Pancreatitis and Biliary Ascariasis, October 15, 1999

Pancreatitis and Biliary Ascariasis, October 15, 1999

In the autumn of the Ji Mao year, a female patient named Wang, aged 20, had suffered from acute pancreatitis a month earlier. She received traditional Chinese medicine treatment at our clinic, including bile-pancreatic compound decoction, anti-inflammatory, analgesic, and bile-expanding therapies, which improved her condition. However, she experienced pain again one day later, but it was intermittent, with a distinct sensation of upward piercing pain. I diagnosed biliary ascariasis and added six black plums, 10 g of areca nut, 10 g of Cinnamomum cassia, and 3 g of Asarum sieboldii to the bile-pancreatic compound formula. The decoction was taken orally, supplemented by 10 g of mirabilite administered in divided doses, which significantly alleviated the pain and facilitated smooth bowel movements the next day, allowing the patient to recover and be discharged. Biliary ascariasis is considered a Jueyin syndrome in traditional Chinese medicine. According to Article 326 of the "Shanghan Lun," "Jueyin diseases manifest as thirst, qi rushing upward to the heart, burning pain in the chest, hunger without eating, vomiting worms upon eating, and incessant diarrhea." Article 338 further states, "For ascariasis, the patient should vomit worms. When the patient is calm but occasionally restless, it indicates coldness in the internal organs, with worms ascending into the diaphragm causing restlessness, which subsides after a while. If the patient eats and then vomits again, it means the worms smell food and come out. For ascariasis, Wumei Wan is the main prescription." Wumei Wan consists of 10 black plums, 10 g of Coptis chinensis, 6 g of Phellodendron amurense, 6 g of dried ginger, 6 g of processed Aconitum, 3 g of Asarum sieboldii, and 10 g of Cinnamomum cassia. This case followed these principles, resulting in recovery.