蛔者根据胃为养。赞助化物之需。故古方欲其安而不欲其动。用炮姜理中
汤加川椒乌梅。所谓闻酸则静。见苦则安也。吴绶谓蛔厥却缘多饥。节庵
谓妄发厥阴汗。胃冷蛔上。又谓吐蛔虽大热。勿犯寒凉。则蛔厥之用温中
也必矣。及阅仲景乌梅丸。乌梅为君。人参附子细辛桂枝蜀椒当归为佐。
而柏皮之外。又加黄连。乃倍干姜。岂寒因热用。热因寒用法乎。乃余见一
妇。烦热呕酸。脉数吐蛔。欲投茱制黄连姜汁炒栀方可。奈医者执用温药。
随饮随毙。益信仲景乌梅丸倍黄连。早已开示后学一大法门。而习俗罕
究也。又治二妇。食伤胀满不堪。蛔窜十余不止。气口脉有力。竟投枳朴等。
温中内消而愈。盖失饥与伤饱。又不可执一者乎。要之蛔在平人。宜有不
宜无。宜少不宜多湿。热甚。蛔虫滋长。发胃脘痛。吐出则少愈。若胃败吐蛔。
色黑且腐。并成族来者。在不治例。
理中汤
人参 白术（土炒） 干姜（炮各一钱） 甘草（八分） 乌梅肉（二个） 川椒（十粒）
水煎。
乌梅丸 治蛔厥
乌梅（七十五个） 人参 附子（炮） 柏皮 桂枝 细辛（各一两五钱）
干姜（二两五钱炮） 黄连（四两） 蜀椒 当归（各一两）
十味各捣末。以苦酒渍乌梅一宿。去核饭上蒸之。饭熟捣梅成泥和匀
诸药。蜜丸梧子大。米饮下十丸。渐加至二十丸。忌生冷滑物。
枳实汤 治胸满。右关脉有力。吐蛔不止。
枳实（麸炒） 紫浓朴（姜制） 广皮（各一钱） 山楂（一钱半） 柴胡（七分） 莱菔子（炒研一钱）
炒熟砂仁末五分。生姜一片。水煎。
清中汤 治脉数。呕酸黄水。烦躁吐蛔。
山栀（炒） 半夏（各一钱） 黄连（七分） 茯苓 广皮（各一钱） 炙甘草（三分）
竹茹一钱。川椒十粒。生姜一片。水煎。
蛔虫依赖胃气作为营养来源，协助消化食物的需求。因此古方希望蛔虫安定而不希望其躁动。使用炮姜理中汤加入川椒、乌梅。这就是所说的“闻到酸味则安静，见到苦味则安伏”。吴绶认为蛔厥是因为饥饿过多所致；节庵认为误发厥阴经的汗，导致胃冷而蛔虫上行；又有人说吐蛔虽然是大热证，但不要犯寒凉药物，那么治疗蛔厥使用温中法就是必然的了。等到我阅读张仲景的乌梅丸，以乌梅为君药，人参、附子、细辛、桂枝、蜀椒、当归为佐药，而在黄柏之外，又加入了黄连，并且加倍使用干姜。这难道是“寒因热用”、“热因寒用”的治法吗？
然而我见过一位妇女，烦热、呕吐酸水、脉数、吐蛔，想要投用吴茱萸制黄连、姜汁炒栀子的方剂。无奈医生固执地使用温药，服药后立即死亡。这更加证实了张仲景乌梅丸中加倍使用黄连，早已为后学开启了一大门径，只是世俗习俗很少去探究罢了。我又治疗两位妇女，饮食损伤导致胀满不堪忍受，蛔虫窜动不止十余次，气口脉有力，竟然投用枳实、厚朴等药，通过温中消导的方法治愈。这是因为失饥（过度饥饿）与伤饱（饮食积滞），又是不可拘泥于一种方法的情况啊。总之，蛔虫在普通人身上，应该有但不宜无，宜少不宜多。湿热甚重，蛔虫滋长，引发胃脘痛，吐出后症状稍减。如果是胃气败绝而吐蛔，颜色黑且腐败，成群结队而来者，属于不治之症。
理中汤
人参 白术（土炒） 干姜（炮各一钱） 甘草（八分） 乌梅肉（二个） 川椒（十粒）
水煎服。
乌梅丸 治疗蛔厥
乌梅（七十五个） 人参 附子（炮） 黄柏 桂枝 细辛（各一两五钱）
干姜（二两五钱炮） 黄连（四两） 蜀椒 当归（各一两）
十味药分别捣成末，用醋浸泡乌梅一夜，去核放在饭上蒸熟，饭熟后将梅肉捣成泥状，与诸药粉混合均匀，蜜丸如梧桐子大。米饮送下十丸，逐渐加量至二十丸。忌食生冷滑腻之物。
枳实汤 治疗胸满，右关脉有力，吐蛔不止。
枳实（麸炒） 紫浓朴（姜制） 广皮（各一钱） 山楂（一钱半） 柴胡（七分） 莱菔子（炒研一钱）
炒熟砂仁末五分，生姜一片，水煎服。
清中汤 治疗脉数，呕吐酸水黄水，烦躁吐蛔。
山栀（炒） 半夏（各一钱） 黄连（七分） 茯苓 广皮（各一钱） 炙甘草（三分）
竹茹一钱，川椒十粒，生姜一片，水煎服。
Ascaris lumbricoides relies on the Stomach Qi for nourishment and assists in meeting the needs of digestion. Therefore, ancient formulas sought to keep the parasites calm rather than active. The Paojiang Lizhong Tang (Baked Ginger Replenish the Middle Decoction) was used with Chuanjiao (Sichuan Pepper) and Wumei (Mume Fruit). This is what is meant by "hearing sourness brings stillness, seeing bitterness brings peace." Wu Shou stated that Jueyue (Reversal Cold due to Parasites) often stems from excessive hunger. Jie'an attributed it to incorrectly inducing sweat in the Jueyin channel, causing Cold in the Stomach and upward migration of the parasites. Others claimed that although vomiting worms may indicate extreme Heat, one must not use cold or cooling herbs; thus, using Warm-Middle methods for treating Jueyue became inevitable. Upon reading Zhang Zhongjing's Wumei Wan (Mume Pill), I found Wumei as the Sovereign herb, with Renshen (Ginseng), Fuzi (Prepared Aconite Root), Xixin (Asarum), Guizhi (Cinnamon Twig), Shujiao (Sichuan Pepper), and Danggui (Angelica Sinensis) as Ministers. Beyond Huangbai (Phellodendron Bark), Huanglian (Coptis Rhizome) was added, and Ganjiang (Dried Ginger) was doubled. Was this the method of "using heat to treat heat" or "using cold to treat cold"?
