Ascariasis is a common disease in children caused by an infection of ascarides.
It is manifested as an abnormal desire for food, sallow complexion,
periumbilical abdominal pain and fecal discharge with round worms. In serious
cases, colic may appear. The cases with intestinal obstruction and biliary
ascariasis may be treated with the principle for colic due to ascariasis
mentioned in this section.
Etiology and Pathogenesis
The disease is caused by the ingestion of food contaminated by ascarid eggs.
Prolonged infection of the worm may impair the spleen and stomach and consume qi
and blood, inducing a series of pathological changes in the body, and in turn,
dysfunction of the spleen and stomach may lead to stagnation of food and
retention of dampness-heat which create a favorable environment for the
reproduction of worms. Since the ascarides tend to accumulate to form a mass and
penetrate the intestinal wall, intestinal obstruction and biliary colic may
Syndrome Differentiation and Therapeutic Principles
A. Syndrome differentiation
In mild cases, there may be no marked symptoms, or occasional periumbilical
abdominal pain and irregular bowel movements may appear. In serious cases,
sallow complexion, emaciation, paroxia, intermittent abdominal pain and palpable
mass and even colic may be present.
B. Therapeutic principles
For an incipient case with a strong physique, anthelminthic therapy should be
applied first and followed by therapies to regulate the spleen and stomach. For
a debilitated patient, the therapy of regulating the spleen and stomach and
tonifying qi and blood should be employed first and followed by the
anthelminthic therapy, or both should be used at the same time. For the case
with severe abdominal pain, the therapy of calming the worms should be adopted
first, and then the anthelminthic therapy should be used.
Classification and Treatment
Manifestations: Intermittent abdominal pain occurring during empty stomach in
the morning or nausea, vomiting, poor appetite, sallow complexion, emaciation,
listlessness or restlessness, teeth grinding during sleep, paroxia, irregular
bowel movement or discharge of worms, white macules appearing on the face in
some children or white and transparent granules on the mucosa of the lower lip
or dark blue spots on the sclera, red tip of tongue with white and greasy or
Therapeutic principles: Dispel ascarids, relieve pain, and regulate the spleen
Prescription: The Modification of Quisqualis Powder
Fructus Quisqualis 10 g
Fructus Meliae 10 g
Radix et Rhizoma Rhei 6 g
Fructus Aurantii 10 g
Radix Glycyrrhizae 6 g
Remarks: Add Rhizoma Picrorhizae (6 g) and Radix Scutellariae (6 g) for cases
with heat-syndrome. Add Radix Aconiti Lateralis Praeparata (6 g) and Rhizoma
Zingiberis (dried, 3 g), and omit Rhei for those with cold-syndrome.
The above prescription is applicable to incipient cases with strong physique and
should be discontinued in time when the disorder is relieved. For the
debilitated cases and those with significant infestation, use Baby-Fattening
Pill which is composed of Radix Codonopsis Pilosulae (10 g), Poria (10 g),
Rhizoma Atractylodis Macrocephalae (10 g), Radix Glycyrrhizae Praeparata (3 g),
Massa Fermentata Medicinalis (10 g), Fructus Crataegi (10 g), Fructus Hordei
Germinatus (10 g). Rhizoma Coptidis (3 g), Rhizoma Picrorrhizae (6 g), Fructus
Quisqualis (fried, 10 g) and Aloe (5 g).
In addition, Decoction of Six Mild Drugs is recommended to strengthen the spleen
and stomach for debilitated children before the application of anthelminthic and
for strong children after anthelminthic treatment.
B. Colic due to irritation of ascarids
Manifestations: Sudden onset of severe abdominal pain, spontaneous sweating,
pallor, deadly coldness of extremities, irritability, nausea, vomiting, vomiting
of ascarids, yellow, greasy tongue coating and wiry or smooth and rapid pulse.
Therapeutic principles: Calm the ascarids, and relieve pain.
Prescription: Fructus Mume Bolus
Fructus Mume 10 g
Herba Asari 3 g
Pericarpium Zanthoxyli 6 g
Rhizoma Coptidis 3 g
Cortex Phellodendri 6 g
Radix Aconiti Lateralis Praeparata 6 g
Rhizoma Zingiberis (dried) 3 g
Ramulus Cinnamomi 6 g
Radix Ginseng 10 g
Radix Angelicae Sinensis 10 g
Remarks: Add Herba Artemisiae Scopariae (10 g), Radix et Rhizoma Rhei (6 g,
decocted later), Fructus Aurantii (6 g) and Semen Arecae (10 g), and omit
Aconiti Lateralis Praeparata, Zingiberis, Cinnamomi and Asari for cases with
fever, chilliness, yellow-tinged sclera, yellow and greasy tongue coating due to
the retention of dampness-heat and extravasation of bile.
A. Mature vinegar; 20 to 30 ml hourly, 3 to 5 times; applicable to cases with
severe abdominal pain.
B. Fructus Quisqualis (fried); dose of one to two pieces per year of age; taken
in the morning on an empty stomach for two to three days; overdosage may induce
hiccups and should be avoided.
Copyright 1995 Hopkins Technology