较广博，药各系以七律，凡五百三十四首，录其第一首“人参诗”云∶五叶三桠别样新，黄
参上党味尤纯，瑶光星散天边宝，人体精成地底珍，开胃助脾能补气，宁心润肺自安神，元
阳可唤春回转，虚实须教识别真。按∶人参功用固大，误服之害亦非细，末句命意深矣。
袁随园所为《徐灵胎先生传》，载治迮耕石疾，阅之不甚了了，近观《洄溪医案》，乃
如释
然。医案云∶芦墟迮耕石暑热坏症，脉微欲绝，遗尿谵语，寻衣摸床，此阳越症，将大汗出
而脱，即以参附加童便饮之，少苏而未识人也。余以事往郡，戒其家曰∶如醒而能言，则
来载我。越三日来请，亟往，果生矣，医者谓前药已效，仍用前方，煎成未饮，余至曰∶阳
已回，火复炽，阴欲竭矣，附子入咽即危。命以西瓜啖之，病者大喜，连日啖数枚，更饮以
清暑养胃而愈。后来谢，述昏迷所见一黑人立其前，欲啖之，即寒令入骨，一小儿以扇驱之
曰∶汝不怕霹雳耶？黑神曰∶熬尔三霹雳，奈我何！小儿曰∶再加十个西瓜何如？黑神惶恐而
退。余曰∶附子古名霹雳散，果服三剂，非西瓜则伏暑不消。其言皆有证据，亦奇事也。
鼻之下口之上为水沟穴，名为人中，其说有二∶一谓自此而上，目耳鼻皆双窍，自此以
下口
及二便皆单窍，上三画阴，下三画阳，合成泰卦也。一则谓天气通于鼻，地气通于口，天食
人以五气，鼻受之，地食人以五味，口受之，穴居其中，故名之曰人中。见程云来《医暇卮
言》
膀胱或谓有上口无下口，或谓有下口无上口，张景岳、李士材亦主此说，人皆信之，而
不知
其非也。若无上下口，何以有交肠之病乎？吴县沈实夫果之，独谓上下皆有口，而上口常闭
，水之入于膀胱，仍是三焦化入，而非从上口以入。若腑气大虚，则力乏而窍不能闭，或邪
热伤腑，则主开泄，而窍亦不能闭，甚至有交肠之病，粪从小肠下口入膀胱上口，并随小便而
出。譬如人身之外窍，脐孔与两耳两乳，亦常闭而不开，有故则或出脓血，或通乳汁，膀胱
之上口亦可以类推矣。此论最为近似。余按∶唐与正治吴巡按病不得溲，卧则微通，立则不
能涓滴，询知常服黑锡丹，因悟结砂时铅不死，硫黄飞去，铅沙入膀胱，卧则偏重犹可溲，
立则正塞水道，以故不能通，令取金液丹三百粒，分为十服，煎瞿麦汤下之，膀胱得硫黄，
积铅成灰，从水道下，犹累累如细砂，病遂愈。观此益可证膀胱之有上下口也。
内容较为广博，书中每味药都配有一首七言律诗，共计五百三十四首。摘录其中第一首《人参诗》说道：“五叶三桠别样新，黄参上党味尤纯，瑶光星散天边宝，人体精成地底珍，开胃助脾能补气，宁心润肺自安神，元阳可唤春回转，虚实须教识别真。”按语说：人参的功效固然巨大，但误服的害处也不小，最后一句的用意非常深远。
袁枚（号随园）所写的《徐灵胎先生传》，记载治疗迮耕石的疾病，读起来不太明白。最近阅读《洄溪医案》，才恍然大悟。医案记载：芦墟人迮耕石患暑热重症，脉象微弱几乎摸不到，遗尿、胡言乱语，手无意识地摸索床沿衣物，这是阳气外越的证候，即将大汗淋漓而脱阳。立即用人参、附子配合童便饮用，患者稍苏醒但不能辨认人。我因事去郡城，嘱咐其家人说：“如果醒来能说话，就来载我去。”过了三天来请，急忙前往，果然救活了。医生认为前面的药有效，仍用前方，煎好还没喝，我到了说：“阳气已回，火气复炽，阴液将要枯竭了，附子入口就会危险。”命令给病人吃西瓜，病人非常高兴，连日吃了几枚，再服用清暑养胃的药而痊愈。后来感谢我，叙述昏迷时看见一个黑人在他面前，想要吃他，立刻冷得刺骨，一个小孩子用扇子驱赶他说：“你不怕霹雳吗？”黑神说：“熬过三个霹雳，你能把我怎么样！”小孩子说：“再加十个西瓜怎么样？”黑神惶恐地退去。我说：附子古名叫霹雳散，果然服了三剂，如果不是西瓜，伏暑就不会消除。他的话都有依据，也是奇事。
