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.
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.