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Turtle Shell Tablets is based on modern Chinese research into treatments for endometriosis. This research has yielded several versions of a small formulation called Neiyi Wan (Endometriosis Pill), with ingredients similar to those listed above. The key ingredients of those pills are turtle shell to shoften masses and rhubarb to vitalize blood (not for laxitive effect; it is usually prepared with vinegar to enhance its blood vitalizing effect). The pill is used in relatively small dosage (compared to some other treatment strategies relying on high dosage decoctions) and, according to the Chinese reports, it is common to gain remission from the disease within an few months. The formula may regulate hormones, inflammatory mediatorsm and components of the immune system that yield the severe pain response, usually accompanying menstruation. The basic Neiyi Wan described in the Chinese reports contains turtle shell, rhubarb, and succinum; the other ingredients in Turtle Shell Tablets also vitalize blood circulation (cinnamon twig and red peony together harmonize the circulation in the vessels and prevent painful spasms). In rare instances, turtle shell and rhubarb can cause abdominal cramping or diarrhea. In such cases, it is better to select an alternative approach, such as using Lindera 15 or Lower Palace Tablets, plus Corydalis 5 during menstruation or whenever pain occurs. Strong dispersing therapies, such as this one, are usually provided for only a few weeks or months; after that, treatment would continue with milder dispersing formulas, usually involving a combination of qi and blood regulating therapies.