〔钱〕脾主困。实则困睡，身热饮水。虚则吐泻生风。脾病困睡泄泻，不思饮食。脾胃虚寒则面 白，
目无精光，口鼻气冷，肌体瘦弱。吐水腹痛不思乳食，用益黄散。下利用调中丸。伤风手足冷者，脾脏怯也，先
用益黄散补脾，后用大青膏发散。脾病见四季，皆放余四脏治之，顺者易治，逆者难治。脾怯当面赤目黄。
五脏相反，随证治之。〔洁〕脾主湿，自病则泄泻多睡，体重昏倦。脾苦湿，急食苦以燥之。实则泄泻赤黄，睡不
露睛，泻黄散主之。虚则泄泻色白，睡露睛，白术散主之。肝乘脾，贼邪，风泻而呕，茯苓半夏汤主之。心乘
脾，虚邪，壮热体重而泻，羌活黄芩苍术甘草汤主之。肺乘脾，实邪，能食，不大便而呕吐，嗽，煎
槟榔、大黄汤下葶苈丸。肾乘脾，微邪，恶寒泄泻，理中丸之类主之。〔刘〕凡
脾之得病，必察肝心两脏之虚实，根其源之所起，然后救疗，盖肝是脾之鬼，心是脾之母，肝气盛则鬼胜，
心气亏则脾家生气不足，盛者抑之则退，亏者益之不乏，所以有抑脾气、益心气两药。诊其脉，肝心两脏俱和，则是
脾自生疾，察其虚实而治之。〔薛〕前证实者，病气实而形气虚也，若面色 白，吐泻腹痛，口鼻气冷，
属寒水侮土，宜用益黄散。若面青唇黯，吐泻，手足并冷，此脾土虚寒，用干姜理中汤。若面色痿黄，手足不冷，
此脾土虚弱，用人参理中汤。若伤风手足并冷，吐痰咳嗽，吐泻腹胀，此脾肺气虚，用五味异功散实脾气，
加防风、升麻散外邪。若发于寅卯之时，用六君、柴胡、升麻补脾土，平肝木。然面黄者脾之本色也，
面赤者火生土为顺，面青者木克土为逆，当平其所胜，以补元气为善。〔海〕脾苦湿，急食苦以燥之，白术。
脾欲缓，急食甘以缓之，甘草。以甘补之，人参。以苦泻之，黄连。脾虚，以甘草、大枣之类补之，如无他证，以钱
氏益黄散补之。虚则补其母，心乃脾之母，以炒盐补心。
益黄散〔钱氏〕 又名补脾散 治脾胃虚寒。
陈橘皮（一两） 青橘皮 诃子肉 甘草（各半两，锉、炒） 丁香（二钱）
上为细末。每服二钱，水一盏，煎至六分，食前温服。
东垣云∶阎孝忠编集钱氏方，以益黄散补土，又言风旺必克脾土，当先实其脾，昧者不审脾中寒热，一
例用补脾药，又不审药中有丁香、青皮，辛热大泻肺金，脾虚之证，岂可反泻其子，为寒水反来侮土，中寒呕
吐腹痛，泻痢青白，口鼻中气冷，益黄散神治之药也。如因服热药巴豆之类过剂、损其脾胃，或因暑天伤
热积热、损其脾胃，而成吐泻，口鼻中气热，而成慢惊者，不可服之。今立一方治胃中风热，名人参安胃散。薛
氏云∶脾土虚寒，寒水侮之，如东垣所云诸证，宜用此方。若因脾土虚弱吐泻者，用六君子汤加柴胡，如不应
或手足俱冷，属虚寒也，更加木香、炮姜。若因乳母脾虚肝侮，必治以前药。若乳母郁怒，致儿患前
证，母服加味归脾汤。
人参安胃散 治脾胃虚热
黄 （二钱） 人参 陈皮（去白各一钱） 生甘草 炙甘草（各半钱） 白芍药（七分） 白茯苓（四分
）黄连（少许）
上为粗末。每服二三钱，水煎五沸，去滓温服。
四君子汤 六君子汤（二方见吐泻）
〔海〕脾实，以枳实泻之，如无他证，以钱氏泻黄散泻之，实则泻其子，肺乃脾之子，以桑白皮泻肺。
泻黄散〔钱氏〕 又名泻脾散
藿香叶（七钱） 山栀子仁（一两） 石膏（半两） 甘草（三两） 防风（四两，去芦、切，焙）
上锉，同蜜酒微炒香，为细末。每服一钱至二钱，水一盏，煎至五分，温服清汁，无时。
〔薛〕前证，若作渴饮冷，卧不露睛，手足热甚，或遍身发黄，属胃经实热，宜用泻黄散。若作渴饮汤，
卧而露睛，手足并冷，属胃经虚热，宜用异功散。若面青搐搦，乳食少思，肝乘脾也，用秘旨补脾汤。若面赤惊
悸，身热昏睡，心乘脾也，用秘旨安神丸。若面白喘嗽，肢体倦怠，肺乘脾也，用补中益气汤。若唇黑
泄泻，手足指冷，肾乘脾也，用益黄散。病后津液不足，口干作渴，宜用七味白术散。若乳母膏粱浓味，七情
郁火所致，当审其因而治其母。
