大意
虫得木之气乃生。得雨之气乃化。故非厥阴风木之气不生。非太阴湿土之气不化。（子和）湿热之虫。脏腑
虚则侵蚀。（丹溪）
内因
诸虫皆因杂食生冷甘肥油腻。节宣不时。腐败停滞。以致中脘勿运。酿成湿热。随五行之气。变化而为诸
般奇怪之形。若腐草为萤之义也。（汇补）
外候
凡虫症眼眶鼻下。必带青色。面上痿黄。或生白斑。或见赤丝。唇疮如粟。或红而肿。或缓而痛。饮食减少。肌
肉不生。睡卧不安。肠鸣腹痛。口吐清水。目无睛光。甚则沉沉寒热。肚大青筋。或为鬼胎血鳖。（汇补）
虫分九种
一曰伏虫。长四寸许。为群虫之长。二曰蛔虫。长一尺许。轻则呕吐腹痛。多则贯心杀人。三曰白虫。长五寸
余。母子相生。其形转大。至四五尺则杀人。四曰肉虫。状若烂杏。令人烦满。五曰肺虫。其状如蚕。令人咳嗽
声嘶。六曰 虫。状如虾蟆。令人呕吐。七曰弱虫。状如瓜瓣。令人多睡。八曰赤虫。状如生肉。令人肠鸣。九曰
蛲虫。状如菜虫。形至微细。居洞肠间。令人痔痢。又有三尸虫。状如犬马尾。薄筋。根据脾而居。乃有头尾。皆长
三寸。（医统）
脉法
脉洪而大。为脾家湿热。及好食茶叶生米草纸怪异等物。当困倦少食。今反饮食如常。形健不渴。悉属虫
症。脉沉实者生。虚大者死。（类案）
治法
体实之人。虫攻脏内。心腹 痛。在上用吐法。在下用攻法。体虚之人。先宜调补元气。然后用王道药。佐以
一二杀虫之品。或追虫之后。继以温补。不然则虫去而气亦随散矣。（入门）
治宜引导
虫之所居。必脏脾胃深处。药之所过。仅在中流。虫闻气而避之。安能攻取。故必用甘甜辛香之物。啖咽津
液。引虫头向上。然后用药。大抵上半月虫头向上。用药易效。下半月虫头向下。用药不应。（汇补）
用药
主以二陈汤。加槟榔、木香、鹤虱、雷丸、苦楝根、使君子等。如体实可吐者。用樟木屑煎汤吐之。可下者。追虫
丸下之。体虚宜调养者。用化虫丸治之。若在上中二焦。攻痛呕吐者。所服药中。加花椒、乌梅。治之尤当。
虫病选方
秘方 治诸般痞积。面色痿黄。肌体羸瘦。四肢无力。及食生冷壁泥茶炭咸辣等物。
青皮 陈皮 三棱 莪术 香附 槟榔 藿香（各一钱） 益智（五分） 官桂（四分） 桔梗（八分） 大黄（一
钱五分） 甘草（三分）
水煎。露一宿。五更空心温服。不得须少饮食。不然则药力减而虫不行矣。
追虫丸
黑牵牛（取头末） 槟榔（各八两） 雷丸 皂角 南木香（各二两）
蜜丸。
化虫丸
鹤虱 槟榔 苦楝根 胡粉（各一两） 白矾（二钱五分） 芜荑 使君子（各五分）
蜜丸服。
遇仙丹 治虫症如神。
白黑丑（头末二两） 槟榔（一两） 三棱 蓬术（各五钱） 牙皂（三钱）
为末。糖拌。小儿一钱。大人三钱。糖汤送下。空心服。是日绝食。待虫下行。然后用薄粥汤。
治寸白虫 于每月初三日前。先炙猪肉一块。置口中。咀嚼其津而勿咽。使诸虫闻香争咂。如箭攻攒。却
以槟榔细末一两。取石榴东引根煎汤调服三钱。
【大意】
虫类依靠木行的风气而生成，依靠雨水的湿气而化育。因此，如果没有厥阴风木之气，虫就不能产生；如果没有太阴湿土之气，虫就不能化育。（引用自刘完素/子和）湿热性质的虫，会在脏腑虚弱时侵蚀人体。（引用自朱丹溪）
【内因】
各种寄生虫都是因为杂食生冷、甘甜、肥腻及油腻食物，加之生活起居调节不当，导致食物腐败停滞在体内，致使中脘（脾胃运化功能）无法正常运转，酝酿成湿热。这些湿热随着五行之气的变化，演变成各种奇怪的虫形，就像腐草化为萤火虫的道理一样。（引用自《证治汇补》）
【外候】
凡是患有虫病的人，眼眶和鼻子下方必然带有青色，面色萎黄，或者脸上出现白斑，或者见到红色血丝，嘴唇生疮像粟米大小，或者红肿，或者舒缓但疼痛，饮食减少，肌肉消瘦不长，睡卧不安稳，肠鸣腹痛，口吐清水，目光无神。严重的会出现持续的寒热症状，腹部胀大且青筋暴露，或者形成类似鬼胎或血鳖的积聚。（引用自《证治汇补》）
【虫分九种】
第一种叫伏虫，长约四寸左右，是群虫的首领。第二种叫蛔虫，长约一尺左右，轻则引起呕吐腹痛，重则贯穿心脏致人死亡。第三种叫白虫，长约五寸多，母子相生，其形体逐渐变大，长到四五尺就会杀人。第四种叫肉虫，形状像烂杏，让人烦闷胀满。第五种叫肺虫，形状像蚕，让人咳嗽声音嘶哑。第六种叫蛲虫（原文缺字，据上下文推测为蛲或类似），形状像蛤蟆，让人呕吐。第七种叫弱虫，形状像瓜瓣，让人嗜睡。第八种叫赤虫，形状像生肉，让人肠鸣。第九种叫蛲虫，形状像菜虫，形体极其微小，居住在直肠之间，让人患痔疮痢疾。另外还有三尸虫，形状像狗的尾巴毛，附着在筋膜上，依托脾脏居住，有头有尾，都长三寸。（引用自《医统》）
