Bie Jia Jian Wan - 鳖甲煎丸 - Turtle Shell Pills

English:	Turtle Shell Pills
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Carapax Trionycis	Bie Jia	90g	Anchors Yang, Dissipates nodules, Invigorates the Blood, Nourishes Yin, Promotes menstruation, Softens hardness. With Chai Hu and Tu Bie Chong, for chronic malarial disorders with organomegaly and hypochondriac pain.
Rz. Belamcandae	She Gan	22.5g	Clears Heat, Clears the Lungs, Eliminates wheezing, Relieves Fire toxicity, Transforms Phlegm.
Rx. Scutellariae	Huang Qin	22.5g	Clears Heat, dries Dampness and cools the Blood. With Da Huang, for constipation.
Rx. Aconiti Lateralis Preparata	Zhi Fu Zi	22.5g	Disperses Cold and Dampness, warms the channels and stops pain. With Gan Jiang, warms the Spleen and Kidneys, benefits Yang, and Disperses Cold.
Rz. Zingiberis	Gan Jiang	22.5g	Warms the Middle, warms the channels and expels Cold. With Zhi Fu Zi, for overabundance of Yin fluids due to Deficiency Cold.
Rx. et Rz. Rhei	Da Huang	22.5g	Drains Heat, purges accumulations, invigorates the Blood, dispels Blood Stasis and eliminates Phlegm. With Zhi Fu Zi, for constipation due to Cold accumulation. With Dang Gui, for Blood Stasis. With Gui Zhi, removes Stasis and unblocks the flow of Qi for Blood Stasis. With Mang Xiao, eliminates obstruction in the Intestines for severe constipation with passage of liquid but no solid stool. With Ren Shen and E Jiao, for chronic Blood Stasis with Qi and Blood Deficiency.
Ram. Cinnamomi	Gui Zhi	22.5g	Unblocks Yang, transforms Qi and thin mucus, warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels, warms the Middle and directs Turbid Yin downward. With Bai Shao, warms and tonifies the Middle Jiao. With Mu Dan Pi, for gynecological discomfort due to Blood Stasis and lower abdominal masses.
Fol. Pyrrosiae	Shi Wei	22.5g	Clears Damp-Heat and expels Phlegm.
Cx. Magnoliae Officinalis	Hou Po	22.5g	Promotes the movement of Qi in the Middle Jiao, resolves Stagnation, descends Qi, dries Dampness and transforms Phlegm. With Gui Zhi and Gan Jiang, for distention and fullness due to congealing of Cold leading to Qi Stagnation. With Gan Jiang, for acute diarrhea from Cold attacking the Middle.
Hb. Dianthi	Qu Mai	22,5g	Drains Damp-Heat from the Urinary Bladder, breaks up Blood Stasis, invigorates Blood circulation, regulates menstruation and unblocks the bowels.
Flos Campsis	Ling Xiao Hua	22.5g	Dispels Blood Stagnation, unblocks the channels and vessels and disperses abdominal masses.
Colla Corii Asini	E Jiao	22.5g	Tonifies the Blood and nourishes and moistens Yin.
Rx. Bupleuri	Chai Hu	45g	Spreads Liver Qi and relieves Stagnation. With Bai Shao, for Liver Blood Deficiency with Liver Qi Stagnation. With Huang Qin, restores normal function of the Liver and Gallbladder. Wit
Dry-fried Dung Beetle	Chao Qiang Lang	45g	Relieves constipation, attacks toxins and disperses Blood Stagnation.
Rx. Paeoniae Alba	Bai Shao	37g	Nourishes the Blood, regulates menstruation, softens the Liver and relieves pain. With Chai Hu, for flank pain due to Liver Qi Stagnation. With Huang Qin, cools Heat and nourishes the Blood.
Cx. Moutan	Mu Dan Pi	37g	Clears Heat, Cools, Dispels Blood Stasis, Drains pus, Invigorates and harmonizes the Blood, Reduces swelling. With Huang Qin and Chai Hu, for Heat causing pre-menstrual fevers or epistaxis during periods. With Tao Ren and Gui Zhi, for amenorrhea and abdominal pain due to Blood Stasis.
Stir-fried Eupolyphaga/ Steleophaga	Chao Tu Bie Chong	37g	Breaks up and drives out Blood Stasis, invigorates Blood circulation and disperses lumps and masses. With Da Huang, breaks up fixed abdominal masses from Blood Stasis. With Da Huang and Tao Ren, for menstrual pain or postpartum abdominal pain due to Blood Stasis.
Dry-fried Nidus Vespae	Chao Lu Feng Fang	30g	Dries Dampness, Expels Wind, Treats tumors and stops pain.
Natrii Sulfas	Mang Xiao	90g	Clears Heat, Drains Fire, Guides out Stagnation, Moistens Dryness, Purges accumulations, Reduces swelling, Softens hardness.
Sm. Persicae	Tao Ren	15g	Breaks up Blood Stasis, invigorates Blood circulation, moistens the Intestines, unblocks the bowels and drains abscesses. With Gui Zhi and Da Huang, for Blood Stasis and Heat in the Lower Jiao.
Rx. Ginseng	Ren Shen	7.5g	Tonifies Spleen and Stomach Qi.
Rz. Pinelliae Preparatum	Zhi Ban Xia	7.5g	Dries Dampness, transforms Phlegm, dissipates nodules and reduces Stagnation. With Hou Po, for s Phlegm-Dampness with Qi Stagnation. With Huang Qin, for Phlegm-Heat induced Rebellious Qi with cough, nausea, and vomiting.
Sm. Lepidii	Ting Li Zi	7.5g	Circulates water, reduces edema and reduces Phlegm.

Formula Actions

• Invigorates the Blood
• Removes Stasis
• Circulates Qi
• Resolves Phlegm
• Eliminates accumulations
• Softens and resolves hard masses

Syndromes

• Qi, Blood and Phlegm Stagnation
• Malaria with splenomegaly due to Qi/Blood stagnation and Damp-Phlegm (Secondary source)

Clinical Manifestations

Immobile masses below the hypochondrium or in the abdomen Abdominal pain Emaciation Poor appetite Alternating chills and fever

Amenorrhea Hard abdominal masses that produce pain Aggravated by pressure Hypochondriac distention T: Purple with echymoses P: Choppy

Treats

Uterine myoma Malaria with splenomegaly Chronic hepatitis Hepatomegaly Jaundice Abdominal masses Amenorrhea

Cirrhosis of the Liver Schistosomiasis Splenomegaly Liver cancer Abdominal pain Poor appetite

Contraindications And Herb/Drug Interactions

Notes

• 1.5kg of plant ash is steeped in 5kg of millet wine and then the ash is filtered out to get the decoction, in which Bie Jia is decocted into a gum. All the other drugs are ground into fine powder. The gum and the powder are made with honey into pills. 3g of the pills are taken with warm boiled water each time, 3 times daily.

Modifications

With general weakness and Deficiency:		For decreased Food intake and indigestion:
+ Rx. Astragali	Huang Qi	+ Fr. Crataegi	Shan Zha
+ Rz. Atractylodis Macrocephalae	Bai Zhu	+ Massa Medicata Fermentata	Shen Qu
+ Rx. Rehmanniae Preparata	Shu Di Huang	+ Endothelium Corneum Gigeriae Galli	Ji Nei Jin
+ Rx. Angelicae Sinensis	Dang Gui