However, I treated a woman who suffered from vexing heat, vomiting acid, rapid pulse, and vomiting worms. I intended to prescribe Huanglian processed with Zhuyu (Evodia Fruit) and Zhiizi fried with Jiangzhi (Ginger Juice). Unfortunately, the physician stubbornly insisted on using warm herbs; she died immediately after taking them. This further confirmed that Zhang Zhongjing's doubling of Huanglian in Wumei Wan had already opened a major path for later scholars, yet customary practices rarely investigate this. I also treated two women who suffered unbearable distension and fullness due to dietary injury, with worms migrating more than ten times. Their Qi Kou (Radial Artery at the Cunkou position) pulse was forceful. I prescribed Zhi Shi (Immature Bitter Orange) and Houpo (Magnolia Bark) among other herbs, curing them through warming the middle and resolving accumulation. This demonstrates that conditions arising from starvation versus overeating cannot be treated with a single rigid approach. In summary, for ordinary people, the presence of worms should exist but not excessively; fewer are better than more. When Damp-Heat is severe, parasites proliferate, causing Epigastric Pain. Vomiting them provides slight relief. However, if worms are vomited due to Stomach Qi exhaustion, appearing black and putrid, or coming in swarms, these fall under untreatable categories.
Lizhong Tang (Replenish the Middle Decoction)
Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried with soil), Ganjiang (Dried Ginger, prepared, each 1 qian), Gancao (Licorice Root, 8 fen), Wumei Rou (Mume Fruit pulp, 2 pieces), Chuanjiao (Sichuan Pepper, 10 grains).
Decoct in water.
Wumei Wan (Mume Pill) - Treats Jueyue (Reversal Cold due to Parasites)
Wumei (75 fruits), Renshen (Ginseng Root), Fuzi (Prepared Aconite Root, processed), Huangbai (Phellodendron Bark), Guizhi (Cinnamon Twig), Xixin (Asarum, each 1 liang 5 qian).
Ganjiang (Dried Ginger, 2 liang 5 qian, processed), Huanglian (Coptis Rhizome, 4 liang), Shujiao (Sichuan Pepper), Danggui (Angelica Sinensis Root, each 1 liang).
Pulverize all ten ingredients separately. Soak Wumei in vinegar overnight, remove pits, steam over rice until cooked, then mash into a paste and mix evenly with the powders. Form pills the size of wutong seeds. Take 10 pills with rice broth, gradually increasing to 20 pills. Avoid raw, cold, and slippery foods.
Zhishi Tang (Immature Bitter Orange Decoction) - Treats Chest Fullness, Forceful Right Guan Pulse, Continuous Worm Vomiting.
Zhishi (Immature Bitter Orange, bran-stir-fried), Zinongpu (Magnolia Bark, ginger-processed), Guangpi (Tangerine Peel, each 1 qian), Shanzha (Hawthorn Fruit, 1.5 qian), Chaihu (Bupleurum Root, 7 fen), Laifuzi (Radish Seed, stir-fried and ground, 1 qian).
Chaoresharen (Stir-fried Amomum Villosum Seed powder, 5 fen), 1 slice of Shengjiang (Fresh Ginger). Decoct in water.
Qingzhong Tang (Clear the Middle Decoction) - Treats Rapid Pulse, Vomiting Acid/Yellow Fluids, Vexation, Worm Vomiting.
Shanzhi (Gardenia Fruit, stir-fried), Banxia (Pinellia Tuber, each 1 qian), Huanglian (Coptis Rhizome, 7 fen), Fuling (Poria), Guangpi (Tangerine Peel, each 1 qian), Zhigancao (Honey-fried Licorice Root, 3 fen).
Zhuru (Bamboo Shavings, 1 qian), Chuanjiao (Sichuan Pepper, 10 grains), 1 slice of Shengjiang (Fresh Ginger). Decoct in water.