An interesting but little known tradition in Daoist (Taoist) practice and Classical Chinese Medicine is the concept of the Three Worms which live in the body and must be eliminated for true health and (in Daoist theory) immortality. This short paper approaches the subject of the Three Worms (and what has traditionally been done about them) using several texts to give a broad view of how the Three Worms were seen, the traditional means used to eliminate them, herbs and dietary practices used to kill the worms, and, finally, some suggestions about integrating this into a modern clinical practice.
I’d like to start by thanking Heiner Freuhauf, Ph.D. for sharing some of his clinical and textual research on the subject. His work is a key link to restoring an important Classical therapeutic method into modern Chinese Medicine practice.

Daoist practice has been a tree with many branches which has grown over the past 2500 to 3000 years. From reclusive shamanism to organized religion to philosophical tea parties, Daoists throughout time have formed so many schools, cults (1), and reclusive mountain communities (monasteries and hermitages) that even just cataloging them all would be a large undertaking. Daoist Alchemy is a term we use to describe the group of Daoists who sought, by some means (internal or external), to extend life and reach a definite state of spiritual exaltation while in the body. Immortality was the operative word, and described a menu of options for the practitioners, who could decide if they wanted to ‘ascend to heaven in broad daylight,’ stay alive on the earth forever, or let everyone think they died when their corpse was actually an illusion cast upon a stick.
Many people love the colorful tales of the Daoist Immortals, which still form an important cultural motif in modern Chinese civilizations. Most people stop at an amused appreciation of the legends, and see no benefit from exploring the practices which claim to bestow immortality on an aspirant. However, as Chinese Medicine grows in popularity around the world, and Western scholars go beyond the Communist-synthesized TCM (2), it becomes apparent that the Daoist roots of Chinese Medicine are of extreme importance historically, philosophically, and even clinically.
Certainly some of the Daoist medical practices will strike the modern reader as suspicious. Namely, the use of talismans and invocations. However, I encourage the reader to consider the similarities of the shaman/priest to the psychotherapist/counselor, both who use concepts and systems largely unintelligable to the layperson to effect a behavioral, emotional, or spiritual cure in a psychologically troubled person through language. Demons are no longer a superstition if YOU find one in your living room! However, this paper isn’t about Taoist psychotherapy, however interesting and misunderstood that area may be. I mention it only to point out the need for new thinking and research into an area which has been all too rapidly dismissed and forgotten in our modern, ‘scientific’ era. The Communist mentality, based as it is in Dialectical Materialism, violently rejected, suppressed, and attempted to destroy anything which was 'spiritual' or 'superstitious.' Let us not do the same.

