San Jia Fu Mai Tang三甲复脉汤
Three-Shell Decoction to Restore the Pulse
Ingredients9 herbs
Indications
Heat lodged in the lower burner late in a warm-febrile disease, consuming yin so that the pulse loses its body and yang drifts. Wind stirs from the same emptiness that leaves the heart unsettled.
Clinical Manifestations
- Palpitations with a hollow, pounding sensation in the chest after fever
- Thin, hurried, irregular pulse in convalescence
- Twitching of the limbs late in a febrile illness
- Heat sensation in the palms and soles with night sweats
- Chest discomfort during recovery, alongside medical assessment
Health Categories
Modern Applications
Common adjustments
- Twitching progresses toward frank tremor with a sense of collapse — Ji Zi Huang (egg yolk) and Wu Wei Zi 五味子 are added — which is to say, the parent formula Da Ding Feng Zhu is used
- Sweating profusely with a collapsing pulse — qi-holding herbs are added and emergency medical care sought in parallel
- Persistent low-grade fever with night sweats — Qing Hao 青蒿 is combined with Bie Jia for the deficient-heat pattern
- The rich ingredients cause fullness and loose stools — E Jiao 阿胶 and Huo Ma Ren are reduced and the Spleen supported
Contraindications
Palpitations, an irregular pulse and chest pain are cardiac symptoms until proven otherwise: new or worsening chest pain, breathlessness, fainting or a racing irregular heartbeat needs medical assessment, and this formula is not a reason to postpone it. Not for excess heat with a forceful pulse and thick coating, where rich tonics hold the pathogen in. Not for a cold, damp, weak digestion — the formula is greasy and causes fullness, nausea and loose stools. E Jiao is donkey-derived and unsuitable for vegetarian patients; Gui Ban and Bie Jia require lawful sourcing. Use in pregnancy only with practitioner supervision.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Used in pregnancy only under practitioner supervision. The formula itself nourishes rather than attacks and E Jiao is commonly used in pregnancy, but the shell medicinals are heavy and sinking and are not given casually to a pregnant patient. Palpitations, an irregular heartbeat or chest pain in pregnancy require obstetric and medical assessment first.
Related Formulas
References
Source Wen Bing Tiao Bian 《温病条辨》 · Qing
「下焦温病，热深厥甚，脉细促，心中憺憺大动，甚则心中痛者，三甲复脉汤主之。」
- Classical source (public domain), cited in the source-quote section.
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）— listed as an appended formula to 大定风珠.
4. CITES and national listings for testudines used as 龟板 and 鳖甲 — sourcing.
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.