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PARASITES

GENERAL

Clinical Manifestations	The following symptoms which are unresponsive to normal treatment should lead to a suspicion of parasitosis: Altered bowel habits Loose, watery stools or Constipation Rectal itching and burning especially at night Excessive appetite Food allergies Symptoms improve after eating Epigastric pain Heartburn Swelling around the umbilicus Respiratory symptoms with hepatomegaly Hepatobiliary symptoms Depression Foul intestinal gas Weight loss Breast swelling and tenderness unrelated to menstruation Parasites can be asymptomatic in up to 50% of the infected population. Lab tests may often show a false negative.
Treatment Principle	Kill parasites
Herb Formulas	For Large Intestine flukes (Fasciolopsis): Bing Wu Huo Qi Tang Hua Chong Wan Dan Dao Qu Hui Tang For Bladder worms (cysticercosis): Hua Chong Wan Topical: For crabs, lice and itching associated with infestations: Zhi Yang Ding For dermatitis due to schistomiasis: Qing Dai Gao
Points

ROUNDWORMS (ASCARIASIS LUMBRICOIDES)

Clinical Manifestations	Generally found in areas where human feces is used as fertilizer Pulmonary phase: Cough Dyspnea Allergies Urticaria Asthma Eosinophilia Intestinal phase: Abdominal discomfort Abdominal pain Occasional vomiting
Treatment Principle	Expel roundworms
Herb Formulas	Shi Bing Huo Qi Dan Dao Fei Chong Tang Bian Fei Chui Shao Tang Guan Zhong Tang Fei Er Wan Hua Chong Wan Dan Dao Qi Hui Tang Wu Tou Gui Zhi Tang Xiao Xian Xiong Tang With Blood Heat or Damp-Heat: Wu Hua Tang With pain: Wu Yi Tang With Spleen and Stomach Deficiency Cold: Ren Shen Chuan Jiao Tang Li Zhong An Hui Tang With Spleen and Stomach Deficiency Cold With Excess Cold: Da Jian Zhong Tang For biliary ascariasis: Da Jian Zhong Tang Dan Dao Qu Hui Tang Da Chai Hu Tang Da Cheng Qi Tang Wen Pi Tang Xiao Cheng Qi Tang Si Ni San Tiao Wei Cheng Qi Tang San Ren Tang With prominent chills and fever: Da Chai Hu Tang modified With prominent Heat: Da Cheng Qi Tang modified With Liver and Stomach Heat: Lian Mei An Hui Tang With Stomach Heat and Kidney Deficiency or Jue Yin Stage-Cold and Heat: Wu Mei Wan With childhood nutritional impairment: Fei Er Wan Bu Dai Wan
Points	For biliary ascariasis: GB-24, GB-34, GB-43, LIV-3, LIV-14, SJ-6, UB-18, UB-19 With severe fever: + DU-14, LI-11 Withalternating chills and fever: + GB-39, SJ-5 With nausea: + PC-6 With jaundice: + DU-9

HOOKWORMS (TRICHURIS TRICHURA, NECATUR AMERICANUS, ANCYLOSTOMA DUODINALE)

Clinical Manifestations	Found in tropical and subtropical regions Early stage: Dermatitis with a pruritic erythematous papulovesicular lesion at the site of the larval invasion Episodic coughing Asthma Fever Eosinophilia Blood tinged sputum Later stage: Diarrhea Abdominal discomfort Anorexia Anemia with fatigue Pallor Deformed nails Dyspnea on exertion Palpitations Peripheral edema Heart failure
Treatment Principle	Expel hookworms
Herb Formulas	Guan Zhong Tang Fei Er Wan Hua Chong Wan Fa Mu Wan Topical: Qing Dai Gao
Points

THREADWORMS (STRONGYLOIDES STERCORALIS)

Clinical Manifestations	Found in tropical, subtropical and temperate areas Pruritic dermatitis at the site of larval penetration Epigastric pain Nausea Diarrhea Cough Rales Eosinophilia
Treatment Principle	Expel threadworms
Herb Formulas
Points

