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Pediatric ascariasis refers to the disease caused by the presence of roundworms in the intestines, specifically associated with Chinese Taxillus Herb.

This condition has been documented under various names in classical medical texts, with the earliest mention found in Suwen, specifically in the "Cough Discussion" chapter, where it is referred to as "long worms." Lingshu, in the "Syncope Discussion" chapter, calls it "jiao hui." The "Cold-Damage Disease Discussion: Jueyin Disease Pulse and Symptom Treatment" chapter refers to it as "hui." Zhubing Yuanhou Lun, in the "Miscellaneous Diseases in Pediatrics" section, refers to it as "roundworms." This indicates that ancient physicians had recognized ascariasis very early on. This section focuses on the symptoms and differentiation of ascariasis caused by roundworms in the intestines, particularly in relation to Chinese Taxillus Herb.

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1. Ascaris Disturbing the Intestines︰The symptoms include abdominal pain, drooling during pain, listlessness, sallow complexion and emaciation, or white patches on the face, gray-blue spots on the white of the eye, dark circles under the eyes, frequent itching in the nostrils, granular dots on the inner side of the lower lip, red papillae-like dots on the tip of the tongue, or excessive hunger and poor appetite, or pica for dirt, paper scraps, and other foreign objects, teeth grinding during sleep, constipation or loose stool, or passing roundworms in the stool. Prolonged cases may lead to abdominal distension, and even palpable hard masses. The key diagnostic points are: (1) Abdominal pain—roundworms reside in the human small intestine; movement of the worms causes pain, which is generally mild, located around the navel or the lower epigastrium, occurs irregularly, recurs repeatedly, and lasts for variable durations. The pain is accompanied by drooling, and after the pain subsides, the patient resumes normal activities and diet. (2) The abdominal pain is migratory, with palpable cord-like masses that respond favorably to massage, appearing and disappearing unpredictably. (3) White patches may appear on the face, most commonly on the forehead and cheeks. These patches are irregularly round with relatively neat edges, pale white in the center resembling tinea versicolor, more noticeable under backlighting, with slightly rough but non-protruding skin surfaces, and no pain or itching. (4) Gray-blue spots may occasionally appear on the white of the eye, varying in size and shape, from as small as a needle tip to as large as a grain of rice, not protruding from the surface of the sclera, numbering from 1–2 to as many as 6–7. (5) Small granular protrusions are present on the mucous membrane of the lower lip, located near the midline toward the root of the lip, surrounded by slight redness. (6) Papillae-like red dots appear on the edges and tip of the tongue, slightly raised above the tongue surface, either sparse and scattered or densely clustered. (7) Vomiting or passing roundworms. (8) Stool examination may reveal roundworm eggs. Additional symptoms may include listlessness, sallow complexion and emaciation, poor appetite, or excessive hunger and voracious eating, or pica for dirt, paper scraps, and other foreign objects, as well as teeth grinding and restless crying during sleep. The treatment should focus on quieting ascaris and expelling parasites, supplemented by fortifying the spleen and nourishing the stomach. Commonly used formulas include Mume Pill for quieting ascaris, Quisqualis Fruit Powder for expelling parasites, and Chubby Child Pill for fortifying the spleen and nourishing the stomach.
2. Ascaris Intestinal Obstruction︰If there are too many roundworms, they may twist together and form a mass, blocking the intestines, leading to paroxysmal severe colicky pain in the abdomen, nausea and vomiting, or even vomiting of roundworms, abdominal distension and fullness, constipation, and visible cord-like masses of varying sizes in the abdomen that change shape upon kneading. When roundworms proliferate excessively in the intestines and twist into a mass, they can obstruct the intestinal tract, causing blockage and obstruction. The distinguishing symptoms are: (1) paroxysmal severe colicky pain in the abdomen, which comes and goes and recurs repeatedly; (2) palpable cord-like masses in the abdomen, more pronounced during pain, which respond favorably to kneading and change shape upon pressure; (3) nausea and vomiting, or even vomiting of roundworms; (4) abdominal distension and fullness with constipation. The treatment should focus on unblocking and purging the interior, {|###|}regulating qi and resolving stuffiness{|###|}, supplemented by {|###|}quieting ascaris{|###|} and expelling worms. The commonly used formula is Xiaoluo Tongjie Decoction. If symptoms persist for an extended period without relief, surgical intervention should be considered.
3. Ascaris Worms Penetrating the Intestines into the ︰Sudden severe abdominal pain may be observed, with a pale complexion, profuse cold sweating, reversal cold of the limbs, or even convulsions. Ascaris worms also have the habit of burrowing in the intestines. If deworming is improperly performed or the child has a fever, it may stimulate the ascaris to burrow chaotically, leading to complications such as biliary ascariasis. The key diagnostic points are: (1) sudden severe abdominal pain, recurring intermittently; (2) the pain is located in the upper abdomen, slightly to the right, and does not respond well to pressure; (3) pale complexion, profuse cold sweating, reversal cold of the hands and feet, unconsciousness, or even convulsions. The treatment should focus on quieting ascaris, regulating qi, and relieving pain. After symptoms are alleviated, deworming and purgation can be applied. Commonly used formulas for quieting ascaris include Mume Pill, and for deworming, Biliary Ascaris Expelling Decoction can be used.

