《神农本草经》论鳖甲主心腹 瘕坚积。《金匮》鳖甲煎丸用之以消疟母（胁下硬块）。药局又皆以
醋炙，其开破肝经之力尤胜。向曾单用鳖甲末三钱，水送服，以治久疟不愈，服后病者觉怔忡异
常，移时始愈，由斯知肝虚弱者，鳖甲诚为禁用之品也。又龟板《神农本草经》亦主 瘕，兼开湿痹。后世
佛手散用之，以催生下胎。尝试验此药，若用生者，原能滋阴潜阳，引热下行，且能利小便（是开湿痹之效）。
而药局中亦皆用醋炙之，若服至一两，必令人泄泻，其开破之力虽逊于鳖甲，而与鳖甲同用以误治虚弱之证，
实能相助为虐也。乃后世方书用此二药以治虚劳之证者甚多，即名医如吴鞠通，其治温邪深入下焦，热深
厥深，脉细促，心中 大动，此邪实正虚，肝风煽动将脱，当用白虎加人参汤，再加龙骨、牡蛎，庶可
挽回，而吴氏竟治以三甲复脉汤，方中鳖甲、龟板并用，虽有牡蛎之收涩，亦将何补？此乃名医之偶失检点也。
愚曾治一媪年近五旬，患温病半月不愈。其左脉弦硬有真气不敛之象，右脉近洪而不任重按，此邪实证
虚也，为拟补正祛邪之剂。病者将药饮一口，嫌其味苦不服。再延他医，为开三甲复脉汤方，略有加减，服
后烦躁异常，此心肾不交，阴阳将离也。医者犹不省悟，竟于原方中加大黄二钱，服后汗出不止。此时若
重用山萸肉二两，汗犹可止，汗止后，病仍可治，惜该医见不及此，竟至误人性命也。
《神农本草经》记载鳖甲主治心腹部的瘕坚积（腹部结块坚硬不移的病证）。《金匮要略》中的鳖甲煎丸使用它来消除疟母（疟疾日久形成的胁下硬块）。药局通常都用醋炙制，其攻破肝经的力量尤其强劲。过去我曾单用鳖甲末三钱，用水送服，治疗久治不愈的疟疾，服药后患者感到心悸异常，过了许久才缓解，由此可知对于肝脏虚弱的人，鳖甲确实是禁用的药物。另外龟板在《神农本草经》中也主治瘕，兼能开通湿痹（因湿邪阻滞经络导致的肢体麻木疼痛等症）。后世佛手散中使用它，用来催产下胎。我曾经试验过这种药，如果使用生品，原本能够滋阴潜阳，引导热邪下行，并且能通利小便（这是开通湿痹的功效）。但药局中也都使用醋炙制品，如果服用达到一两，必然会导致腹泻，其攻破之力虽然比鳖甲稍弱，但如果与鳖甲同用误治虚弱之证，实际上会相互助长危害。然而后世方书中使用这两味药治疗虚劳病证的非常多，即使是名医吴鞠通，他治疗温邪深入下焦，热邪深重导致四肢厥冷，脉象细数急促，心中悸动不安，这是邪气实而正气虚，肝风煽动即将脱失的危候，应当使用白虎加人参汤，再加龙骨、牡蛎，或许可以挽回局面，但吴氏竟然用三甲复脉汤治疗，方中鳖甲、龟板并用，虽然有牡蛎的收涩作用，又有什么补益呢？这是名医偶尔疏忽大意所致。
我曾经诊治一位年近五十岁的老妇人，患温病半个月未愈。她的左脉弦硬，有真气不能收敛的征象，右脉近于洪大但不能重按，这是邪气实证而正气虚弱的表现，我为她开具了扶正祛邪的方剂。病人喝了一口药，嫌味道苦不肯再服。随后请另一位医生诊治，医生开了三甲复脉汤方，略有加减，服药后烦躁异常，这是心肾不交，阴阳即将离决的表现。医生仍然没有醒悟，竟然在原方中加入大黄二钱，服药后汗出不止。此时如果重用山萸肉二两，汗还可以止住，汗止后，病情仍可救治，可惜那位医生见识不到这一点，最终导致误人性命。
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.