PINWORMS (ENTEROBIUS VERMICULARIS, OXYURIASIS)

Clinical Manifestations	Found worldwide Nocturnal perianal and vulvular itching Insomnia Restlessness Irritability Vague gastrointestinal symptoms
Treatment Principle	Expel pinworms
Herb Formulas	Bian Fei Chui Shao Tang Hua Chong Wan Dan Dao Qu Hui Tang Zhui Chong Wan
Points

TRICHINOSIS ( TRICHINELLA SPIRALIS)

Clinical Manifestations	Found where pork is eaten Diarrhea Cramps Malaise Muscle pain and tenderness Fever Facial edema Conjunctivitis
Treatment Principle	Kill parasites
Herb Formulas
Points

WHIPWORMS (TRICHURIASIS)

Clinical Manifestations	Found worldwide, particularly tropical and subtropical areas Usually asymptomatic Heavy infection: Diarrhea Lower abdominal cramps Flatulence Tenesmus Rectal prolapse Bloody stool
Treatment Principle	Expel whipworms
Herb Formulas
Points

TAPEWORMS (CESTODIASIS, TAENIASIS)

Clinical Manifestations	This includes: Beef Tapeworm (Taenia Saginata) Fish Tapeworm (Dyphllobothrium Latum) Pork Tapeworm (Taenia Solum) Found worldwide There are actually six types of tapeworm including rat, dog and human in addition to the three listed above. Fish and pork tapeworm find more limited distribution than the others Usually asymptomatic There may be vague gastrointestinal symptoms such as: Diarrhea Nausea Abdominal pain Anorexia Fatigue Hunger Dizziness
Treatment Principle	Expel Tapeworms
Herb Formulas	Bian Fei Chui Shao Tang Hua Chong Wan Dan Dao Qu Hui Tang Li Zhong Tang Lian Li Tang
Points

JUE YIN COLD

Clinical Manifestations	Vomits clear fluid Vertex headache Body cold Diarrhea Complete exhaustion of Yang Roundworms Biliary ascariasis T: Pale C: White P: Weak.
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity
Herb Formulas	Da Jian Zhong Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25

JUE YIN COLD AND HEAT

Clinical Manifestations	Delirium Heat in upper body Cold in lower body Sensation of Qi rushing to the chest Vomits worms Persistent thirst Feverishness Anorexia (hungry but can't eat) Chronic diarrhea Cold extremities Maybe edema Vertex headache Vomits food Cardiac Heat with pain T: Red or pink or pale and flabby C: Thick and greasy or thin P: Deep, thready and weak or wiry
Treatment Principle	Clear worms Clear Heat (Do not purge, create diaphoresis, or create emesis) Revive Yang
Herb Formulas	Wu Mei Wan
Points	Moxa needle REN-4, REN-6, REN- 8, ST-25, ST-36, needle DU-14, LI-4, LI-11, LIV-3, REN-17

COLD-DAMP DISTRESSES THE SPLEEN

Clinical Manifestations	Distention and fullness of epigastrium and abdomen Nausea Vomiting Anorexia Loose stools Diarrhea Reduced sensation of taste No thirst or preference for hot drinks Sticky sensation in mouth Borborygmus Lassitude Yin jaundice Heavy head Maybe edema Maybe copious white vaginal discharge Maybe cold limbs, fear of Cold or feeling chilled T: Pink C: Thick, white and greasy or sticky P: Deep and slow
Treatment Principle	Warm Cold Transform Dampness Harmonize the Stomach Strengthen the Spleen
Herb Formulas	Ping Wei San
Points	Moxa or moxa needle REN-6, REN-12, SP-6, SP-9, ST-36, UB-20 Cold-Damp Dysentery: Moxa or moxa needle LI-4, REN-6, REN-12, SP-6, ST-25, ST-37 Cold-Damp Diarrhea: Moxa or moxa needle REN-6, REN-12, ST-25, ST-36, ST-37, UB-25 Cold-Damp Vaginal Discharge: Moxa or moxa needle GB-26, REN-4, REN-6, SP-6, ST-36, UB-30 Cold-Damp Jaundice (Yin Jaundice): Moxa or moxa needle DU-9, GB-24, LIV-13, SP-9, ST-36, UB-19, UB-20 , UB-48

