（三钱） 牡蛎（三钱） 水煎大半杯，温服。有痰者，加蜀漆。
丹皮柴胡犀角汤
丹皮（三钱） 柴胡（三钱） 犀角（一钱研汁） 生地（三钱） 芍药（三钱） 茯苓
（三钱） 甘草（二钱炙） 水煎大半杯，温服。有痰者，加蜀漆。
瓜蒂散
（方见痰饮）
蛔虫病，属于厥阴肝经的病变。肝木之气夹杂水火之中气，被湿土所郁遏，导致上下气机无法调和，于是寒热相互逼迫，温煦之气在中焦郁结，生机受阻，气血腐坏朽烂，从而产生蛔虫。其症状表现为下寒上热，治疗以乌梅丸为主方。
乌梅丸
乌梅（一百枚，不经过蒸制，捣成膏状） 人参（二两） 桂枝（二两） 干姜（二两） 附子（二两） 川椒（二两，去掉目，炒制） 当归（二两） 茯苓（三两） 用炼蜜与乌梅膏混合制成丸药，大小如梧桐子，每次服用三十丸，每日两次。
如果虫积严重，加大黄二两、巴豆霜二钱，以下尽为最佳效果。如果是线白虫的症状，这是肝木之气陷入大肠，肝气郁结不得疏达，所以肛门瘙痒，虫子生长在大肠部位，随着庚金之气化形，所以颜色发白。而肝木陷入的根本原因，总归是由于脾土湿气过重，应当在燥湿健脾、疏泄肝木的方法中，重用杏仁、橘皮来泄除大肠的滞气，佐以升麻，提升手阳明大肠经下陷的气机。
癫狂病，就是惊悸病的重症。人的某一个脏腑之气偏盛，那么该脏腑的情志就会偏向极端，声音也会异常发出。癫病的特点是安静且多悲恐，这是因为肺肾之气旺盛。狂病的特点是躁动且多喜怒，这是因为肝心之气旺盛。肺肾属阴，肝心属阳。《难经》说：“重阴者癫，重阳者狂”，正是这个意思。然而，金水之阴气旺盛，是因为阳明经的湿寒；木火之阳气旺盛，是因为太阴经的湿热。湿寒发动时，睡眠和饮食都会废弛，悲恐惧怕发作，面目黄瘦，腿膝清凉，身体静止而神志迷乱，大便坚硬而小便涩滞，这些都是金水之气旺盛的表现。湿热发动时，睡眠和饮食都正常，喜怒情绪兼有，面目红润肥胖，手臂肘部温暖，身体躁动而神志聪慧，大便调畅而小便通利，这些都是木火之气旺盛的表现。癫病源于阴气旺盛，狂病源于阳气旺盛，阴阳各自判别，本源不同气类。但是癫病患者历时会出现轻微的狂症，狂病患者积日会出现轻微的癫症。阳气胜则生狂，阴气复则作癫。胜复相互乘袭，导致癫狂交替出现，这是阴阳俱偏的情况。如果是癫病出现悲恐失正的情况，以苓甘姜桂龙骨汤为主方。如果是狂病出现喜怒乖常的情况，以丹皮柴胡犀角汤为主方，如果有宿痰胶固需要涌吐的，以瓜蒂散为主方。
苓甘姜桂龙骨汤
半夏（三钱） 甘草（二钱） 生姜（三钱） 桂枝（三钱） 茯苓（三钱） 白芍（三钱） 龙骨（三钱） 牡蛎（三钱） 用水煎取大半杯，温服。有痰的，加蜀漆。
丹皮柴胡犀角汤
丹皮（三钱） 柴胡（三钱） 犀角（一钱，研汁） 生地（三钱） 芍药（三钱） 茯苓（三钱） 甘草（二钱，炙） 用水煎取大半杯，温服。有痰的，加蜀漆。
瓜蒂散
（方剂见痰饮篇）
Ascariasis (Roundworm Disease) is a pathology of the Jueyin Liver Meridian (Jueyin Gan Jing). The Wood Qi of the Liver, containing the intermediate Qi of Water and Fire, is obstructed by Damp Earth, preventing the harmonious regulation of upper and lower Qi. Consequently, Cold and Heat press against each other, and Warm Qi stagnates in the middle, blocking the generation of life force, leading to putrefaction and decay, thereby giving rise to roundworms. The clinical manifestation presents as Cold below and Heat above; it is primarily treated with Wumei Wan (Mume Pill).
