Disease Scalpel (二豎刀 Nijūtō) is a form of Holder Magic used primarily in battle by Richard Aria. It is one of the main reasons for his moniker. Disease Scalpel allows Richard to use his unique magical power by converting it into a "negative status" and channel it into a scalpel. By doing this, he is able to cause several different effects. These could include, inflicting illnesses onto an opponent, reducing their output of magical power or vice-versa and even allow himself to counter any poison that is used against him. His abilities are such with this magic that he can cause several different "status effects" in only moments with a variety of scalpels, causing immense confusion amongst enemy ranks. Sanjo compares this magic to "Debuffs and Buffs" in RPG's, allowing him to seep slow but near-inevitable defeat against an opponent.
- Paralysis Scalpel (麻痺メス Mesu Mahi): Richard's scalpel begins to collect static energy and then flashes. When this scalpel makes contact with the foe, it infects them with paralysis, leaving hem unable to move.