Bie Jia Jian Wan鳖甲煎丸
Turtle Shell Decocted Pill
Ingredients23 herbs
Indications
Long-standing accumulationin which blood stasis, phlegm-damp and lingering heat have solidified into a mass, in a patient whose right qi is already worn down. Attack and support have to run at the same time.
Clinical Manifestations
- Palpable mass below the ribs after chronic malarial illness
- Abdominal massesof long standing
- Enlarged spleen or liver with a fixed hard edge
- Chronic fixed hypochondriac pain with emaciation
Health Categories
Modern Applications
Common adjustments
- Marked qi deficiency and exhaustion — increase Ren Shen 人参 and pair with a qi tonic decoction between courses
- Ascites or marked abdominal swelling — this is beyond the formula alone — treat within an integrated plan and investigate the underlying liver disease
- Blood deficiency with pallor — increase E Jiao 阿胶 and add Dang Gui 当归
Contraindications
Not for a patient too depleted to tolerate attack, and not where the mass has not been investigated — an abdominal mass in an adult requires a diagnosis before it is treated as. Not for anyone with a bleeding tendency, low platelets, or on anticoagulant medication. The insect medicinals are a common cause of allergic reaction; stop at the first sign of rash or wheeze.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Absolutely contraindicated in pregnancy and while breastfeeding. The formula is built on mass-breaking insect medicinals —, Shu Fu, — together with Da Huang, Tao Ren, and Ban Xia, and it can cause uterine contraction, bleeding and loss of the pregnancy. in particular has antithrombotic activity, so the formula should not be combined with warfarin, direct oral anticoagulants or antiplatelet drugs except under a physician who is monitoring clotting.
References
Source Jin Gui Yao Lue 《金匮要略》 · Eastern Han
「病疟以月一日发，当以十五日愈；设不差，当月尽解；如其不差，当云何？师曰：此结为癥瘕，名曰疟母，急治之，宜鳖甲煎丸。」
- Classical source (public domain) — 《金匮要略·疟病脉证并治》, Eastern Han, Zhang Zhong-jing.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— 理血剂 · 活血祛瘀, pattern and 配伍 analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.