Historical and Theoretical Background
Daoist Alchemy has been divided into two schools: internal elixir (nei dan) and external elixir (wai dan). Like most divisions, this is mostly for conceptual convenience, and doesn’t truly reflect a strict division amongst the historical practice of Daoist Alchemy. Briefly, the internal elixir school believes that meditation (qi gong) and visualization practices are sufficient to bring about the change of conciousness desired. Some of these practices focussed strongly on the conservation and transformation of sexual energy (jing). The external elixir school sought to gather or produce a substance or drug which would confer immortality. Thus the ‘pill of immortality’. The importance of this school’s contribution to medicine, chemistry, and metallurgy should not be underestimated (It is hoped that Joseph Needham’s Science and Civilization in China will be reprinted soon). One example is the character for pill, which shows its affiliation with the red (cinnabar) elixir. Logically, the first people in China who made pills were the alchemist/doctors. The external elixir school also had a strong following of sexual practitioners, both men and women, who sought to use the interplay of yin and yang in the bedroom as both a metaphorical meditation on the mutually engendering polarities in nature and as a means to produce a highly charged 'elixir'. (The controlled stimulation of sexual hormone production would have strong effects on the nervous and immune systems, and could possibly slow biological aging through presently unknown hormonal pathways.)
While some present-day historians and authors posit a strict ideological division between the internal and external schools of Daoist alchemy, it is much more likely that most practitioners combined the two, using herbs to enhance meditations, and visualizations to aid their medicines. Indeed, this is the constant position of the classics.
Here I must digress to briefly discuss the influence of Buddhism on Daoism in Chinese history. Buddhism, introduced to China around 200 C.E. (700 years after Lao Zi wrote the Dao De Jing), was a well-funded missionary religion, intent on converting the world. This movement entered into China, where Daoism was a respected, accepted shamanic/spiritual tradition which was non-conversionary and reclusive in nature. As Buddhism began to use glitzy, gold-embossed temples to woo the politicians and the upper class, Daoism saw the threat the new religion posed and responded by organizing around a ‘Daoist Pope.' They began to compete with Buddhism for survival and political influence. Daoism was, from the start, a philosophy which rejected visible political involvement and popular appeal, as is evident in Lao Zi’s famous abdication of his government post for the seclusion of the Western mountains. However, when faced with the cunning, well-funded Buddhist missionaries, who began to ridicule Daoism’s easily misunderstood esoteric practices, the religious Daoist orthodoxy was formed to preserve some essence of indigenous religion in China. Nevertheless, Buddhism won imperial favor, and throughout the following centuries, a bitter feud took place between the two religions. Buddhists burned Daoist books, Daoists wrecked Buddhist temples, Buddhist influenced government officials forced Daoist monks to convert to Buddhism or be killed, Daoists wrote texts suggesting Buddha was a reincarnation of Lao Zi, and on and on. Eventually, the two religions were largely merged in the popular mind, and it remains so to this day. Most temples use symbols of both religions--the Ba Gua over Kuan Yin, the Eight Immortals next to Sakyamuni, etc. The ideological censorship which occured within Daoism as it struggled to maintain its existence has been largely overlooked. In my opinion, this is due to the taboos surrounding what was the essence of Daoist Alchemy: sex and drugs. At one point, there were many sexological texts in the Daoist Canon. According to Douglas Wile, these were censored and removed some time in the second millenium. Daoist drug use, however, survived via the medical tradition, though in a watered-down form.
In an effort to understand the main conflict between Buddhism and Daoist Alchemy, I have come to the conclusion that Buddhists couldn’t tolerate the idea that enlightenment, immortality, or spiritual experience could come through the ingestion of a pill. (A similar conflict led to the prohibition of LSD, psylocybin, mescaline, and other psychedelics in the 20th century U.S., despite that country’s claims to protect ‘freedom of religion' and the 'inalienable right to...pursuit of happiness.') For Buddhists, morality was 1/3 of the spiritual path (the three legs of the Buddhist path are Dharma-the teaching, Sangha-the religious community, and Sila-the keeping of moral precepts), and no spiritual progress could be made without adhering to the moral precepts of Gautama Buddha, which included ‘no sexual misconduct’ and ‘no drinking intoxicating liquors’ as moral dogma. Thus, the Taoist acceptance of plant entheogens as a valid approach to producing spiritual experience was a direct threat to Buddhist dogma and the social control it afforded the ruling class. When people believe that their material suffering comes from their moral weakness, and not from inept politicians, they are much more concerned with their inner guilt than with social revolution. In a similar vein, the Taoist traditions (we’ll probably never know how widely they were practiced or known) of sexual meditation, including certain sects which practiced group sex, were undoubtedly discomforting to the celibate Buddhist clergy. Testament to the efficacy and secret appeal of these practices is the Tantric Buddhist tradition, which is said (by Buddhists, nonetheless) to be the quickest (and most dangerous) path to enlightenment. However, it has been a highly secret fringe practice in Buddhism, probably unknown to the mainstream Buddhists.
This background is meant to set the frame for the Taoist concept of Immortality, not as a result of adherence to a moral code, but as the result of a therapeutic regimen more medical, pharmaceutical, and physiological than religious in concept. It is hoped this will shed more light on the Taoist contributions not only to Chinese Medicine, but to scientific thought in general.

This leads us back to the Three Worms. Parasites, which can include fungal, protozoan, and bacterial infections, all have different ways of affecting their host organisms. In some sense, the less powerful parasites are the most insidious in their effects. Visible worms, which can lead to painful cramping and passing of worms in the stools, are more easily diagnosed and eliminated than a fungal invasion, such as Candida albicans, a yeast who is currently a popular parasitic pet in the west. Candida can lead to a variety of chronic symptoms, hard to pin down and recalcitrant to treat. Depression, lethargy, digestive discomfort, chronic fatigue, poor memory, and all sorts of gooey discharges are all related to Candidiasis. And what does Candida feed on? Mostly grains and sugars!

So the Daoists said there was a worm in each Dan Tien (Elixir Field--the three main energy centers). The one in the lower abdomen causes lust in addition to intestinal distress. The one in the heart center causes anxiety as well as heart and lung diseases. The one in the forehead (Third Eye) center caused psychic distress and attachment to worldly things. They feed off of grains, and endeavor to kill the body for their feast.

To have any hope of living a long time, the Daoists counselled, one must abstain from grains while killing the Three Worms with herbs, exercises, and a diet of vegetables and mushrooms.

Have you yet read Daoist Dietetics for more information?

When enough people write in and comment about this essay, I will write more.

(1) Here we use the word ‘cult’ not to denote some Evil Satanic group, but to designate a small, inwardly focussed group of practitioners who share a secret practice or world-view. Cults are generally much more peaceful than those who persecute them. The American Heritage Dictionary gives the following definition: “An exclusive group of persons sharing an esoteric, usually artistic or intellectual interest.” Return to source

(2) ‘Traditional Chinese Medicine,’ which is the official title for the systematized, streamlined version of Chinese Medicine created under the aegis of Chairman Mao. Return to source

Entheogen is the currently promted term used to encompass the variety of substances which produce (-gen) the inner (-en) experience of the divine mystery (-theo). See Johnathan Ott’s Pharmacotheon for a more detailed discussion of this lexicon. Return to source.

Quotes and Sources:

From:
Taoism: The Parting of the Way
by Holmes Welch
Beacon Press, Boston. 1957, 1965, 1972
ISBN: 0-8070-5973-0

Page 127:

[Ko Hung] gives several formulas for killing the Three Worms who, according to the Interior Gods hygeine school, resided in the body’s vital centers. He recommends avoiding garlic, mustard, and so forth for one hundred days before an alchemical experiment. He considers sexual hygiene essential to the quest of immortality. “The most important thing is to return the semen to repair the brain.” (Pao P’u Tzu)