Wumei Wan (Mume Pill)
Wumei (Hui Mei Fruit, 100 pieces, not steamed, pounded into paste) Renshen (Ginseng Radix, 2 liang) Guizhi (Cinnamon Twig, 2 liang) Ganjiang (Dried Ginger, 2 liang) Fuzi (Prepared Aconite Root, 2 liang) Chuanjiao (Sichuan Pepper, 2 liang, remove eyes, stir-fried) Danggui (Angelica Sinensis, 2 liang) Fuling (Poria, 3 liang) Combine with refined honey and the Wumei paste to form pills, sized like wutong seeds. Take 30 pills per dose, twice daily.
If the worm accumulation is severe, add Dahuang (Rhubarb Rhizome, 2 liang) and Bashuang (Croton Seed Frost, 2 qian), aiming for complete expulsion. If the symptoms are those of thread-like white worms, this indicates Liver Wood Qi sinking into the Large Intestine, with Wood stagnation failing to diffuse, causing anal itching. The worms reside in the Large Intestine, transforming their shape according to Geng Metal Qi, hence their white color. The root cause of the sinking Liver Wood lies entirely in Spleen Earth Dampness. One should employ methods to dry Dampness and soothe Liver Wood, heavily using Xingren (Apricot Seed) and Ju Pi (Citrus Peel) to drain stagnation in the Large Intestine, assisted by Shengma (Cimicifuga Rhizome) to lift the sinking Qi of the Hand-Yangming Large Intestine Meridian.
Dian-Kuang (Manic-Depressive Psychosis) is the severe form of Jingji (Palpitations and Fright). When the Qi of one Zang organ becomes excessive, the emotional tendency of that organ becomes biased, and its vocal expression becomes abnormal. Dian disease is characterized by quietness and frequent sorrow/fear, resulting from exuberant Lung and Kidney Qi. Kuang disease is characterized by agitation and frequent joy/anger, resulting from exuberant Liver and Heart Qi. Lung and Kidney belong to Yin; Liver and Heart belong to Yang. The *Nan Jing* states: "Excess Yin leads to Dian, Excess Yang leads to Kuang," which precisely conveys this meaning. However, the exuberance of Metal-Water Yin stems from Damp-Cold in the Yangming; the exuberance of Wood-Fire Yang stems from Damp-Heat in the Taiyin. When Damp-Cold activates, sleep and appetite cease, sorrow and fear arise, the face appears yellow and emaciated, legs and knees feel cool, the body remains still while the spirit is confused, stool is hard, and urination is difficult; these are signs of exuberant Metal-Water. When Damp-Heat activates, sleep and appetite are good, joy and anger coexist, the face appears red and plump, arms and elbows feel warm, the body moves while the spirit is alert, stool is regular, and urination is smooth; these are signs of exuberant Wood-Fire. Dian originates from Yin exuberance, Kuang from Yang exuberance; Yin and Yang are distinct and do not share the same origin. However, Dian patients may experience slight Kuang over time, and Kuang patients may develop slight Dian after accumulating days. When Yang prevails, Kuang arises; when Yin returns, Dian occurs. Prevailing and returning phases multiply each other, causing Dian and Kuang to alternate, representing a state of dual deviation of Yin and Yang. For Dian disease with aberrant sorrow and fear, Linggan Jianggui Longgu Tang (Poria, Licorice, Ginger, Cinnamon, Dragon Bone Decoction) is indicated. For Kuang disease with irregular joy and anger, Danpi Chaihu Xijiao Tang (Moutan, Bupleurum, Rhinoceros Horn Decoction) is indicated. If there is stubborn phlegm requiring emesis, Gudi San (Melon Stalk Powder) is indicated.
Linggan Jianggui Longgu Tang (Poria, Licorice, Ginger, Cinnamon, Dragon Bone Decoction)
Banxia (Pinellia Tuber, 3 qian) Gancao (Licorice Root, 2 qian) Shengjiang (Fresh Ginger, 3 qian) Guizhi (Cinnamon Twig, 3 qian) Fuling (Poria, 3 qian) Baishao (White Peony Root, 3 qian) Longgu (Fossilized Bones, 3 qian) Muli (Oyster Shell, 3 qian) Decoct in water to obtain half a cup, take warm. If phlegm is present, add Shuqi (Artemisia Scoparia Herb).
Danpi Chaihu Xijiao Tang (Moutan, Bupleurum, Rhinoceros Horn Decoction)
Danpi (Moutan Bark, 3 qian) Chaihu (Bupleurum Root, 3 qian) Xijiao (Rhinoceros Horn, 1 qian, crushed for juice) Shengdi (Rehmannia Root, 3 qian) Shaoyao (Peony Root, 3 qian) Fuling (Poria, 3 qian) Gancao (Licorice Root, 2 qian, honey-fried) Decoct in water to obtain half a cup, take warm. If phlegm is present, add Shuqi (Artemisia Scoparia Herb).
Gudi San (Melon Stalk Powder)
(See formula under Phlegm-Fluids chapter)