【钱乙】脾脏的功能特点是容易受困。如果脾实证，会出现嗜睡、身体发热和口渴饮水的症状；如果脾虚证，则会出现呕吐、腹泻并引发肝风内动（惊风）。脾病时常见嗜睡、泄泻、食欲不振。若脾胃虚寒，则面色苍白，眼神无光彩，口鼻呼出气息寒冷，肌肉消瘦体弱。出现吐清水、腹痛、不想吃奶或食物等症状时，使用益黄散治疗。如果是下利（腹泻），使用调中丸治疗。伤风导致手足发冷的，属于脾脏怯弱，先用益黄散补脾，再用大青膏发散外邪。脾病在四季中显现时，都参照其余四脏的方法来治疗，脉证相符的容易治愈，脉证相逆的难以治愈。脾脏怯弱的面部特征是面赤目黄。五脏之间生克关系相反时，随具体证候进行治疗。
【李东垣/洁古】脾主湿，脾自病则表现为多泄泻、多睡、身体沉重、昏沉疲倦。脾被湿所苦，应紧急食用苦味药物以燥湿。脾实证表现为泄泻色赤黄，睡眠时眼睛不闭合，用泻黄散主治。脾虚证表现为泄泻色白，睡眠时眼睛睁开（露睛），用白术散主治。肝气乘袭脾脏，称为贼邪，表现为风泻且伴有呕吐，用茯苓半夏汤主治。心气乘袭脾脏，称为虚邪，表现为高热、身体沉重且泄泻，用羌活黄芩苍术甘草汤主治。肺气乘袭脾脏，称为实邪，表现为能进食但大便不通且呕吐、咳嗽，用煎煮槟榔、大黄汤送服葶苈丸治疗。肾气乘袭脾脏，称为微邪，表现为恶寒、泄泻，用理中丸之类的主治。
【刘完素】凡是脾脏患病，必须观察肝、心两脏的虚实情况，探究其根源所在，然后进行救治。因为肝是脾的“鬼”（即克我者，此处指病理上的克制关系，实则肝木克脾土，刘氏此处语境似有特定理论背景或笔误，通常肝为脾之贼，心为脾之母），心是脾的“母”。肝气盛则克制太过（鬼胜），心气亏则脾的生气不足。对于盛的脏腑要抑制它使其退却，对于亏的脏腑要补益它使其充足，所以有抑脾气、益心气的两种用药思路。诊察脉象，如果肝、心两脏脉象调和，则是脾脏自身生病，需辨别其虚实而治疗。
【薛己】前面的实证，是指病气实而形体正气虚。如果面色㿠白，呕吐腹泻、腹痛，口鼻气息寒冷，属于寒水侮土（肾水反侮脾土），宜用益黄散。如果面色青、嘴唇暗紫，呕吐腹泻，手足均冷，这是脾土虚寒，用干姜理中汤。如果面色萎黄，手足不冷，这是脾土虚弱，用人参理中汤。如果因伤风导致手足均冷，吐痰咳嗽，呕吐腹泻、腹胀，这是脾肺气虚，用五味异功散来充实脾气，加防风、升麻以发散外邪。如果症状发生在寅卯时（凌晨3-7点，肝木旺时），用六君子汤、柴胡、升麻补脾土，平抑肝木。一般来说，面色黄是脾的本色；面色赤是火生土，为顺证；面色青是木克土，为逆证，应当平抑其所不胜（肝木），以补元气为善。
【张元素】脾被湿所苦，应紧急食用苦味药物以燥湿，如白术。脾欲缓和，应紧急食用甘味药物以缓急，如甘草。用甘味药补脾，如人参。用苦味药泻脾（清泻脾热），如黄连。脾虚时，用甘草、大枣之类的药补益，如果没有其他兼证，用钱乙的益黄散补脾。虚证则补其母，心是脾的母脏，可用炒盐补心。
益黄散（钱乙方）：又名补脾散，治疗脾胃虚寒。
陈皮（一两）、青皮、诃子肉、甘草（各半两，锉碎、炒制）、丁香（二钱）。
以上药物研成细末。每次服用二钱，加水一盏，煎至六分，饭前温服。
李东垣说：阎孝忠编纂钱乙的方剂，用益黄散来补土，又说风旺必然克制脾土，应当先充实脾土。愚昧的人不审察脾中的寒热，一律使用补脾药，又不审察药中有丁香、青皮，辛热大泻肺金。脾虚之证，岂可反而泻其子（肺），导致寒水反过来侮土？出现中寒呕吐、腹痛、泻痢青白、口鼻中气冷等症状，益黄散是神效的药物。但如果是因为服用热药如巴豆等过量，损伤了脾胃；或者因暑天伤热积热，损伤了脾胃，从而形成吐泻，口鼻中气热，进而形成慢惊风的，不可服用此方。现在制定一方治疗胃中风热，名为人参安胃散。
薛己说：脾土虚寒，寒水侮之，像李东垣所说的各种证候，宜用此方（益黄散）。如果因脾土虚弱导致吐泻的，用六君子汤加柴胡；如果无效或手足俱冷，属于虚寒，再加木香、炮姜。如果因乳母脾虚导致肝木乘侮小儿，必须以前述药物治疗。如果乳母郁怒，导致小儿患前述证候，母亲服用加味归脾汤。
人参安胃散：治疗脾胃虚热。
黄芪（二钱）、人参、陈皮（去白，各一钱）、生甘草、炙甘草（各半钱）、白芍药（七分）、白茯苓（四分）、黄连（少许）。
以上药物捣成粗末。每次服用二三钱，加水煎煮五沸，去渣温服。
【张元素】脾实证，用枳实泻之，如果没有其他兼证，用钱乙的泻黄散泻之。实证则泻其子，肺是脾的子脏，用桑白皮泻肺。
