〔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。实证表现为嗜睡、身体发热、口渴饮水；虚证则出现呕吐、腹泻并引发肝风（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，目光无神，口鼻呼出气息寒冷，肌肉消瘦体弱。若出现呕吐清水、腹痛、不愿吃奶进食，使用益黄散。若因下利（腹泻）致病，使用调中丸。若伤风且手足发冷，这是脾脏怯弱所致，先用益黄散补益脾气，再用大青膏发散外邪。脾病在四季中显现，都参照其余四脏的治法来治疗，脉证相符者易治，脉证相逆者难治。脾脏怯弱可见面赤、目黄。五脏之间五行生克关系相反时，随具体证候进行治疗。
【李杲（洁古）】脾主湿，脾自病则多见泄泻、多睡、身体沉重、昏沉疲倦。脾恶湿，急需食用苦味食物以燥湿。实证表现为泄泻色赤黄，睡眠时眼睛不闭合，用泻黄散主治。虚证表现为泄泻色白，睡眠时眼睛半睁（露睛），用白术散主治。肝木乘袭脾土，为贼邪，表现为风泻伴呕吐，用茯苓半夏汤主治。心火乘袭脾土，为虚邪，表现为高热、身体沉重而泄泻，用羌活黄芩苍术甘草汤主治。肺金乘袭脾土，为实邪，表现为能进食但大便不通且呕吐、咳嗽，用煎好的槟榔、大黄汤送服葶苈丸。肾水乘袭脾土，为微邪，表现为恶寒、泄泻，用理中丸之类主治。
【刘完素】凡是脾脏患病，必须考察肝、心两脏的虚实情况，追溯其根源所在，然后进行救治。因为肝是脾的“鬼”（即克我者，此处指肝木克脾土，但在子母关系中语境特殊，通常肝为脾之贼，此处依原文逻辑），心是脾的“母”。肝气盛则克制太过，心气亏则脾的生气不足。对于盛者抑制它则邪气退去，对于亏者补益它则正气不乏，所以有抑脾气、益心气的两种药物。诊察脉象，若肝、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】前述实证，是指病气实而形体之气虚。若面色㿠白，呕吐泄泻、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。若面色青、唇色暗，呕吐泄泻，手足均冷，这是脾土虚寒，用干姜理中汤。若面色萎黄，手足不冷，这是脾土虚弱，用人参理中汤。若伤风导致手足均冷，吐痰咳嗽，呕吐泄泻、腹胀，这是脾肺气虚，用五味异功散补益脾气，加防风、升麻疏散外邪。若在寅卯时（清晨3-7点，属木旺之时）发病，用六君子汤、柴胡、升麻补脾土，平抑肝木。然而，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，应当平抑其所胜之脏，以补元气为善。
【滑寿（海藏）】脾恶湿，急需食用苦味以燥湿，如白术。脾欲缓急，急需食用甘味以缓和，如甘草。用甘味补益，如人参。用苦味泻实，如黄连。脾虚，用甘草、大枣之类补益，若无其他兼证，用钱氏益黄散补脾。虚证则补其母，心乃脾之母，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）。
以上研为细末。每次服用二钱，加水一盏，煎至六分，饭前温服。
李东垣说：阎孝忠编集钱乙方剂，用益黄散补土，又说风旺必克脾土，应当先充实脾土。愚昧之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（肺为脾之子）？若是寒水反来侮土，出现中寒呕吐、腹痛、泻痢青白、口鼻中气冷，益黄散是神效之药。但如果因服用热药巴豆之类过量，损伤脾胃；或因暑天伤热积热，损伤脾胃，而成吐泻，口鼻中气热，形成慢惊风者，不可服用。现在立一方治疗胃中风热，名为人参安胃散。
薛己说：脾土虚寒，寒水侮之，如东垣所述诸证，宜用此方（益黄散）。若因脾土虚弱致吐泻者，用六君子汤加柴胡；如不应或手足俱冷，属虚寒也，再加木香、炮姜。若因乳母脾虚肝木乘袭，必治以前药。若乳母郁怒，导致患儿患前述证候，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）。
以上为粗末。每次服用二三钱，水煎五沸，去渣温服。
【滑寿（海藏）】脾实，用枳实泻之，若无其他兼证，用钱氏泻黄散泻之。实则泻其子，肺乃脾之子，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）。
以上锉碎，同蜜酒微炒香，研为细末。每次服用一钱至二钱，加水一盏，煎至五分，温服清汁，不拘时候。
【薛己】前述证候，若口渴喜冷饮，睡眠时眼睛不闭合，手足很热，或遍身发黄，属于胃经实热，宜用泻黄散。若口渴喜热饮，睡眠时眼睛半睁（露睛），手足均冷，属于胃经虚热，宜用异功散。若面色青、抽搐强直，吃奶进食少思，是肝木乘袭脾土，用秘旨补脾汤。若面色赤、惊悸，身体发热、昏睡，是心火乘袭脾土，用秘旨安神丸。若面色白、气喘咳嗽，肢体倦怠，是肺金乘袭脾土，用补中益气汤。若嘴唇黑、泄泻，手足指冷，是肾水乘袭脾土，用益黄散。病后津液不足，口干作渴，宜用七味白术散。若因乳母食用膏粱厚味，七情郁火所致，当审察病因并治疗母亲。
[Qian Yiyuan] The Spleen is prone to being constrained. In excess conditions, there is drowsiness, fever, and thirst for drinking water. In deficiency conditions, vomiting, diarrhea, and wind-stirring (convulsions) occur. Spleen disease manifests as drowsiness, diarrhea, and lack of appetite. If the Spleen and Stomach are deficient and cold, the face is pale, the eyes lack luster, breath from the mouth and nose is cold, and the body is emaciated. With vomiting of clear fluid, abdominal pain, and refusal of milk or food, Yi Huang San (Yellow Benefit Powder) is used. For diarrhea, Tiao Zhong Wan (Regulate the Middle Pill) is used. If wind-cold injury causes cold hands and feet, it indicates Spleen Qi timidity; first use Yi Huang San to tonify Spleen Qi, then Da Qing Gao (Great Blue Ointment) to disperse external pathogens. When Spleen disease appears in any season, treat according to the methods for the other four Zang organs; cases where pulse and symptoms agree are easy to treat, while those where they contradict are difficult. Spleen deficiency may present with a red face and yellow eyes. When the Five Zang organs interact contrary to their normal generating/restraining cycles, treat according to the specific syndrome.
