Large-fruited elm

A thin child with a distended abdomen, picky appetite, pale sallow face, and recurrent colicky pain around the navel where worms are suspected

Worm infestation in a patient who is also cold and sluggish in the middle, where a warming vermifuge is preferred to the bitter cold ones

Overview. Ulmus macrocarpa is a small elm of northern China, Mongolia, and Korea, easily told by its unusually large winged fruits. The medicine, wu yi, is not the raw fruit but a fermented cake: the ripe samaras are crushed, mixed with flour and aromatic herbs, and left to ferment and dry into a dark, strong-smelling mass. It has been listed since the earliest Chinese materia medica as a warm vermifuge and digestive, and it sits in the parasite-expelling category alongside quisqualis and areca.

Clinical Notes. Wu yi is a supporting worm herb rather than a first choice on its own. Classical worm pills combine it with quisqualis fruit, areca seed, melia bark, carpesium fruit, and morning glory seed, and modern practice usually reaches for pharmaceutical anthelmintics first.

Chinese Medicine Profile. Temperature: warm. Taste: acrid, bitter. Channels: Spleen, Stomach. Actions: Kills intestinal parasites; Disperses food accumulation and relieves abdominal distension; Dries dampness and stops itching when applied to the skin; Warms the middle burner and supports digestion weakened by worms.