经曰∶肠中有虫瘕、蛟蛔，皆不可取以小针。又曰∶饮食者，皆入于胃，胃中有热则虫动，虫动则胃缓，
胃缓则涎出。夫虫痛者，蛔虫也。盖由小儿脾胃虚弱，多食甘肥生冷，留而为积，积化为虫，动则腹痛，发
则肿聚一块，痛有来去，乍作乍止，呕恶吐涎，口出清水，久而不治，其虫长至一尺，则贯胃伤心杀人矣。外证
面白唇红，六脉洪大，是其候也。内有虫，必口馋好甜，或喜食泥土、茶叶、火炭之类，宜攻去之，槟榔丸。
小儿虫痛，凡脾胃怯弱者，多有此证。其攻虫取积之法，却又未可常用。及取虫之后，速宜调补脾胃，或
集成肥儿丸，或乌梅丸，或六君子汤多服之，以杜虫之复生。
槟榔丸 治小儿一切虫积，能杀诸虫。
小槟榔（一两） 南木香（五钱） 鹤虱子（五钱） 光贯仲（五钱） 广锡灰（五钱） 陈漆渣（烧灰）
正轻粉（一钱） 白雷丸（二钱） 巴豆霜（一钱）
以漆渣灰五钱，同众药研为细末，醋煮
面糊丸麻子大。每服二十丸，五更时，苦楝根皮煎汤下。
集成肥儿丸 方见卷四黄瘅门。
乌梅丸 方见卷四腹痛门。
六君子汤 方见卷二类搐门。
凡小儿甘肥过度，或糖食甜物太多，乃致湿热久停而成积，积久生虫，时发腹痛，以手摸之，腹内有块，或
作一条梗起。外证面白唇红，六脉浮洪，其痛时作时止，痛止即能饮食者，虫痛无疑。又有腹痛，一痛即死者，
亦是虫证。欲去此虫，无如苦楝根皮，诚天下打虫第一神方。其法，于月初旬，虫头向上之时行之。先夜掘苦楝
根，须取每年结子者方是母树，其根浮于土面者有毒，不可用，专取土中者，净洗泥土，以刀刮其红皮，止取白皮
四五钱，儿大者六七钱，切碎听用。次早，以油煎鸡蛋令儿嗅之，以引其虫头向上而求食；另于别室，以水一盏，
浓煎苦楝皮汤一小杯，不可使儿闻其药气，一闻其气，虫即潜伏矣；俟药熟，以鸡蛋与儿食，即服药，半日不可
饮食，俟虫下后，方饮食之。服药后，儿似困顿，万万放心。虫下后精神如旧，仍当急为健脾，庶虫不复生，永
无患矣。
《黄帝内经》中说：肠道中有虫瘕（腹中结块，由虫积引起）、蛟蛔（一种寄生虫），都不可用小针进行针刺治疗。又说：饮食进入人体后，都会先到达胃部。如果胃中有热，就会使虫体躁动；虫体躁动则导致胃壁松弛；胃壁松弛则津液外溢流出涎沫。所谓“虫痛”，就是由蛔虫引起的疼痛。这主要是因为小儿脾胃功能虚弱，又过多食用甘甜、油腻及生冷食物，这些食物停滞在体内形成积滞，积滞日久化生为虫。虫体活动时引发腹痛，发作时腹部可摸到肿起的包块，疼痛时有时无，突然发作又突然停止，伴有恶心呕吐、吐出涎沫或清水的症状。如果长期不治疗，虫体可长到一尺长，进而穿透胃壁损伤心脏，危及生命。外在表现为面色苍白而嘴唇发红，六脉（寸关尺三部，左右手共六部）洪大有力，这是其征候。体内有虫的人，必定口馋喜欢吃甜食，或者喜欢咀嚼泥土、茶叶、火炭等异物，应当采用攻逐杀虫的方法治疗，推荐使用槟榔丸。
小儿虫痛，凡是脾胃虚弱怯懦的小儿，大多会出现这种证候。但是，攻逐虫积的方法却不可以经常使用。在驱虫之后，必须迅速调理补益脾胃，可以服用集成肥儿丸，或者乌梅丸，或者多服六君子汤，以防止虫子再次滋生。
【槟榔丸】治疗小儿各种虫积，能够杀灭各类寄生虫。
配方：小槟榔（一两）、南木香（五钱）、鹤虱子（五钱）、光贯仲（五钱，即川楝子）、广锡灰（五钱）、陈漆渣（烧成灰）、正轻粉（一钱）、白雷丸（二钱）、巴豆霜（一钱）。
制法：取漆渣灰五钱，与其他药物一起研成细末，用醋煮面糊作为粘合剂，制成如麻子大小的丸药。每次服用二十丸，在五更天（凌晨3-5点），用苦楝根皮煎汤送服。
【集成肥儿丸】方剂见本书卷四黄瘅门。
【乌梅丸】方剂见本书卷四腹痛门。
【六君子汤】方剂见本书卷二类搐门。
凡是小儿摄入过多的甘肥食物，或者糖果甜点吃太多，导致湿热长久停留而形成积滞，积滞日久便生出虫来，时常发作腹痛。用手触摸腹部，能感觉到里面有硬块，或者有一条梗起的感觉。外在表现为面色苍白、嘴唇发红，六脉浮洪，疼痛时作时止，疼痛停止后就能正常进食的，无疑是虫痛。还有一种情况是腹痛发作后即死亡，这也是虫证所致。想要去除这种虫，没有比苦楝根皮更好的了，这确实是天下驱虫的第一神方。具体方法是：选择在月初旬，此时虫头向上的时候施行。前一天晚上挖掘苦楝树根，必须选取每年结果实的母树，漂浮在土面的根有毒，不能使用，专门选取深入土中的根，洗净泥土，用刀刮去红色的外皮，只取白色的内皮四五钱，年龄较大的儿童可用六七钱，切碎备用。第二天早晨，用油煎鸡蛋让小儿闻其气味，以引诱虫头向上并向食物移动；另外在一个单独的房间里，准备一盏水，浓煎苦楝皮汤至一小杯，不要让小儿闻到药气，一旦闻到气味，虫就会潜伏起来。等到药汤熬好，给小儿吃鸡蛋，随即服药。服药后半日内禁止饮食，等到虫排出后，再开始进食。服药后，小儿可能显得困顿疲惫，不必担心。虫排出后，精神会恢复如常，此时仍应紧急健脾益气，这样虫子就不会再生，永远免除后患。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When there are worm masses (*chongjia*, abdominal lumps caused by parasitic accumulation) or roundworms (*jiaohui*, a type of parasite) in the intestines, small needles must not be used for acupuncture." It also says: "Food and drink enter the stomach. If there is heat in the stomach, the worms become active; when the worms are active, the stomach wall relaxes; when the stomach wall relaxes, saliva flows out." The so-called "worm pain" refers to pain caused by roundworms (*Ascaris lumbricoides*). This occurs primarily because children have weak spleen and stomach functions, and consume excessive amounts of sweet, fatty, and raw/cold foods. These foods stagnate in the body, forming accumulations (*ji*), which over time transform into worms. When the worms move, they cause abdominal pain. During an attack, a swollen lump can be felt in the abdomen. The pain comes and goes, starting suddenly and stopping abruptly, accompanied by nausea, vomiting of saliva, or clear fluid. If left untreated for a long time, the worms may grow up to one chi (approx. 33 cm) long, penetrating the stomach and damaging the heart, leading to death. Externally, the complexion is pale with red lips, and the six pulses (pulse positions at the cun, guan, and chi locations on both wrists) are surging and large. These are the signs. Patients with internal worms typically crave sweets or have pica, such as eating dirt, tea leaves, or charcoal. They should be treated with purgative and vermifuge methods, specifically using *Binglang Wan* (Areca Seed Pill).