泻黄散（钱乙方）：又名泻脾散。
藿香叶（七钱）、山栀子仁（一两）、石膏（半两）、甘草（三两）、防风（四两，去芦头、切段、焙干）。
以上药物切碎，同蜜酒微炒至香，研成细末。每次服用一钱至二钱，加水一盏，煎至五分，随时温服清汁。
【薛己】前面的证候，如果口渴想喝冷水，睡觉时眼睛不闭，手足很热，或者全身发黄，属于胃经实热，宜用泻黄散。如果口渴想喝热水，睡觉时眼睛睁开，手足均冷，属于胃经虚热，宜用异功散。如果面色青、抽搐拘挛，吃奶少、食欲差，是肝气乘袭脾脏，用秘旨补脾汤。如果面色赤、惊悸，身体发热、昏睡，是心气乘袭脾脏，用秘旨安神丸。如果面色白、气喘咳嗽，肢体倦怠，是肺气乘袭脾脏，用补中益气汤。如果嘴唇黑、泄泻，手指冷，是肾气乘袭脾脏，用益黄散。病后津液不足，口干作渴，宜用七味白术散。如果因乳母食用膏粱厚味，或因七情郁火所致，应当审察病因并治疗母亲。
[Qian Yiyuan] The Spleen is prone to being constrained. In excess conditions, there is lethargy (somnolence), fever, and thirst with desire to drink. In deficiency conditions, there is vomiting, diarrhea, and the generation of wind (internal stirring of wind). Spleen disease presents with lethargy, diarrhea, and lack of appetite. If the Spleen and Stomach are deficient and cold, the face is pale, the eyes lack luster, the breath from the mouth and nose is cold, and the body is emaciated. For symptoms such as vomiting clear water, abdominal pain, and refusal of milk or food, use Yihuang San (Yellow Benefit Powder). For loose stools, use Tiaozhong Wan (Regulate the Middle Pill). For wind-strike causing cold hands and feet, it is a case of Spleen deficiency; first use Yihuang San to tonify the Spleen, then use Daqing Gao (Great Cyan Ointment) to disperse external pathogens. When Spleen disease manifests in any season, treat it by referring to the methods for the other four Zang organs. Cases where the pulse and symptoms agree are easy to treat; those where they contradict are difficult. Spleen deficiency manifests as a red face and yellow eyes. When the Five Zang organs act contrary to their normal generating/restraining cycles, treat according to the specific syndrome.