【脉法】
脉搏洪大而有力，是脾家湿热，以及喜好食用茶叶、生米、草纸等怪异物品的表现。应当感到困倦、食欲减退，现在反而饮食正常，身体健壮且不口渴，这些都归属于虫病。脉搏沉实的预后良好，脉搏虚大的预后不良（主死）。（引用自《名医类案》）
【治法】
体质强壮的人，虫攻击内脏，心腹疼痛，病位在上用催吐法，病位在下用攻下法。体质虚弱的人，先适宜调理补益元气，然后使用温和的王道药物，佐以一两种杀虫的药物。或者在驱虫之后，接着进行温补，否则虫子虽然去了，人的气也会随之消散。（引用自《医学入门》）
【治宜引导】
虫子所居住的地方，必定在脾胃深处，药物经过的地方，仅仅在中焦。虫子闻到药气会躲避，怎么能起到攻杀作用呢？所以必须使用甘甜辛香的食物，让患者吞咽津液，引导虫头向上，然后再用药。大致上半月虫头向上，用药容易见效；下半月虫头向下，用药就不应验。（引用自《证治汇补》）
【用药】
主要使用二陈汤，加入槟榔、木香、鹤虱、雷丸、苦楝根、使君子等。如果体质壮实可以催吐的，用樟木屑煎汤催吐；可以攻下的，用追虫丸攻下。体质虚弱适宜调养的，用化虫丸治疗。如果病在上中二焦，出现攻痛呕吐的，在所服药物中加入花椒、乌梅，治疗尤为恰当。
【虫病选方】
秘方：治疗各种痞积，面色萎黄，身体瘦弱，四肢无力，以及食用生冷、墙壁泥土、茶、炭、咸辣等物品引起的病症。
青皮、陈皮、三棱、莪术、香附、槟榔、藿香（各一钱）、益智仁（五分）、官桂（四分）、桔梗（八分）、大黄（一钱五分）、甘草（三分）。
用水煎煮，露天放置一夜，五更时分空腹温服。服药后不得稍许进食，否则药力减弱，虫子不能排出。
追虫丸：
黑牵牛（取头末）、槟榔（各八两）、雷丸、皂角、南木香（各二两）。
炼蜜为丸。
化虫丸：
鹤虱、槟榔、苦楝根、胡粉（各一两）、白矾（二钱五分）、芜荑、使君子（各五分）。
炼蜜为丸服用。
遇仙丹：治疗虫病如神效。
白丑、黑丑（头末二两）、槟榔（一两）、三棱、蓬术（各五钱）、牙皂（三钱）。
研为细末，用糖拌服。小儿服一钱，大人服三钱，用糖汤送下。空腹服用，当天禁食，等待虫子下行后，然后用稀薄粥汤调养。
治疗寸白虫：在每月初三日前，先烤一块猪肉，放在口中，咀嚼出津液但不要咽下，让各种虫子闻到香味争相吸吮，如同箭矢聚集一样，然后用一两槟榔细末，取石榴东引根煎汤调服三钱。
[General Principle]
Parasites are generated by the Qi of Wood (Wind) and transformed by the Qi of Rain (Dampness). Therefore, without the Qi of Jueyin Liver-Gallbladder Wind-Wood, parasites cannot be born; without the Qi of Taiyin Spleen-Stomach Damp-Earth, parasites cannot transform. (Zihe) Parasites with damp-heat nature erode the Zang-Fu organs when they are deficient. (Danxi)
[Internal Causes]
Various intestinal worms arise from indiscriminate consumption of raw, cold, sweet, fatty, and greasy foods, coupled with irregular lifestyle regulation. This leads to food putrefaction and stagnation, causing the Zhongwan (Middle Jiao/Spleen-Stomach transport function) to fail in its operation, brewing up damp-heat. Following the Qi of the Five Elements, these transform into various strange shapes, similar to the principle that decaying grass transforms into fireflies. (Huibu)