Ascariasis is a common intestinal parasitic disease in pediatrics, primarily caused by unclean diet, consumption of unwashed fruits and vegetables, and ingestion of undercooked food containing worm eggs. Zabing Zhengzhi Zhunsheng．The chapter on worms states: "Eating fruits and the internal organs of livestock and poultry that contain worm eggs leads to the disease." It clearly points out that the disease is caused by ingesting "worm eggs." Moreover, the warm and humid climate in spring and summer is conducive to the maturation of worm eggs, increasing the chances of infection, making these seasons the peak periods for ascariasis. Hence, the ancients also believed that ascariasis is caused by the steaming of dampness-heat.

The disease is often triggered by the weak constitution of children, Jingyue Quanshu．The chapter on various worms says: "However, based on common observations, those with strong organs and vigorous qi rarely have worms, as the ingested food is transformed in the marrow, making it difficult for worms to survive. Those who suffer from worms are ultimately due to the weakness of organ qi and the slowness of transformation, leading to the accumulation and gradual generation of worms." Therefore, most children with ascariasis initially have spleen-stomach weakness. Healthy individuals may not develop the disease even if infected, or the symptoms may be mild.

Ascariasis is widely distributed in our country, commonly seen in children who lack knowledge of hygiene. Mild cases can cause malnutrition and digestive disorders in children, while severe cases can even be life-threatening. Therefore, paying attention to dietary hygiene and proper fecal management is of great significance in preventing ascariasis.

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1. Youyou Jicheng．Treatment of Worm Pain: "The Classic says: In the intestines, there are worm masses and parasites, none of which can be treated with small needles. It also says: All food and drink enter the stomach; if there is heat in the stomach, the worms will move, and if the worms move, there will be stomach prolapse, and if there is stomach prolapse, there will be salivation. The pain caused by worms is due to roundworms, generally because children have weak spleen and stomach, eat too much sweet, fatty, or raw and cold food, which stays and accumulates, transforming into worms. When the worms move, there is abdominal pain, and when they gather, they form a lump, the pain comes and goes, starts and stops suddenly, with nausea and vomiting of saliva, and clear water coming from the mouth. If not treated for a long time, the worms can grow to a foot long, piercing the stomach and heart, which can be fatal. External signs include a pale face and red lips, and the six pulse conditions are strong and large, which are the symptoms. If there are worms inside, there will be a craving for sweets, or a desire to eat dirt, tea leaves, or charcoal, etc., and they should be expelled, using Areca Seed Pills.
2. Children with worm pain, especially those with weak spleen and stomach, often have this condition. The method of expelling worms and removing accumulation should not be used frequently, and after expelling the worms, it is necessary to quickly regulate and tonify the spleen and stomach. Either use the Integrated Chubby Child Pill, or Mume Pill, or Six Gentlemen Decoction should be taken frequently to prevent the worms from regenerating."
3. Yizong Bidu．Various Pains in the Heart and Abdomen: "Worm pain is characterized by white spots on the face, red lips, and a good appetite, or pain immediately after eating, or being able to eat immediately after pain, or frothing at the mouth."
4. 《Medical Three-Character Classic．Heart Abdominal Pain and Chest Impediment》: "One type of worm pain, Mume Pill. Worm pain, which comes and goes, with white spots on the lips and tongue, and the pain worsens after eating. Worms are transformed from the wind and wood of the Jueyin, and Mume Pill is appropriate."