关上脉微浮，积热在胸中，呕吐蛔虫，心健忘。
关上脉紧而滑者，蛔动。尺中脉沉而滑者，寸白虫。
腹中痛，脉当沉若弦，而反洪大，此为有蛔虫。
腹中痛，多喘呕，而脉洪者，为虫。(按喘，疑当作唾。)
疳蚀，其脉细数，若虚小者生，紧急者死。
按∶虫病多起于湿热太盛，木郁土中而化生也。亦有瘀血所化者，世谓痨虫是也。大抵
在肠
胃者易除，在经络者难治。其脉不外弦滑、细数之两途，然亦有弦迟者，胃中寒湿也；亦有
细涩者，胃汁为虫所消耗也。至于《洄溪医案》所称肠胃为虫蚀尽，而人犹不遽死，则怪诞
之说矣。然事亦有甚奇者，族有贫妇，初觉七窍内如细虫萦援，数年后，目盲，皮肤枯槁
，
而遍身振掉不息，夜寐稍静，偶一言动，即肢体无一不战战栗栗然者。已十余年矣，今尚未
死，此必伤于微风，化生细虫，吸血伤筋也。大抵虫证与痰证相类，痰多怪证，虫亦多怪证
也。为晕眩昏厥，为癫痫狂妄，为吐利血水，为皮肤顽麻，奇痛奇痒，为四肢拘急，痿缓振
掉，为怪梦纷纭，不可思议。世称人有患虱瘤者，《神农本草》水银，有杀皮肤中虱之文，
不诬也。予近治汪君，初起颧上有水，常如屋溜一滴，并不破皮，后遂右半面常自觉振动，
如吹大风状，一日数发，已六七年。发时即须尖亦手不可近，触之，其痛彻心也，皮色如常
，不肿不变，内外药治，仅得小效，后挑出牙虫无数而愈，平时牙并不痛。此亦奇证，与前
贫妇之类，皆所亲睹者也。
关部脉象微浮，提示胸中有积热，症状表现为呕吐蛔虫、心中健忘。
关部脉象紧而滑，是蛔虫蠕动的征象；尺部脉象沉而滑，是寸白虫（绦虫）的征象。
腹中疼痛，脉象应当沉或弦，如果反而出现洪大脉，这是体内有蛔虫的表现。
腹中疼痛，伴有频繁气喘和呕吐，且脉象洪大，这是有虫证。（按语：此处“喘”字，怀疑应作“唾”，即吐唾液之意。）
疳蚀病（一种因寄生虫或营养不良导致的慢性消耗性疾病），其脉象细数，如果脉象虚小则预后良好可生，如果脉象紧急则预后不良主死。
按语：虫病大多起因于湿热过盛，肝木郁结于脾土之中而化生。也有由瘀血转化而成的，世人所说的痨虫即是此类。大体而言，虫在肠胃者容易清除，在经络者难以治疗。虫证的脉象不外乎弦滑、细数两种类型，但亦有出现弦迟脉的，这是胃中寒湿所致；亦有出现细涩脉的，这是胃中津液被虫消耗所致。至于《洄溪医案》中所称肠胃被虫蚀尽而人还不立即死亡的说法，则是荒诞不经的言论。然而事情也有极其奇特的，我家族中有一位贫苦妇女，起初感觉七窍内有如细虫缠绕牵引，几年后双目失明，皮肤干枯憔悴，且全身不停震颤抖动，夜间睡眠时稍显安静，偶尔一言一行，肢体便无一处不战栗发抖。这种情况已持续十余年，如今尚未死亡，这必定是受了微风侵袭，化生出细虫，吸食血液损伤筋脉所致。大体上，虫证与痰证相似，痰证多产生怪异病症，虫证也多产生怪异病症。如出现晕眩昏厥、癫痫狂妄、呕吐腹泻带血水、皮肤顽固麻木、奇痛奇痒、四肢拘挛急迫或痿软无力震颤、怪梦纷纭不可思议等症。世人称有人患虱瘤，《神农本草经》记载水银能杀灭皮肤中的虱子，并非虚妄之谈。我最近诊治汪先生，初起时颧骨上有水泡，常像屋檐滴水一样挂着一滴，并不破皮，后来右半边脸经常自觉振动，如同吹大风的样子，一天发作数次，已持续六七年。发作时连胡须都颤抖，手不能靠近，一触碰，疼痛直达心扉，但皮色正常，不肿不变，内外药物治疗仅得微小效果，后来挑出无数牙虫而痊愈，平时牙齿并不疼痛。这也是奇异病症，与前文所述贫妇的情况类似，都是我亲眼目睹的。
The pulse at the Guan position (mid-position, corresponding to the Spleen and Stomach) is slightly floating, indicating accumulated heat in the chest. Symptoms include vomiting Ascaris lumbricoides (roundworms) and forgetfulness of the Heart.
