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Bi Jia (Turtle-shaped Mass) refers to a condition where a mass in the abdomen is shaped like a turtle. Some cases arise from consuming turtle meat followed by exposure to cold, leading to indigestion; others result from eating various meats and then encountering cold, causing pathological changes. All these are caused by deficiency of Spleen and Stomach Qi, which fails to transform and transport when confronted with cold pathogens.

The term "Jia" (Mass) implies "false," indicating that although a tangible mass exists, it is movable and can be shifted in position.

In the past, a master and his servant both suffered from Bi Jia. The servant died first, and upon opening his abdomen, a white turtle was found still alive. Coincidentally, someone riding a white horse came to see the turtle; the horse urinated on the turtle, causing it to retract its head. Consequently, horse urine was forced into the turtle, which dissolved into water. The master said, "My illness will soon be cured." He drank the liquid and indeed recovered. (From *Chao Shi Bing Yuan*)

In another instance, a person died suffering from Zheng Accumulation (hard, fixed masses). His dying wish was for his abdomen to be opened to remove the lesion. The extracted mass was hard as stone with visible grain patterns. People considered it a foreign object, stole it, and carved it into a knife handle. Later, when using this knife to cut *Sambucus chinensis* (Lian Qiao/San Leng context implies cutting herbs), the handle dissolved into water, revealing its efficacy in treating Zheng Jia.

A monk at Xianqing Temple had been ill for several years. Although he did not need to lie in bed, after the fourth watch (around 1-3 AM), he felt stifling hardness in his heart region and could not sleep peacefully, requiring him to get up and walk. The temple residents became accustomed to this, unaware of the disease. He sought treatment from Dai Ren (Zhang Congzheng). Dai Ren induced emesis, expelling one or two sheng of gelatinous phlegm resembling black alum water, followed by yellow-green fluid, and subsequently purged several sheng of pus and blood. Thereafter, he felt as if a huge mountain had been removed from his chest, and his appetite returned significantly.

The wife of Liu Ziping from Guojun Village had an abdominal mass the size of a ladle for eighteen years. Her menstruation had ceased, and all other treatments failed. Dai Ren instructed her to undergo emesis four times and purgation six times within one month. Approximately one or two buckets of phlegm were expelled, containing undigested matter resembling boiled okra and fish intestines. She felt the accumulation being excised, gradually subsiding. Once the accumulation was completely cleared, the scar of the mass resembled a mortar, with no significant damage to her body. At this point, her face regained a youthful complexion, and her menstruation resumed.

The wife of the Magistrate of Yangxia suffered from Fei Qi (Liver Enlargement/Mass). Initially, it was the size of a wine cup, accompanied by alternating chills and fever upon each flare-up. After fifteen or sixteen years, exacerbated by grief and sorrow, the condition worsened severely. Only an area about three fingers wide below the heart remained unaffected; the rest of the abdomen was hard as a stone slab, preventing sitting or lying down. Acupuncture and herbal medicine proved ineffective. Respectfully inviting Dai Ren, upon diagnosis, he stated: "This is Fei Qi, contracted in late summer, located under the left hypochondrium like an inverted cup. If untreated for long, it causes malaria-like chills and fevers." He administered Gua Di San (Melon Pedicle Powder) to induce vomiting, expelling one or two sheng of yellow, fish-glue-like phlegm. That night, he continued treatment with Zhou Che Wan (Boat and Cart Pill) and Tong Jing San (Unblocking Meridian Powder). At the fifth watch (around 3-5 AM), she passed five or six stools consisting of half yellow phlegm and half pus/blood, experiencing pain in all areas of accumulation. Subsequently, Bai Zhu San (Atractylodes Macrocephala Powder) and Dang Gui San (Angelica Sinensis Powder) were used combined with herbs to harmonize blood flow and meridians. After three or four cycles of emesis and purgation, the disease finally resolved. This case illustrates a long-standing accumulation.