SPLEEN YANG DEFICIENCY WITH EXCESS COLD

Clinical Manifestations	Excruciating epigastric and abdominal pain to the point of not being able to to be touched May be borborygmus. Vomiting to the point of not being able to eat Superficial skin pulsations throughout the abdomen May be fluid sounds May be fluid sounds May be cold limbs Strong sensation of Cold in the chest and epigastrium. Severe pain in the head and feet Roundworms Biliary ascariasis T: Pale or Dark purple C: White and greasy or Slippery P: Thin and tight or slow and wiry or Deep and thready or Hidden
Treatment Principle	Warm and tonify Middle Jiao Yang Direct rebellious Qi downward Relieve pain Eliminate parasites
Herb Formulas	Da Jian Zhong Tang
Points

SPLEEN AND STOMACH DEFICIENCY COLD

Clinical Manifestations	Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Sallow or pale, dull complexion Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Pale C: White and greasy P: Deep, thready and forceless
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Li Zhong An Hui Tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Lian Po Yin Zhong Man Fen Xiao Wan
Points	LI-11, REN-6, REN-10, REN-12, ST-25, ST-36, ST-37 With prominent Heat: + LI-4, ST-44 With prominent Damp: + SP-6, SP-9 With nausea: + PC-6 With constipation: + SJ-6 With scanty urination: + KI-7, REN-9 With tenesmus : + REN-4, UB-30 With Shao Yang symptoms: + GB-34, GB-39, SJ-5 With Lingering fever: + DU-13 LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 For Damp-Heat Diarrhea: LI-4, SP-9, ST-25, ST-36, ST-44, UB-25 For Damp-Heat Dysentery: LI-4, LI-11, SP-9, ST-25, ST-37, ST-44

LIVER AND GALL BLADDER STAGNANT HEAT (BILE DUCT OBSTRUCTION WITH HEAT)

Clinical Manifestations	Quickly developing jaundice Severe, colicky, recurrent right-sided hypochondriac pain Pain may radiate to the shoulder and upper back Fever and chills or Alternating fever and chills Bitter taste in the mouth Dry throat and mouth Nausea Anorexia Aversion to fats and oils Abdominal distention Pale, sticky stools Scanty, concentrated urine Dysuria T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Soothe the Liver Drain the Gall Bladder Clear Heat Relieve fullness
Herb Formulas	Dan Dao Qi Hui Tang Dang Gui Long Hui Wan Jin Ling Zi San Chinese patent medicines: Ji Gu Cao Wan Li Dan Pian Long Dan Xie Gan Wan
Points	DU-9. GB-24, GB-34, LIV-3, LIV-14, SI-4, UB-19 With worms in the bile duct: + LI-20 through to ST-2 With fever : + DU-14, LI-11 With alternating fever and chills: + GB-41, SJ-5 With nausea : + PC-6

LIVER AND STOMACH HEAT

Clinical Manifestations	Abdominal pain Anorexia Vomiting of worms after eating Red face Fever Irritability Dry mouth Maybe inversion T: Red C: Yellow P: Rapid
Treatment Principle	Clear Heat Calm Roundworms
Herb Formulas	Lian Mei An Hui Tang
Points

CHILDHOOD NUTRITIONAL IMPAIRMENT

Clinical Manifestations	Parasites Intermittent abdominal pain Indigestion Emaciation Loose stools Feverishness Foul breath A sallow complexion A large, distended abdomen Anorexia Decreased intake of food Weak constitution Constant fatigue Maybe nausea and vomiting Dry mouth Thirst
Treatment Principle	Kill parasites Reduce accumulations Strengthen the Spleen Clear Heat
Herb Formulas	Fei Er Wan Bu Dai Wan
Points