Worm pain in children is common among those with weak and deficient spleen and stomach. However, vermifuge and accumulation-resolving methods should not be used frequently. After expelling the worms, it is crucial to promptly regulate and tonify the spleen and stomach. One may administer *Jicheng Fei'er Wan* (Chen Fuzheng's Spleen-Strengthening Pill), *Wumei Wan* (Mume Pill), or take *Liujunzi Tang* (Six Gentlemen Decoction) extensively to prevent the recurrence of worms.
[Binglang Wan] Treats all types of parasitic accumulation in children and kills various parasites.
Ingredients: Xiao Binglang (Arecae Semen, 1 liang), Nan Muxiang (Aucklandiae Radix, 5 qian), Heshizi (Chrysanthemi Indici Fructus, 5 qian), Guang Guanzhong (Toosendan Fructus, 5 qian), Guang Xihui (Stannum Ash, 5 qian), Chen Qizha (Lac Residue, burnt to ash), Zheng Qingfen (Calomelas, 1 qian), Bai Leiwu (Wanrosii Fructus, 2 qian), Badoushuang (Crotonis Seminis Exsiccatum Oleum Extractum, 1 qian).
Preparation: Take 5 qian of lac residue ash and grind it finely with the other herbs. Use vinegar and wheat paste to form pills the size of hemp seeds. Take 20 pills at dawn (wugeng time), washed down with a decoction of *Kuilgenpi* (Meliae Cortex).
[Jicheng Feier Wan] See Formula in Volume 4, Section on Jaundice.
[Wumei Wan] See Formula in Volume 4, Section on Abdominal Pain.
[Liujunzi Tang] See Formula in Volume 4, Section on Convulsions.
Excessive consumption of sweet and fatty foods, or too many candies and sweets, leads to long-term retention of damp-heat, forming accumulations. Over time, these accumulations generate worms, causing intermittent abdominal pain. Palpation reveals lumps or cord-like structures in the abdomen. Externally, the face is pale with red lips, and the six pulses are floating and surging. The pain is intermittent, and the child can eat normally when the pain subsides; this is undoubtedly worm pain. There is also a severe form where death follows immediately after an episode of abdominal pain, which is also due to worms. To eliminate these worms, nothing is superior to *Kuilgenpi* (Meliae Cortex); it is truly the premier vermifuge formula in the world. The method is as follows: Perform the treatment in the early part of the lunar month, when the worms' heads are oriented upward. Dig up the roots of the Melia tree the night before. Select only the mother tree that bears fruit annually. Roots floating on the soil surface are toxic and should not be used; select only roots from deep within the soil. Wash clean, scrape off the red outer bark, and use only the white inner bark (4-5 qian for younger children, 6-7 qian for older children). Chop and set aside.
On the morning of the treatment, fry an egg in oil and let the child smell it to attract the worms' heads upward towards food. In a separate room, prepare a cup of strong decoction of *Kuilgenpi* in water. Ensure the child does not smell the medicinal odor, as the worms will hide if they detect it. Once the decoction is ready, give the egg to the child, followed immediately by the medicine. Withhold food and drink for half a day. Resume feeding only after the worms are expelled. The child may appear lethargic after taking the medicine; do not worry. Once the worms are expelled, their spirit will return to normal. At this point, urgently tonify the spleen to prevent regeneration of worms, ensuring no future harm.