If the pulse at the Guan position is tight and slippery, it indicates the movement of roundworms. If the pulse at the Chi position (distal position, corresponding to the Kidneys and Lower Jiao) is deep and slippery, it indicates Taenia saginata (beef tapeworm).
Abdominal pain with a pulse that should be deep or wiry but is instead surging and large indicates the presence of roundworms.
Abdominal pain accompanied by frequent panting (Note: "panting" here is suspected to be a textual error for "spitting saliva") and vomiting, with a surging pulse, indicates a parasitic infection.
In cases of Gan erosion (a chronic wasting disease often caused by parasites or malnutrition), the pulse is fine and rapid. A deficient and small pulse suggests survival, while a tense and urgent pulse suggests death.
Commentary: Parasitic diseases mostly arise from excessive damp-heat, where Liver Wood stagnates within Spleen Earth and transforms into parasites. Some are also transformed from blood stasis, known in the world as "Tuberculosis worms" (parasites associated with consumption). Generally, parasites located in the Intestines and Stomach are easy to eliminate, whereas those in the Meridians are difficult to treat. The pulses for parasitic diseases generally fall into two categories: wiry-slippery or fine-rapid. However, there are also wiry-slow pulses, indicating cold-dampness in the Stomach; and fine-choppy pulses, indicating that stomach fluids have been consumed by the parasites. Regarding the claim in *Huixi Medical Cases* that the intestines and stomach can be completely eroded by parasites without immediate death, this is an absurd theory. Nevertheless, there are extremely bizarre cases. I know of a poor woman in my clan who initially felt like fine worms were winding around inside her seven orifices. Several years later, she went blind, her skin became dry and emaciated, and her entire body trembled incessantly. She was relatively calm during sleep, but any slight movement or speech caused her limbs to shake and shiver uncontrollably. This has persisted for over ten years, yet she is still alive. This must be due to invasion by subtle wind pathogens, transforming into fine worms that suck blood and damage tendons. Generally, parasitic syndromes are similar to phlegm syndromes; just as phlegm produces many strange symptoms, parasites also produce many strange symptoms. These may manifest as dizziness, syncope, epilepsy, mania, vomiting and diarrhea with bloody fluid, stubborn numbness of the skin, strange pains and itching, limb contracture or flaccidity with tremors, and bizarre dreams beyond comprehension. It is said in the world that some people suffer from "louse tumors." *Shennong Bencao Jing* records that Mercury (Hydrargyrum) kills lice in the skin, which is not unfounded. Recently, I treated Mr. Wang. Initially, he had water blisters on his cheekbones, resembling a single drop of water dripping from an eaves gutter, without breaking the skin. Later, the right half of his face frequently felt vibrating, as if blown by strong winds, occurring several times a day for six or seven years. During attacks, even his beard trembled, and it could not be touched; touching it caused pain piercing to the heart. The skin color remained normal, without swelling or change. Internal and external medicinal treatments yielded only slight effects. Finally, after extracting countless "tooth worms," he recovered, although his teeth did not hurt normally. This is also a rare syndrome, similar to the aforementioned poor woman, both of which I witnessed personally.