鼻子下面嘴巴上面的穴位叫水沟穴，名为人中，关于它的说法有两种：一种说法是从这里往上，眼耳鼻都是双窍，从这里往下，口及大小便都是单窍，上面三画属阴，下面三画属阳，合成泰卦。另一种说法是天气通于鼻，地气通于口，天以五气养人，由鼻受纳；地以五味养人，由口受纳，穴位居其中间，所以叫它人中。见于程云来的《医暇卮言》。
膀胱有人说有上口无下口，有人说有下口无上口，张景岳、李士材也主张这种说法，人们都相信它，却不知道它是错的。如果没有上下口，怎么会有交肠病呢？吴县沈实夫果之，唯独认为上下都有口，而且上口经常关闭，水进入膀胱，仍然是经过三焦气化渗入，而不是从上口直接流入。如果腑气大虚，则力量匮乏导致窍不能闭合；或者邪热损伤腑脏，则主开泄，窍也不能闭合，甚至出现交肠病，粪便从小肠的下口进入膀胱的上口，并随着小便排出。就像人身体的外窍，脐孔与两耳、两乳，也经常关闭而不打开，有病时则或流出脓血，或通畅乳汁，膀胱的上口也可以这样类推。这个论述最为接近真理。我按：唐与正治疗吴巡按的病，小便不通，躺着时稍微能通，站着时完全不能滴出，询问得知他常服黑锡丹，因此领悟到炼制丹药时铅没有死（转化），硫黄飞走了，铅沙进入膀胱，躺着时偏重尚且可以排尿，站着时正中堵塞水道，所以不能通利，让他取金液丹三百粒，分为十次服用，用瞿麦汤煎服送下，膀胱得到硫黄，将积存的铅化成灰，从水道排出，像细砂一样一粒粒落下，病于是痊愈。看这个例子更加可以证明膀胱是有上下口的。
The content is quite extensive, with each medicinal herb accompanied by a seven-character regulated verse (Qilu), totaling five hundred and thirty-four poems. The first poem, "Poem on Ginseng," states: "Five leaves and three forks, uniquely fresh; Huangshen from Shangdang has the purest taste. Scattered like the star Yaoguang, a treasure from the sky's edge; Refined within the human body, a gem formed at the earth's bottom. It opens the stomach and assists the spleen to tonify Qi; Calms the heart and moistens the lungs to naturally soothe the spirit. Original Yang can summon the return of spring; One must discern true deficiency and excess." Commentary notes: Although the efficacy of Ginseng (Renshen, 人参) is indeed great, the harm caused by its misuse is not trivial; the intent behind the last line is profound.