[Jiegu/Li Dongyuan] The Spleen governs dampness. Self-disease of the Spleen results in frequent diarrhea, excessive sleep, heavy body, dizziness, and fatigue. When the Spleen suffers from dampness, urgently consume bitter flavors to dry it. Excess conditions present as diarrhea with red-yellow stool, and sleep with eyes open; Xiehuang San (Drain Yellow Powder) is the primary formula. Deficiency conditions present as diarrhea with white stool, and sleep with eyes exposed (exposed eyelids); Baizhu San (Atractylodes Macrocephala Powder) is the primary formula. Liver Qi invading the Spleen is called "Thief Evil," presenting as wind-diarrhea with vomiting; Fuling Banxia Tang (Poria and Pinellia Decoction) is used. Heart Qi invading the Spleen is called "Deficient Evil," presenting with high fever, heavy body, and diarrhea; Qianghuo Huangqin Cangzhu Gancao Tang (Notopterygium, Scutellaria, Atractodes, and Licorice Decoction) is used. Lung Qi invading the Spleen is called "Excess Evil," presenting with ability to eat but constipation, vomiting, and coughing; Tingli Wan (Descurainia Seed Pill) is administered using a decoction of Binglang (Areca Nut) and Dahuang (Rhubarb) as the vehicle. Kidney Qi invading the Spleen is called "Minor Evil," presenting with aversion to cold and diarrhea; Lizhong Wan (Regulate the Middle Pill) and similar formulas are used.
[Liu Wansu] Whenever the Spleen becomes diseased, one must examine the excess or deficiency of the Liver and Heart, trace the origin, and then treat. The Liver is the "Ghost" (pathological constraint) of the Spleen, and the Heart is the Mother of the Spleen. If Liver Qi is excessive, the constraint prevails; if Heart Qi is deficient, the generative Qi of the Spleen is insufficient. Excess should be suppressed to recede, and deficiency should be supplemented to be abundant. Hence, there are two medicinal approaches: suppressing Spleen Qi and supplementing Heart Qi. Upon palpating the pulse, if both Liver and Heart are harmonious, the illness originates solely in the Spleen; treat based on its excess or deficiency.
[Xue Ji] The aforementioned excess condition refers to pathogenic Qi being excess while form Qi is deficient. If the face is pale, with vomiting, diarrhea, abdominal pain, and cold breath from mouth/nose, this is Cold Water insulting Earth (Kidney Water insulting Spleen Earth); use Yihuang San. If the face is green and lips dark, with vomiting, diarrhea, and cold hands and feet, this is Spleen Earth deficient and cold; use Ganjiang Lizhong Tang (Dried Ginger Regulate the Middle Decoction). If the face is sallow/yellowish without cold hands and feet, this is Spleen Earth weakness; use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction). If wind-strike causes cold hands and feet, with phlegm vomiting, cough, diarrhea, and abdominal distension, this is Spleen-Lung Qi deficiency; use Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) to solidify Spleen Qi, adding Fangfeng (Saposhnikovia) and Shengma (Cimicifuga) to disperse external pathogens. If symptoms occur during Yin-Mao hours (5 AM - 9 AM, Wood time), use Liu Jun Zi Tang (Six Gentlemen Decoction), Chaihu (Bupleurum), and Shengma to tonify Spleen Earth and calm Liver Wood. Generally, a yellow face is the true color of the Spleen; a red face indicates Fire generating Earth (favorable); a green face indicates Wood controlling Earth (unfavorable). One should calm the controlling element and prioritize tonifying Yuan Qi.
[Zhang Yuansu] When the Spleen suffers from dampness, urgently consume bitter flavors to dry it, such as Baizhu (Atractylodes Macrocephala). When the Spleen desires relaxation, urgently consume sweet flavors to soothe it, such as Gancao (Licorice). Use sweet flavors to tonify, such as Renshen (Ginseng). Use bitter flavors to drain (clear heat), such as Huanglian (Coptis). For Spleen deficiency, tonify with Gancao and Dazao (Jujube); if no other symptoms exist, use Qian's Yihuang San to tonify the Spleen. For deficiency, tonify the Mother; the Heart is the Mother of the Spleen, so use fried salt to tonify the Heart.
Yihuang San [Qian's Formula]: Also known as Bupi San (Tonify Spleen Powder), treats Spleen-Stomach deficiency-cold.
Chenpi (Tangerine Peel, 1 liang), Qingpi (Green Tangerine Peel), Hezirou (Pericarpium Arecae Semen Preparatum), Gancao (Licorice, each 0.5 liang, crushed and stir-fried), Dingxiang (Clove, 2 qian).
Grind into fine powder. Take 2 qian per dose, add 1 cup of water, boil to 0.6 cup, take warm before meals.