[Jie Gu] The Spleen governs dampness. Self-disease manifests as frequent diarrhea, excessive sleep, heavy body, lethargy, and fatigue. The Spleen dislikes dampness; urgently consume bitter flavors to dry it. Excess conditions manifest as diarrhea with red-yellow stool and eyes remaining open during sleep; Xie Huang San (Drain Yellow Powder) is the primary formula. Deficiency conditions manifest as white-colored diarrhea and eyes half-open during sleep (sleeping with eyes partially open); Bai Zhu San (Atractylodes Macrocephala Powder) is the primary formula. Liver Wood overacting on Spleen Earth is "Thief Evil," presenting as wind-diarrhea with vomiting; Fu Ling Ban Xia Tang (Poria and Pinellia Decoction) is used. Heart Fire overacting on Spleen Earth is "Deficient Evil," presenting with high fever, heavy body, and diarrhea; Qiang Huo Huang Qin Cang Zhu Gan Cao Tang (Notopterygium, Scutellaria, Atractylodes, and Licorice Decoction) is used. Lung Metal overacting on Spleen Earth is "Excess Evil," presenting with ability to eat but constipation, vomiting, and coughing; Ting Li Wan (Lepidium Seed Pill) is administered using decocted Areca Seed and Rhubarb soup. Kidney Water overacting on Spleen Earth is "Minor Evil," presenting with aversion to cold and diarrhea; Li Zhong 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" (Overcontroller) of the Spleen, and the Heart is the Mother of the Spleen. If Liver Qi is excessive, the controlling force dominates; if Heart Qi is deficient, the generating Qi of the Spleen is insufficient. Suppress the excess to make it recede, tonify the deficiency to ensure abundance. Hence, there are medicines to suppress Spleen Qi and tonify Heart Qi. Upon palpation, if both Liver and Heart pulses are harmonious, the disease originates in the Spleen itself; 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), suitable for Yi Huang San. If the face is green and lips dark, with vomiting, diarrhea, and cold hands/feet, this is Spleen Earth deficient and cold, suitable for Gan Jiang Li Zhong Tang (Dried Ginger Regulate the Middle Decoction). If the face is sallow/yellowish, with warm hands/feet, this is Spleen Earth weakness, suitable for Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). If wind-cold causes cold hands/feet, phlegm vomiting, cough, diarrhea, and abdominal distension, this is Spleen-Lung Qi deficiency; use Wu Wei Yi Gong San (Five-Ingredient Extraordinary Efficacy Powder) to solidify Spleen Qi, adding Fang Feng (Saposhnikovia Root) and Sheng Ma (Cimicifuga Rhizome) to disperse external pathogens. If onset occurs at Yin-Mao hours (5 AM - 9 AM, Wood time), use Liu Jun Zi Tang (Six Gentlemen Decoction), Chai Hu (Bupleurum Root), and Sheng Ma to tonify Spleen Earth and calm Liver Wood. However, 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 overacting organ and prioritize tonifying Yuan Qi.
[Hai Zang] The Spleen dislikes dampness; urgently consume bitter flavors to dry it, such as Bai Zhu (Atractylodes Macrocephala). The Spleen desires relaxation; urgently consume sweet flavors to relax it, such as Gan Cao (Licorice). Tonify with sweet flavors, such as Ren Shen (Ginseng). Drain with bitter flavors, such as Huang Lian (Coptis Rhizome). For Spleen deficiency, tonify with Gan Cao and Da Zao (Jujube); if no other syndromes exist, use Qian's Yi Huang 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.
Yi Huang San [Qian Shi]: Also known as Bu Pi San (Tonify Spleen Powder). Treats Spleen-Stomach deficiency-cold.
