丹溪云∶脾具坤静之德，而有干健之运，夫胃阳也，主气，脾阴也，主血，胃司纳受，脾司运化，一纳一
运，化生精气，清气上升，糟粕下降，纳五谷，化津液，其清者为荣，浊者为卫，阴阳得此，谓之橐 ，故东垣
以脾胃为五脏之根本也。脾气既弱，则健运之令不行，化生之功已失职，而嗜卧多困，所由生焉，法当温补
其脾，脾气既旺，则脏腑清阳之气升举，易于营运，又何困倦之有，海藏用四君子加木香、砂仁、半夏，白术倍
之，姜枣煎服，诚良法也。若脾虚好睡多惊，则是心血虚而火动之，宜安神养血。若因心脾气虚，有痰者，宜
用人参、五味子、茯苓以补心气，当归、芍药、酸枣仁以养心血，橘红、半夏以开痰。若因脾肺气虚，
胸膈有痰，用补中益气汤以健脾胃，胆星天竺丸（痰涎）以化痰涎。若因饮食停滞而作，用四君子汤以益脾土，
山楂、神曲以消饮食。若因脾虚而好睡，用五味异功散（吐泻）以补脾气，当归、芍药以生脾血，芍药须用酒拌炒
黄，不则酸寒伤脾，此假热
以对假寒也。若乳母饮酒，致儿昏醉好睡者，以干姜、陈皮煎汤解之，不应，用异功散加干葛即愈矣。
〔海藏〕脾胃不和，四君子加白术一倍，姜枣煎。脾困，四君子加木香、砂仁、人参各半钱煎。脾胃虚
弱，生气多困，四君子加炒半夏曲、没石子等分，为末，入冬瓜子少许同煎。
〔本〕治脾风多困。用人参散。入慢惊参用
人参 冬瓜仁（各半两） 南星（切片，用浆水姜汁煮、存性，一两）
上为细末。每一钱，水半盏，煎二三分，温服。
朱丹溪说：脾具有坤卦安静柔顺的德行，同时具备乾卦刚健不息的运化功能。胃属阳，主管气；脾属阴，主管血。胃负责受纳食物，脾负责运化水谷，一纳一运，从而化生精气。清轻之气上升，重浊糟粕下降，受纳五谷，化生津液，其中清的部分成为营气（营养血液的气），浊的部分成为卫气（护卫体表的气）。阴阳依靠这些物质基础，被称为“橐籥”（风箱，比喻脾胃如风箱般鼓动生化之源），所以李东垣将脾胃视为五脏的根本。
脾气既然虚弱，那么健运的功能就无法行使，化生精气的职责已经失职，嗜睡和困倦的症状由此产生。治疗方法应当温补脾脏。脾气旺盛后，脏腑的清阳之气得以升举，易于运行营运，哪里还会有困倦呢？张元素（海藏）使用四君子汤（益气健脾的基础方）加入木香、砂仁、半夏，白术加倍用量，加生姜、大枣煎服，这确实是良法。
如果因为脾虚导致嗜睡且容易受惊，这是心血虚而虚火内动的表现，适宜安神养血。如果是因为心脾气虚且有痰湿，适宜用人参、五味子、茯苓来补益心气，当归、芍药、酸枣仁来滋养心血，橘红、半夏来化痰开结。如果是因为脾肺气虚，胸膈有痰，用补中益气汤（补气升阳的代表方）来健运脾胃，用胆星天竺丸（清热化痰方）来化解痰涎。如果是因为饮食停滞引起，用四君子汤来补益脾土，山楂、神曲来消食导滞。如果是因为脾虚导致嗜睡，用五味异功散（四君子汤加陈皮，主治吐泻及脾虚气滞）来补益脾气，当归、芍药来滋生脾血。芍药必须用酒拌炒至黄色，否则其酸寒之性会损伤脾阳，这是以假热之治来应对假寒之证。如果乳母饮酒，导致婴儿昏醉嗜睡，用干姜、陈皮煎汤解毒；若无效，用异功散加葛根即可痊愈。
〔张元素/海藏〕脾胃不和，用四君子汤加一倍量的白术，加姜枣煎服。脾困，用四君子汤加木香、砂仁、人参各半钱煎服。脾胃虚弱，易生气且困倦，用四君子汤加炒半夏曲、没石子等分，研为细末，加入少许冬瓜子同煎。
〔《本草》或相关医籍] 治疗脾风导致的嗜睡。用人参散。如果是慢惊风，人参用量需斟酌。
配方：人参、冬瓜仁（各半两）、南星（切片，用浆水和姜汁煮至存性，一两）。
以上药材研为细末。每次取一钱，加水半盏，煎至剩余二三分量，温服。
Zhu Danxi stated: The Spleen possesses the virtue of Kun (Earth), characterized by stillness and receptivity, yet it has the function of Qian (Heaven), characterized by vigorous movement and transformation. The Stomach is Yang, governing Qi; the Spleen is Yin, governing Blood. The Stomach is responsible for receiving and accepting food, while the Spleen is responsible for transportation and transformation. One receives, one transforms, thereby generating Jing-Qi (Essence-Qi). The clear Qi ascends, while the turbid waste descends. By receiving the five grains and transforming fluids, the clear portion becomes Ying Qi (Nutritive Qi) and the turbid portion becomes Wei Qi (Defensive Qi). With this Yin and Yang foundation, they are referred to as "Tuoyue" (Bellows, metaphorically describing the Spleen-Stomach as the source of biological generation). Therefore, Li Dongyuan regarded the Spleen and Stomach as the root of the five Zang organs.
