又名脾约丸
治肠胃燥热, 大便秘结, 小便数多.
麻子二升 芍药半斤 枳实半斤 大黄 ( 去皮 ) 一斤 厚朴 ( 去
皮) 一斤 杏仁 ( 去皮, 尖熬, 碾脂 ) 一升, 右六味为末, 炼蜜
为丸, 桐子大, 饮服十丸, 日三服; 渐加, 以利为度.
【集注】成无己曰: 约者, 约结之约, 又约束也. 经曰: 饮入于胃,
游溢精气, 上输于脾, 脾气散精, 上归于肺, 通调水道, 下输膀胱,
水精四布, 五经并行. 今胃强脾弱, 约束津液, 不得四布, 但输膀胱
,小便数而大便硬, 故曰脾约. 麻仁甘平而润, 杏仁甘温而润. 经曰
:脾欲缓, 急食甘以缓之. 本草曰: 润可去燥. 是以麻仁为君, 杏仁
为臣. 枳实破结, 厚朴泻满, 故以为佐. 芍药调中, 大黄通下, 故以
为使. 朱震亨曰: 既云脾约, 血枯火燔津竭, 理宜滋阴降火, 津液自
生,何秘之有? 此方惟热甚而禀实者可用, 热微而虚者, 愈致燥涸之
苦矣.
治血结胸中, 手不可近, 或中焦蓄血, 寒热胸满,
漱水不欲咽, 善忘, 昏迷如狂者. 此方治败血留经, 通月事.
桃仁 ( 去皮, 尖 ) 五十个 桂枝三两 大黄四两 芒硝二两 甘草
二两,, 右五味, 以水七升, 煮取二升半, 去滓; 纳芒硝, 更上火微
沸;下火先食, 温服五合; 日三服, 当微痢.
又名脾约丸。
治疗肠胃燥热，大便秘结，小便次数增多。
麻子仁二升，芍药半斤，枳实半斤，大黄（去皮）一斤，厚朴（去皮）一斤，杏仁（去皮、尖，炒后碾成脂状）一升。以上六味药研为细末，用炼蜜制成丸剂，大小如梧桐子，每次服用十丸，每日三次；逐渐增加剂量，以大便通畅为度。
【集注】成无己说：所谓“约”，是约束的意思。《内经》说：饮食进入胃中，精气游溢出来，向上输送给脾，脾气散布精微物质，向上归于肺，通调水道，向下输送到膀胱，水液精微四布全身，五脏经脉并行运行。如今胃气强盛而脾气虚弱，约束津液，使其不能四布全身，只能输送到膀胱，导致小便频数而大便干硬，所以称为“脾约”。麻子仁味甘性平而滋润，杏仁味甘性温而滋润。《内经》说：脾脏喜欢缓和，急需用甘味食物来缓和它。本草书说：润燥可以去除干燥。因此用麻子仁作为君药，杏仁作为臣药。枳实破除结滞，厚朴消除胀满，所以作为佐药。芍药调和脾胃，大黄通便泻下，所以作为使药。朱震亨说：既然称为脾约，若是血枯火旺津液枯竭，按理应当滋阴降火，津液自然生成，哪里有便秘呢？这个方子只适用于热邪极盛且体质壮实的人，如果热邪轻微且体质虚弱，使用此方只会加重干燥枯竭的痛苦。
治疗瘀血结于胸中，疼痛剧烈至手不可触碰，或者中焦蓄血，出现寒热往来、胸中胀满，漱口但不想吞咽，健忘，神志昏迷如同发狂的症状。此方用于治疗败血留滞经络，疏通月经。
桃仁（去皮、尖）五十个，桂枝三两，大黄四两，芒硝二两，甘草二两。以上五味药，用水七升，煮取二升半，滤去药渣；加入芒硝，再次上火微沸；去火后，饭前温服五合；每日三次服药，应当出现轻微的腹泻。
Also known as Pi Yue Wan (Spleen Restriction Pill).
Indicated for dry-heat in the stomach and intestines, constipation, and frequent urination.
Hemp Seed (Cannabis Fructus) 2 sheng, White Peony Root (Paeoniae Radix Alba) 0.5 jin, Immature Bitter Orange (Aurantii Fructus Immaturus) 0.5 jin, Rhubarb (Rhei Radix et Rhizoma) (peeled) 1 jin, Magnolia Bark (Magnoliae Officinalis Cortex) (peeled) 1 jin, Apricot Kernel (Armeniacae Semen Amarum) (peeled, tip removed, stir-fried, and ground into paste) 1 sheng. The above six herbs are powdered, mixed with refined honey to form pills, sized like wu-tong seeds. Take 10 pills per dose with water, three times daily; gradually increase the dosage until bowel movement is unobstructed.
[Collected Annotations] Cheng Wuji stated: "Yue" (restriction) refers to binding or constraining. The Classic of Internal Medicine states: When food and drink enter the stomach, their essence floats and overflows, moving upward to the spleen. The spleen scatters the essence, sending it upward to return to the lungs, which regulate the water passages and transport it downward to the bladder. Water essence is distributed throughout the body, and the five meridians function in parallel. Currently, the stomach qi is strong while the spleen qi is weak, constraining the body fluids so they cannot distribute throughout the body but only flow to the bladder. This results in frequent urination and hard stools, hence it is called "Pi Yue" (Spleen Restriction). Hemp seed is sweet, neutral, and moistening; apricot kernel is sweet, warm, and moistening. The Classic states: The spleen desires relaxation; one should urgently consume sweet substances to relax it. Materia Medica states: Moistening agents can remove dryness. Therefore, hemp seed is used as the sovereign herb, and apricot kernel as the minister herb. Immature bitter orange breaks up stagnation, and magnolia bark eliminates fullness, so they serve as assistant herbs. White peony root harmonizes the middle jiao, and rhubarb promotes purgation, so they serve as courier herbs. Zhu Zhenheng said: Since it is termed Spleen Restriction, if blood is depleted and fire flares consuming fluids, the principle should be to nourish yin and descend fire, allowing fluids to regenerate naturally; why would there be constipation? This formula is only suitable for cases with extreme heat and robust constitution. For those with mild heat and deficiency, using this formula will exacerbate the suffering of dryness and depletion.
Indicated for blood stasis knotting in the chest, causing pain so severe that the area cannot be touched by hand, or blood accumulation in the middle jiao presenting with alternating chills and fever, chest fullness, rinsing the mouth without desire to swallow, forgetfulness, and coma-like delirium. This formula treats retained bad blood in the meridians and regulates menstruation.
Apricot Kernel (Armeniacae Semen Amarum) (peeled, tip removed) 50 pieces, Cinnamon Twig (Cinnamomi Ramulus) 3 liang, Rhubarb (Rhei Radix et Rhizoma) 4 liang, Mirabilite (Natrii Sulfas) 2 liang, Licorice Root (Glycyrrhizae Radix et Rhizoma) 2 liang. The above five herbs are boiled in 7 sheng of water to obtain 2.5 sheng, then strained. Add mirabilite, boil again briefly over fire. Remove from heat. Take 5 he of the decoction warm before meals, three times daily. A slight diarrhea is expected.