Chen Pi (Tangerine Peel, 1 liang), Qing Pi (Green Tangerine Peel), He Zi Rou (Chebulic Myrobalan Flesh), Gan Cao (Licorice, each 0.5 liang, crushed and stir-fried), Ding Xiang (Clove, 2 qian).
Grind into fine powder. Take 2 qian per dose, add 1 cup of water, decoct to 0.6 cup, take warm before meals.
Dong Yuan stated: Yan Xiaozhong compiled Qian's formulas, using Yi Huang San to tonify Earth, stating that Wind prosperity must overcome Spleen Earth, so one must first solidify the Spleen. Ignorant people fail to examine cold/heat in the Spleen, uniformly using Spleen-tonifying herbs. They also fail to notice that Ding Xiang and Qing Pi are acrid-hot and greatly drain Lung Metal. In Spleen deficiency, how can one drain its Child (Lung)? If Cold Water insults Earth, causing middle-cold vomiting, abdominal pain, green-white dysentery/diarrhea, and cold breath from mouth/nose, Yi Huang San is a miraculous remedy. However, if caused by overdose of hot drugs like Ba Dou (Croton Seed) damaging the Spleen/Stomach, or summer heat accumulation damaging the Spleen/Stomach leading to vomiting/diarrhea, hot breath from mouth/nose, and slow convulsions, it must not be taken. I now establish a formula to treat Wind-Heat in the Stomach, named Ren Shen An Wei San (Ginseng Calm the Stomach Powder).
Xue stated: For Spleen Earth deficiency-cold insulted by Cold Water, as described by Dong Yuan, this formula is suitable. For vomiting/diarrhea due to Spleen Earth weakness, use Liu Jun Zi Tang plus Chai Hu; if ineffective or with cold hands/feet indicating deficiency-cold, add Mu Xiang (Aucklandia Root) and Pao Jiang (Prepared Ginger). If caused by the nursing mother's Spleen deficiency with Liver overaction, treat with the previous medicines. If the nursing mother's depression/anger causes the infant's syndrome, the mother should take Jia Wei Gui Pi Tang (Modified Return the Spleen Decoction).
Ren Shen An Wei San: Treats Spleen-Stomach deficiency-heat.
Huang Qi (Astragalus Root, 2 qian), Ren Shen (Ginseng), Chen Pi (Tangerine Peel, peeled, 1 qian each), Sheng Gan Cao (Raw Licorice), Zhi Gan Cao (Honey-fried Licorice, 0.5 qian each), Bai Shao Yao (White Peony Root, 0.7 qian), Bai Fu Ling (Poria, 0.4 qian), Huang Lian (Coptis, a little).
Grind into coarse powder. Take 2-3 qian per dose, decoct in water for five boils, remove dregs, take warm.
Si Jun Zi Tang (Four Gentlemen Decoction) and Liu Jun Zi Tang (see Diarrhea section).
[Hai Zang] For Spleen excess, drain with Zhi Shi (Immature Bitter Orange). If no other syndromes exist, use Qian's Xie Huang San to drain. For excess, drain the Child; the Lung is the Child of the Spleen, so drain the Lung with Sang Bai Pi (Mulberry Root Bark).
Xie Huang San [Qian Shi]: Also known as Xie Pi San (Drain Spleen Powder).
Huo Xiang Ye (Agastache Leaf, 7 qian), Shan Zhi Zi Ren (Gardenia Seed, 1 liang), Shi Gao (Gypsum, 0.5 liang), Gan Cao (Licorice, 3 liang), Fang Feng (Saposhnikovia Root, 4 liang, remove radicle, cut, bake).
Crush, stir-fry lightly with honey and wine until fragrant, grind into fine powder. Take 1-2 qian per dose, add 1 cup of water, decoct to 0.5 cup, take warm clear liquid, anytime.
[Xue Ji] Regarding the aforementioned syndromes: If thirsty with desire for cold drinks, eyes closed during sleep, very hot hands/feet, or generalized jaundice, this is Stomach Meridian excess-heat; use Xie Huang San. If thirsty with desire for hot drinks, eyes half-open during sleep, cold hands/feet, this is Stomach Meridian deficiency-heat; use Yi Gong San. If face is green with twitching/clenching, poor appetite, this is Liver overacting on Spleen; use Mi Zhi Bu Pi Tang (Secret Formula Tonify Spleen Decoction). If face is red with palpitations/fright, fever, and drowsiness, this is Heart overacting on Spleen; use Mi Zhi An Shen Wan (Secret Formula Calm Spirit Pill). If face is white with panting/cough, limb fatigue, this is Lung overacting on Spleen; use Bu Zhong Yi Qi Tang (Supplement the Middle and Boost Qi Decoction). If lips are black with diarrhea, cold toes, this is Kidney overacting on Spleen; use Yi Huang San. After illness, with insufficient fluids, dry mouth, and thirst, use Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Powder). If caused by the nursing mother consuming rich/greasy foods or emotional stagnation-fire, investigate the cause and treat the mother.