Yuan Mei (courtesy name Suiyuan) wrote the "Biography of Mr. Xu Lingtai," which records the treatment of Zhe Gengshi's illness, but the account was not very clear upon reading. Recently, after consulting the *Huixi Medical Cases* (*Huixi Yian*), the matter became clear as if released from confusion. The medical case records: Zhe Gengshi from Luxu suffered from a severe heatstroke syndrome. His pulse was faint and nearly imperceptible; he experienced urinary incontinence, delirious speech, and unconsciously groped for clothes on the bed. This is a syndrome of Yang floating outward (Yang Yue Zheng), where profuse sweating leading to collapse is imminent. He was immediately given a decoction of Ginseng (Renshen, 人参) and Aconite Root (Fuzi, 附子) mixed with child's urine. He slightly revived but could not recognize people. I had business in the commandery city and instructed his family: "If he wakes up and can speak, come fetch me." Three days later, they came to invite me. I hurried there and found him alive. The physician claimed the previous medicine was effective and continued using the same prescription. Before it was drunk, I arrived and said: "Yang has returned, but Fire has flared up again, and Yin fluids are about to be exhausted. If Aconite Root (Fuzi, 附ate) enters the throat, it will be dangerous." I ordered that watermelon be fed to the patient. The patient was greatly delighted, eating several melons over consecutive days, followed by a formula to clear summerheat and nourish the stomach, resulting in recovery. Later, he thanked me and recounted what he saw while unconscious: a black figure stood before him, wanting to eat him, causing bone-chilling cold. A child drove it away with a fan, saying, "Are you not afraid of thunderbolts?" The Black Spirit replied, "Endure three thunderbolts, what can you do to me?" The child said, "How about adding ten more watermelons?" The Black Spirit retreated in fear. I said: Aconite Root (Fuzi, 附子) was anciently named "Thunderbolt Powder" (Pili San). Had he taken three doses without watermelon, the latent summerheat would not have dissipated. His words were well-founded; it is indeed a strange event.
The acupoint located below the nose and above the mouth is called Shuigou (Water Ditch), also known as Renzhong (Human Middle). There are two explanations for its name: One theory states that from this point upward, the eyes, ears, and nose are paired orifices; downward, the mouth and the two excretions are single orifices. The upper three lines represent Yin, and the lower three lines represent Yang, combining to form the hexagram Tai (Peace). Another theory posits that Heaven's Qi connects through the nose, and Earth's Qi connects through the mouth. Heaven nourishes humans with Five Qi, received via the nose; Earth nourishes humans with Five Flavors, received via the mouth. The acupoint resides in the middle, hence the name Renzhong (Human Middle). This is seen in Cheng Yunlai's *Medical Idle Talk* (*Yi Xia Zhi Yan*).
It is sometimes said that the Bladder (Pangguang, 膀胱) has an upper opening but no lower one, or vice versa. Zhang Jingyue and Li Shicai also supported this view, and people generally believed it, unaware that it was incorrect. Without upper and lower openings, how could the condition of Jiaochang (Intestinal Cross-Connection) occur? Shen Shifu Guozhi from Wu County alone argued that both openings exist, but the upper opening is usually closed. Water entering the Bladder (Pangguang, 膀胱) still permeates through the Sanjiao (Triple Burner) transformation, rather than entering directly from the upper opening. If the Qi of the Fu organs is severely deficient, lack of strength causes the orifice to fail to close; or if pathogenic heat damages the Fu organ, promoting open discharge, the orifice also fails to close. In extreme cases, Jiaochang occurs, where feces enter the upper opening of the Bladder (Pangguang, 膀胱) from the lower opening of the Small Intestine and exit with urine. Just as external orifices of the body, such as the umbilicus, ears, and breasts, are usually closed but open to discharge pus/blood or milk when diseased, the upper opening of the Bladder (Pangguang, 膀胱) can be inferred similarly. This argument is the most plausible. My commentary: Tang Yu Zheng treated Governor Wu for urinary retention. When lying down, urination was slightly possible; when standing, not a drop could pass. Upon inquiry, it was learned that he frequently consumed Black Tin Pill (Heixi Dan). Thus, it was realized that during pill preparation, Lead did not fully transform, while Sulfur volatilized. Lead sand entered the Bladder (Pangguang, 膀胱). When lying down, weight distribution allowed some urination; when standing, it blocked the waterway centrally, preventing flow. He was instructed to take three hundred grains of Golden Liquid Pill (Jinye Dan), divided into ten doses, administered with a decoction of Knotweed Herb (Qumai, 瞿麦). The Bladder (Pangguang, 膀胱) received Sulfur, converting accumulated Lead into ash, which discharged through the urinary tract like fine sand. The disease was cured. This case further proves that the Bladder (Pangguang, 膀胱) has both upper and lower openings.