When Spleen Qi is weak, the command of vigorous transformation fails to operate, and the function of generating essence and Qi is neglected, leading to lethargy and drowsiness. The treatment method should be to warm and tonify the Spleen. Once Spleen Qi is robust, the Clear Yang Qi of the Zang-Fu organs will ascend and rise, facilitating smooth circulation and operation, leaving no room for fatigue. Zhang Yuansu (Hanghai) used Si Jun Zi Tang (Four Gentlemen Decoction) added with Mu Xiang (Aucklandiae Radix), Sha Ren (Amomi Fructus), and Ban Xia (Pinelliae Rhizoma), with Bai Zhu (Atractylodis Macrocephalae Rhizoma) doubled in dosage, decocted with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus). This is indeed an excellent method.
If drowsiness accompanied by fright arises from Spleen deficiency, it indicates Heart Blood deficiency with stirring of deficient fire; calming the Spirit and nourishing Blood is appropriate. If caused by deficiency of both Heart and Spleen Qi with phlegm-dampness, Ren Shen (Ginseng Radix et Rhizoma), Wu Wei Zi (Schisandrae Fructus), and Fu Ling (Poria) should be used to tonify Heart Qi; Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), and Suan Zao Ren (Ziziphi Spinosae Semen) to nourish Heart Blood; Ju Hong (Citri Reticulatae Pericarpium Rubrum) and Ban Xia to resolve phlegm. If caused by deficiency of Spleen and Lung Qi with phlegm in the chest and diaphragm, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to strengthen the Spleen and Stomach, and Dan Xing Tian Zhu Wan (Asarum and Tugarinoffia Pill) to resolve phlegm-fluids. If caused by food stagnation, Si Jun Zi Tang should be used to benefit Spleen Earth, and Shan Zha (Crataegi Fructus) and Shen Qu (Massa Medicata Fermentata) to digest food. If drowsiness results from Spleen deficiency, Wu Wei Yi Gong San (Five-Ingredient Powder Enhancing Achievement) should be used to tonify Spleen Qi, and Dang Gui and Bai Shao to generate Spleen Blood. Bai Shao must be stir-fried with wine until yellow; otherwise, its sour and cold nature will damage the Spleen. This represents treating apparent heat with apparent heat (correcting a false cold condition). If a nursing mother drinks alcohol, causing the infant to become intoxicated and drowsy, Gan Jiang (Zingiberis Rhizoma) and Chen Pi (Citri Reticulatae Pericarpium) decocted in water can resolve it. If ineffective, Yi Gong San added with Ge Gen (Puerariae Lobatae Radix) will cure it.
[Hanghai]: For disharmony between Spleen and Stomach, use Si Jun Zi Tang with double the amount of Bai Zhu, decocted with Ginger and Jujube. For Spleen fatigue, use Si Jun Zi Tang added with half a qian each of Mu Xiang, Sha Ren, and Ren Shen, decocted. For Spleen-Stomach weakness, irritability, and fatigue, use Si Jun Zi Tang added with Chao Ban Xia Qu (Stir-fried Pinellia and Malt Fermented Mass) and Mei Shi Zi (Myrobalan Fruit) in equal parts, powdered, with a small amount of Dong Gua Zi (Benincasae Semen) added during decoction.
[Ben Cao/Text]: Treats Spleen Wind causing excessive drowsiness. Use Ren Shen San (Ginseng Powder). For slow convulsions, adjust the dosage of Ren Shen accordingly.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Dong Gua Ren (Benincasae Semen) (each half liang); Nan Xing (Arisaematis Rhizoma) (sliced, boiled in Jiang Shui [fermented grain liquid] and Jiang Zhi [ginger juice] until retaining its nature, one liang).
Grind the above into fine powder. Take one qian each time, add half a zhan of water, decoct until only two or three fen remain, and take warm.