Worm-expelling formulas

Medicinal formulas designed to expel or kill worms and other parasites from the digestive tract giving rise to what is traditionally called worm accumulation manifesting in abdominal pain, diarrhea, vomiting, vomiting of worms, passing of worms in the stool, either no thought of food and drink or rapid hungering with increased eating, predilection for strange foods, anal itch, grinding of the teeth in the night, clamoring stomach, vomiting of clear water, a complexion that is withered-yellow complexion or green-blue, possibly with white macules or red threads, and a pulse that is now large now small. In prolonged cases that are not adequately treated, there may be emaciation, listlessness of essence-spirit, dim vision, dry hair, enlarged abdomen with prominent green-blue veins, and puffy swelling, a condition traditionally referred to as gān accumulation. Mild cases may present with no obvious symptoms, in which case the worms may be detected only by modern biomedical testing.

Modern parasitology discusses numerous kinds of parasites that can be found in numerous parts of the body, including roundworm (Ascaris), tapeworm (Cestodes), pinworm (Oxyurids), large intestine fluke worms, hookworm (Nematodes). Chinese texts mostly speak of roundworm, but traditional literature also mentions inch white worm disease (寸白虫病 cùn bái chóng bìng, tapeworm) and redworm disease (赤虫病 chì chóng bìng, large intestinal fluke disease). Roundworm gives rise to itchy nose and ears, white speckles inside the lips, and blue macules in the whites of the eyes (sclerae). Hookworm is usually marked by a predilection for strange food, a withered-yellow complexion, and puffy swelling. Tapeworm is characterized by the passing of white segments in the stool. Note also that, in the past, tooth decay and many skin diseases were attributed to worms or bugs (虫 chóng), even when these were not visible to the eye.

Main agents

• Chinaberry root bark (Meliae Radicis Cortex, 苦楝根皮 kǔ liàn gēn pí)
• Mume (Mume Fructus, 乌梅 wū méi)
• Areca (Arecae Semen, 槟榔 bīng láng)
• Carpesium seed (Carpesii Fructus, 鹤虱 hè shī)
• Omphalia (Omphalia, 雷丸 léi wán)
• Quisqualis (Quisqualis Fructus, 使君子 shǐ jūn zǐ)

Worm accumulation patterns can take the form of cold, heat, vacuity, or repletion, so the above agents are combined with medicinals that address these specific problems.

• Zanthoxylum (Zanthoxyli Pericarpium, 花椒 huā jiāo) is added to warm the center and dispel cold.
• Coptis (Coptidis Rhizoma, 黄连 huáng lián) and coptis (Coptidis Rhizoma, 黄连 huáng lián) are used to clear heat.
• Barley sprout (Hordei Fructus Germinatus, 麦芽 mài yá) medicated leaven (Massa Medicata Fermentata, 神曲 shén qū) are added when there is food accumulation turning into gān accumulation.
• Ginseng (Ginseng Radix, 人参 rén shēn) andChinese angelica (Angelicae Sinensis Radix, 当归 dāng guī) can be added to treat vacuity.
• Rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng) can be added to help expel the worms through the stool.

Representative formulas:

• Mume Pill (乌梅丸 wū méi wán)
• Mume Pill (乌梅丸 wū méi wán)
• Cloth Bag Pill (布袋丸 bù dài wán)

Note that there are no subcategories of worm-expelling agents.

Cautions

• Worm-expelling formulas should be taken on an empty stomach.
• Patients should avoid greasy foods.
• Worm-expelling agents are toxic, so the dosage should be carefully controlled to avoid damaging right qì or cause poisoning.
• Use with care in the weak and elderly, and in pregnant women.
• After worm-expelling treatment has concluded, attention should be paid to adjusting the spleen and stomach.

See miscellaneous causes of disease.