[External Manifestations]
In cases of worm diseases, the eye sockets and area below the nose must show a bluish-green color, the complexion is sallow or yellowish, white spots may appear on the face, or red blood vessels may be visible. Lip sores resemble millet grains, appearing either red and swollen or slow and painful. There is reduced appetite, emaciation, restless sleep, borborygmus, abdominal pain, spitting of clear saliva, and dull eyesight. Severe cases present with persistent chills and fever, distended abdomen with prominent blue veins, or formations resembling "ghost fetus" or "blood鳖" (accumulations). (Huibu)
[Nine Types of Worms]
1. Fu Chong (Hidden Worm): Approximately four cun long, it is the leader of all worms.
2. Hui Chong (Roundworm): Approximately one chi long. Mild cases cause vomiting and abdominal pain; severe cases penetrate the heart and cause death.
3. Bai Chong (White Worm): Over five cun long, reproducing parent-to-child, growing larger until reaching four or five chi, which causes death.
4. Rou Chong (Flesh Worm): Resembles rotten apricot kernels, causing irritability and fullness.
5. Fei Chong (Lung Worm): Resembles silkworms, causing coughing and hoarseness.
6. [Missing Character] Chong: Resembles a toad, causing vomiting.
7. Ruo Chong (Weak Worm): Resembles melon seeds, causing excessive sleepiness.
8. Chi Chong (Red Worm): Resembles raw meat, causing borborygmus.
9. Tuo Chong (Pinworm): Resembles vegetable worms, extremely minute in shape, residing in the large intestine, causing hemorrhoids and dysentery.
