This is a "Nade-mamori" amulet from Ishikiri Tsurugi-ya Shrine, affectionately known as "Ishikirisan" in Osaka. The shrine is believed to cut through stone and also to cure swellings (called "denbo" in Osaka). Nowadays, many worshippers visit seeking the divine favor to sever bad connections with illness and to bring about good connections with health. This amulet contains a protective charm and sacred rice, and instructions for use are written on the back (see photo). Note that you can return the old amulet to any shrine. I visited and received this on January 2nd, Reiwa 8 (2026). I will pass it on to someone who needs it.