Biejia Jian Wan (Turtle Shell Decoction Pill)

金匱要略

For malaria, if it occurs on the first day of the month, it should resolve by the fifteenth day; if it does not improve, it should resolve by the end of the month; if it still does not improve, what then? The master said: This forms abdominal masses, named malaria mother. Treat it urgently; Biejia Jian Wan is suitable. (Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet))

Carapax Trionycis 12 fen (prepared), Belamcanda rhizome (Wu Shan) 3 fen (roasted), Scutellaria root 3 fen, Bupleurum root 6 fen, woodlouse 3 fen (boiled), dried ginger 3 fen, rhubarb 3 fen, peony root 5 fen, cassia twig 3 fen, Tingli seed 1 fen (boiled), Pyrrosia leaf 3 fen (de-haired), magnolia bark 3 fen, moutan bark 5 fen (core removed), Dianthus superbus 2 fen, Campsis flower 3 fen, Pinellia tuber 1 fen, ginseng 1 fen, ground beetle 5 fen (boiled), donkey-hide gelatin 3 fen (prepared), honeycomb 4 fen (prepared), red nitre 12 fen, dung beetle 6 fen (boiled), peach kernel 2 fen. The above twenty-three ingredients are ground into powder. Take one dou of ash from under a forging stove and one hu five dou of clear wine; soak the ash, wait until half the wine is gone, place the Carapax Trionycis in it, boil until it becomes mushy like glue and lacquer, strain to obtain the juice, add the other medicines, and decoct into pills the size of Firmiana seeds. Take seven pills on an empty stomach, three times a day. (Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases))

The above twenty-three ingredients: take one dou of ash from under a forging stove and one hu five dou of clear wine; soak the ash, wait until half the wine is gone, place the soft-shelled turtle shell in it, boil until it becomes mushy like glue and lacquer, strain to obtain the juice, add the other medicines, and decoct into pills the size of Firmiana seeds. Take seven pills on an empty stomach, three times a day. (Modern usage: except for nitre, soft-shelled turtle shell, and donkey-hide gelatin, dry and cut the remaining 20 ingredients into pieces, add 600 g of yellow wine, mix well, cover and seal, stew over water until the wine is gone and the medicines are cooked, dry, then mix and pulverize with the three ingredients including nitre into a fine powder, and make into pills with refined honey, each pill weighing 3 g. Take 1–2 pills each time, 2–3 times a day, swallowed with warm boiled water.)

丸劑

Move qi and activate blood, eliminate dampness and Resolve Phlegm, soften hardness and dissipate masses.

Chronic malaria that does not heal, with hard masses below the hypochondrium, forming malaria mother, as well as abdominal masses and accumulations.

This formula is good at dissipating masses and dispersing nodules, but its power to support vital qi is insufficient. If there are masses with severe vital qi deficiency, use with caution.