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The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states that Biejiia (Tartar Testudinis, Turtle Shell) primarily treats jianji (hard accumulations) in the heart and abdomen. The Biejia Jianwan (Turtle Shell Pill for Eliminating Malaria Mass) in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) uses it to eliminate Nuomu (malaria mass, a hard lump under the hypochondrium). Pharmacy preparations are typically stir-fried with vinegar, enhancing its power to break through and dissipate stagnation in the Liver meridian. I once used three qian of Biejiia powder alone, taken with water, to treat persistent malaria. After taking it, the patient experienced severe palpitations (zhengchong), which only subsided after some time. From this, I realized that for those with Liver deficiency, Biejiia is indeed a contraindicated substance. Furthermore, Guiban (Testudinis Plastrum, Carapace and Plastrum of Turtle) is also recorded in the *Shennong Bencao Jing* as treating jianji and opening up shibi (bi-syndrome caused by dampness). In later times, Foshou San (Buddha's Hand Powder) used it to induce labor and expel the fetus. I have experimented with this herb; if used raw, it can originally nourish Yin and subdue Yang, guide heat downward, and promote urination (which is the effect of opening shibi). However, pharmacy preparations also use vinegar-processed versions. If taken up to one liang, it will inevitably cause diarrhea. Although its breaking power is slightly inferior to that of Biejiia, when used together with Biejiia to mis-treat deficiency syndromes, they actually assist each other in causing harm. Nevertheless, many prescriptions in later medical texts use these two herbs to treat xulao (consumptive disease). Even famous physicians like Wu Jutong treated cases where warm pathogenic factors had penetrated deeply into the Lower Jiao, characterized by deep heat and deep cold extremities, a fine and rapid pulse, and severe palpitations. This indicates excess pathogen and deficient righteous qi, with Liver wind stirring and impending collapse. One should use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) and add Longgu (Fossilized Mammoth Tooth/Bone) and Muli (Oyster Shell) to potentially save the condition. Yet Wu prescribed Sanjia Fumai Tang (Three Shells Decoction to Restore the Pulse), using both Biejiia and Guiban in the formula. Despite the astringent properties of Muli, what benefit would this bring? This was a momentary lapse in judgment by a renowned physician.

I once treated an elderly woman near fifty years old who suffered from a warm disease for half a month without recovery. Her left pulse was wiry and stiff, indicating a failure of true qi to consolidate; her right pulse was nearly flooding but could not withstand heavy pressure, indicating an excess syndrome with underlying deficiency. I prescribed a formula to tonify righteousness and dispel pathogens. The patient took one sip of the medicine, found it too bitter, and refused to continue. She then sought another physician, who prescribed Sanjia Fumai Tang with slight modifications. After taking it, she became extremely irritable, indicating a failure of communication between the Heart and Kidney, and impending separation of Yin and Yang. The physician remained unaware of this critical state and added Erqian (two qian) of Dahuang (Rhubarb Root and Rhizome) to the original prescription. After ingestion, sweating continued uncontrollably. At this point, if a heavy dose of Shan Yurou (Cornus Fruit) of two liang were used, the sweating could still be stopped. Once the sweating ceased, the illness could still be treated. Unfortunately, the physician lacked this insight, ultimately leading to a fatal error.