Today, I’d like to talk with you about a classic formula for tackling "stubborn lumps" in the body—Biejia Jian Pills.

As we all know, issues like cysts and nodules are often viewed in Traditional Chinese Medicine as "masses" formed by the stagnation of qi, blood, phlegm, and blood stasis. To address them, formulas such as Guizhi Fuling Pills are commonly used to resolve blood stasis and disperse masses. However, Guizhi Fuling Pills primarily use herbal ingredients, which are relatively mild in nature. When dealing with particularly stubborn, long-standing, or hard-to-the-touch masses, their potency in breaking down and dispersing these lumps may sometimes fall short.

At this point, our ancestors’ "secret weapon," left by Zhang Zhongjing in *Synopsis of the Golden Chamber*—Biejia Jian Wan (Turtle Shell Decoction Pill)—comes into play. Why is its "combat power" stronger? The key lies in its use of the "worm and insect searching and purging" method, which is more concentrated in force and has greater penetrating power.

How does Biejia Jian Wan "break through tough challenges"? Let’s break it down:

Mainly "softening": The core of the formula is E-Jiao (Donkey-Hide Gelatin), which acts like a "softener," specifically targeting those hard and tough nodules. Combined with Fengfang (Honeycomb) and Xiaoshi (Sal Ammoniac), they work together to "soak and soften" the hard masses, laying the foundation for the next step of removal. At the same time, Qumai (Dianthus) is responsible for promoting urination, expelling those "phlegm-dampness waste fluids" that have solidified into lumps through the water pathway.

Deep "breaking stasis": This step is powerful! It incorporates the foundational effect of Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) in warming and unblocking blood vessels. More crucially, it adds "insect drugs" such as Tubiechong (Ground Beetle) and Qianglang (Dung Beetle). These act like "miniature drilling machines" within the body, excelling at penetrating deep into the fine meridians and blood vessels, gradually "prying apart" and "breaking up" those long-entrenched, stubbornly intertwined stagnant blood. For dealing with those hard, indurated masses that haven’t dissipated for years, this combination is the main force.

Target the "Root Cause": Simply dispersing isn't enough; you must prevent re-growth. Here, Bupleurum (Chai Hu) and Magnolia Bark (Hou Po) are used to regulate the flow of qi, preventing stagnation; Pinellia (Ban Xia) and Fresh Ginger (Sheng Jiang) are used to resolve phlegm-dampness, clearing the internal environment of the body and cutting off the "nutrient source" for the growth of masses.

Protect the "Self": With such a powerful assault, could it harm the body? The formula anticipates this too. It includes small amounts of Codonopsis (Dang Shen) to tonify qi and Donkey-Hide Gelatin (E Jiao) to nourish blood. This is like providing ample supplies and logistics for the "combat troops," ensuring that our own "righteous qi" is not excessively depleted while attacking the pathogenic factors.

Let me interject with a real-world example:

Last year, I treated a 45-year-old woman, Ms. Li, who had been diagnosed with uterine fibroids for several years. The largest was nearly 4 cm, firm in texture. She experienced heavy menstrual flow with clots and frequent lower abdominal distension and pain. She had previously tried some formulas for promoting blood circulation and resolving stasis, but the effects weren't significant. Based on her condition, which was differentiated as a case of phlegm-stasis intermingling with a prolonged course, I incorporated the Turtle Shell Decoction Pill (Biē Jiǎ Jiān Wán) into her foundational regulating formula (with the dosage adjusted as prescribed). After persisting with the treatment for about three months, a re-examination showed the fibroid had significantly shrunk by nearly 40% and its texture had softened. Her menstrual situation improved greatly, and the abdominal pain and distension had essentially disappeared. This case demonstrates the Turtle Shell Decoction Pill's genuine, relatively good ability to attack and dissipate hard masses with a long disease course and firm texture.

A final reminder to everyone:

Turtle Shell Decoction Pill is indeed a powerful "general" for attacking stubborn conditions, with significant effects, but it itself is a comprehensive formula containing 23 herbs, with a rigorous formulation and strong potency. It is not a health supplement and should not be purchased and taken casually on one's own! It must be used under the guidance of an experienced traditional Chinese medicine practitioner who will conduct a detailed pattern differentiation to determine whether it is suitable for your specific constitution and condition, as well as how to use it (including dosage, treatment duration, and whether it needs to be combined with other medications, etc.). When used correctly, it is a good medicine; when used incorrectly, it may harm the body. Remember to use it rationally under professional guidance!