Li Dongyuan stated: Yan Xiaozhong compiled Qian's formulas, using Yihuang San to tonify Earth, stating that Wind prosperity must overcome Spleen Earth, so one must first solidify the Spleen. Ignorant practitioners fail to examine cold/heat in the Spleen and uniformly use Spleen-tonifying herbs. They also fail to notice that Dingxiang and Qingpi are acrid-hot and greatly drain Lung Metal. In Spleen deficiency, how can one drain the Son (Lung)? This leads to Cold Water insulting Earth. For middle-jiao cold with vomiting, abdominal pain, green-white dysentery/diarrhea, and cold breath from mouth/nose, Yihuang San is a miraculous remedy. However, if vomiting/diarrhea arises from overuse of hot drugs like Badou (Croton Seed) damaging the Spleen/Stomach, or from summer heat accumulation damaging the Spleen/Stomach, leading to hot breath from mouth/nose and slow convulsions, this formula is contraindicated. I now establish a formula to treat Wind-Heat in the Stomach, named Renshen Anwei San (Ginseng Calm the Stomach Powder).
Xue Ji stated: For Spleen Earth deficiency-cold with Cold Water insulting it, as described by Li Dongyuan, use this formula (Yihuang San). For vomiting/diarrhea due to Spleen Earth weakness, use Liu Jun Zi Tang plus Chaihu; if ineffective or if hands/feet are cold (indicating deficiency-cold), add Muxiang (Aucklandia) and Paojiang (Prepared Ginger). If the infant's condition is caused by the nursing mother's Spleen deficiency and Liver invasion, treat with the aforementioned medicines. If the mother's depression and anger cause the infant's condition, the mother should take Jiawei Guipi Tang (Modified Restore the Spleen Decoction).
Renshen Anwei San: Treats Spleen-Stomach deficiency-heat.
Huangqi (Astragalus, 2 qian), Renshen (Ginseng), Chenpi (Tangerine Peel, peeled, each 1 qian), Sheng Gancao (Raw Licorice), Zhi Gancao (Honey-fried Licorice, each 0.5 qian), Baishao (White Peony Root, 0.7 qian), Baifuling (Poria, 0.4 qian), Huanglian (Coptis, a small amount).
Grind into coarse powder. Take 2-3 qian per dose, boil in water for five boils, strain, and take warm.
Sijunzi Tang (Four Gentlemen Decoction) and Liu Junzi Tang (see "Vomiting and Diarrhea" section).
[Zhang Yuansu] For Spleen excess, drain with Zhishi (Immature Bitter Orange); if no other symptoms, use Qian's Xiehuang San to drain. For excess, drain the Son; the Lung is the Son of the Spleen, so drain the Lung with Sangbaipi (Morus Alba Bark).
Xiehuang San [Qian's Formula]: Also known as Xiepi San (Drain Spleen Powder).
Huoxiangye (Agastache Leaf, 7 qian), Shanzhiziren (Gardenia Seed, 1 liang), Shigao (Gypsum, 0.5 liang), Gancao (Licorice, 3 liang), Fangfeng (Saposhnikovia, 4 liang, remove rhizome, cut, roast).
Crush, stir-fry slightly with honey and wine until fragrant, grind into fine powder. Take 1-2 qian per dose, add 1 cup of water, boil to 0.5 cup, take warm clear liquid at any time.
[Xue Ji] Regarding the aforementioned syndromes: If there is thirst with desire for cold drinks, sleep with eyes closed, and very hot hands/feet, or generalized jaundice, this is Stomach Meridian excess-heat; use Xiehuang San. If there is thirst with desire for hot drinks, sleep with eyes open, and cold hands/feet, this is Stomach Meridian deficiency-heat; use Yigong San. If the face is green with spasms/clenching, and poor appetite/milk intake, this is Liver invading Spleen; use Mizhi Bupi Tang (Secret Instruction Tonify Spleen Decoction). If the face is red with fright and palpitations, fever, and lethargy, this is Heart invading Spleen; use Mizhi Anshen Wan (Secret Instruction Calm Spirit Pill). If the face is white with wheezing/cough and limb fatigue, this is Lung invading Spleen; use Buzhong Yiqi Tang (Boost the Middle and Augment the Qi Decoction). If the lips are black with diarrhea and cold toes, this is Kidney invading Spleen; use Yihuang San. After illness, if fluid deficiency causes dry mouth and thirst, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder). If the condition is caused by the nursing mother consuming rich/greasy foods or emotional stagnation-fire, investigate the cause and treat the mother.