Additionally, there are San Shi Chong (Three Corpses Worms), resembling dog tail hairs, thin and attached to fascia, residing based on the Spleen, having heads and tails, each three cun long. (Yitong)
[Pulse Diagnosis]
A pulse that is surging and large indicates damp-heat in the Spleen system and cravings for strange substances like tea leaves, raw rice, grass paper, etc. One should feel fatigued and have poor appetite; if instead, diet is normal, physique is robust, and there is no thirst, all belong to worm diseases. A deep and solid pulse indicates survival; a deficient and large pulse indicates death. (Leian)
[Treatment Methods]
For individuals with strong constitutions where worms attack the internal Zang organs causing heart and abdominal pain, use emesis for lesions above and purgation for lesions below. For individuals with weak constitutions, first regulate and tonify Yuan Qi, then use gentle "King's Way" medicines, assisted by one or two anti-parasitic agents. Or, after expelling worms, follow with warming and tonifying treatments; otherwise, while the worms leave, the Qi will dissipate with them. (Rumen)
[Guidance in Treatment]
Worms reside in the deep depths of the Zang and Spleen/Stomach. Medicines only pass through the middle flow. Worms avoid the medicinal odor, making direct attack difficult. Therefore, sweet and pungent-aromatic substances must be used to induce swallowing of saliva, guiding the worm's head upward before administering medicine. Generally, during the first half of the lunar month, the worm's head is upward, making treatment effective; during the second half, the head is downward, making treatment ineffective. (Huibu)
[Medication]
The main prescription is Er Chen Tang (Two-Cured Decoction), added with Areca Seed (Binglang), Aucklandia (Muxiang), Chrysanthemum Seed (Sheshi), Polyporus (Leiwan), Melia Root Bark (Kualian Gen), and Quisqualis Fruit (Shijunzi). If the constitution is strong and emesis is suitable, use Camphor Wood shavings decoction for emesis; if purgation is suitable, use Zhui Chong Wan (Worm-Chasing Pill). For those requiring nourishment due to weakness, use Hua Chong Wan (Worm-Dissolving Pill). If the disease is in the Upper and Middle Jiao with attacking pain and vomiting, adding Sichuan Pepper (Huajiao) and Dark Plum (Wumei) to the medication is particularly appropriate.
[Selected Formulas for Worm Diseases]
Secret Formula: Treats various痞 accumulations, sallow complexion, emaciated body, weak limbs, and conditions caused by eating raw/cold items, wall mud, tea, charcoal, salty/spicy foods.
Green Tangerina Peel (Qingpi), Aged Tangerina Peel (Chenpi), Burreed Rhizome (Sanleng), Turmeric Tuber (Ezhu), Cyperus Rhizome (Xiangfu), Areca Seed (Binglang), Agastache (Huoxiang) (each 1 qian); Alpinia Oxyphylla (Yizhi) (0.5 qian); Cassia Twig (Guangui) (0.4 qian); Platycodon Root (Jiegeng) (0.8 qian); Rhubarb (Dahuang) (1.5 qian); Licorice Root (Gancao) (0.3 qian).
Decoct in water, expose overnight, take warm on an empty stomach at Wugeng time (3-5 AM). Do not eat anything afterwards, otherwise the medicinal power decreases and worms will not move.
Zhui Chong Wan (Worm-Chasing Pill):
Black Morning Glory Seed (Heiqianniu - take the first powder), Areca Seed (Binglang) (each 8 liang); Polyporus (Leiwan), Gleditsia Sinensis Pod (Zaojiao), Southern Costus Root (Nanmuxiang) (each 2 liang).
Make into honey pills.
Hua Chong Wan (Worm-Dissolving Pill):
Chrysanthemum Seed (Sheshi), Areca Seed (Binglang), Melia Root Bark (Kualian Gen), Lead White (Hufen) (each 1 liang); Alum (Baifan) (2.5 qian); Chinese Cornus Fruit (Wuyi), Quisqualis Fruit (Shijunzi) (each 0.5 qian).
Make into honey pills and take.
Yuxian Dan (Immortal-Meeting Pill): Highly effective for worm diseases.
White and Black Morning Glory Seeds (Baiheiqianniu - first powder, 2 liang), Areca Seed (Binglang) (1 liang), Burreed Rhizome (Sanleng), Curcuma Longa (Pengzhu) (each 5 qian), Gleditsia Sinensis Pod (Ya-zao) (3 qian).
Grind into powder, mix with sugar. Children take 1 qian, adults take 3 qian, delivered with sugar water. Take on an empty stomach, fast on that day until worms descend, then consume thin porridge soup.
Treatment for Taenia (Cunbai Chong): On the days prior to the 3rd of each lunar month, roast a piece of pork, place it in the mouth, chew to extract saliva but do not swallow. Let the worms smell the fragrance and swarm towards it as if arrows gathering. Then, take 3 qian of fine Areca Seed powder mixed with decoction from the East-facing root of Pomegranate tree (Shiliu Dongyin Gen).