（足太阴属脏）
脾属土。中央黄色。后天之木也。下受命门之火。以蒸化谷食。上输谷食之液。以灌溉脏腑。故
人生存活之原。独脾土之功为最大。然其性喜燥而恶湿。一受湿渍。则土力衰。而肝木即乘
以侮之。位中焦。眼胞鼻准及四肢。皆其分野。与胃相表里。故其药略同。脾无表症。皆属于里。
脾虚者。右关脉必细软。其症为呕吐。为泄泻。为久痢。为腹痛。为肢软。为面黄。为发肿。为肌瘦。
为鼓胀。为恶寒。为自汗。为喘。为积滞不消。为饮食化痰。为脱肛。为肠血。
呕吐者。中空也。六君子汤加煨姜主之。泄泻者。土不胜湿也。五味异功散加木香主之。久痢者。气
虚下陷也。补中益气汤主之。腹痛者。肝木乘脾也。芍药甘草汤加木香主之。肢软者。脾属四肢也。
五味异功散主之。面黄者。本色虚现也。六君子汤主之。发肿者。皮不亮。手按成窟。补中益气汤去
升、柴主之。肌瘦者。脾主肌肉也。十全大补汤主之。鼓胀者。中空无物。气虚也。六君子汤主之。恶
寒者。阳虚不达于表也。附子理中汤主之。自汗者。脾主肌肉。表虚不摄也。五味异功散加黄 、五味
主之。喘者。土不生金也。五味异功散加北五味、牛膝主之。积滞不消者。化谷无力也。六君子汤加
谷芽、砂仁、肉桂主之。饮食化痰者。土不胜湿也。六君子汤主之。脱肛者。气虚下陷也。补中益气汤
主之。肠血者。脾不统血也。归芍六君子汤主之。
脾实者。右关必洪实。其症为气积。为血积。为食积。为痞积。为虫积。为痰饮。为蛊胀。
为腹痛。为不能食。
气积者。气郁发闷也。沉香降气丸主之。血积者。蓄血作痛如刺。有定处也。泽兰汤主之。食积者。坚
滞胀满也。大和中饮主之。痞积者。血滞成痞。 瘕 癖可按也。太无神功散、和中丸主之。虫积者。
湿热所化也。唇内有白点。化虫丸主之。痰饮者。或停心下。伏两胁有声。咳则痛。小半夏加茯苓汤主
之。蛊胀者。中实有物。非蛊即血也。和中丸主之。腹痛者。中有滞也。香砂二陈汤加山楂、麦芽、浓朴
主之。不能食者。食未消也。保和丸主之。
脾寒之症。右关必沉迟。唇舌必白。其症为呕吐。为泄泻。为白痢。为腹痛。为身痛。为黄胆。为湿
肿。为肢冷。为厥脱。
呕吐者。食不消而反胃也。平胃散主之。泄泻者。土失职也。六君子汤加炮姜主之。白痢者。积寒伤
气也。六君子汤加木香主之。腹痛者。绵绵不减。香砂理中汤主之。如挟食拒按。木香丸。身痛者。拘
急为风。重坠为湿。风用香苏散。湿用苍白二陈汤。黄胆者。土为湿制。有阴寒之象。熏黄色黯。茵陈五
苓散。湿肿者。不烦渴。喜热。五苓散主之。肢冷者。阳气不营于四末也。附子理中汤主之。厥脱者。
气衰火息也。附子理中汤加大剂人参主之。
脾热之症。右关必数。舌苔薄而黄。唇赤。其症为热吐。为流涎。为洞泄。为泻渤。为赤痢。为腹痛。
为目胞肿痛。为酒疸。为眩晕。为阳黄胆。
热吐者。食不得入也。橘皮竹茹汤加姜汁炒黄连主之。流涎者。睡中出沫。脾热蒸湿也。黄芩芍药汤
主之。洞泄者。暑湿胜土。一泄如注也。四苓散加益元散主之。泻渤者。暑湿内搏。利如蟹渤。将变痢
也。黄芩芍药汤主之。赤痢者。暑热伤血也。治痢奇方主之。或葛根治痢散。噤则开噤散。腹痛者。乍
作乍止。芍药甘草汤加黄连清之。目胞肿痛者。火上升也。柴芩煎主之。酒疸者。酒湿积而为疸也。
加味枳术汤加茵陈、葛根主之。眩晕者。酒湿生热上蒸也。葛花清脾汤主之。阳黄胆者。黄如橘皮
有光。目溺皆黄。栀子柏皮汤主之。如便闭。茵陈大黄汤。
(Foot-Taiyin belongs to the Zang organs)
Spleen belongs to Earth. The center corresponds to yellow. It is the Wood of the Post-Heaven (Note: Textual ambiguity, literally "Post-Heaven Wood"). Below, it receives the fire of the Gate of Life (Mingmen) to steam and transform grain and food; above, it transports the fluids of grain and food to irrigate the Zang-Fu organs. Therefore, the root of life and survival for humans lies primarily in the great merit of Spleen Earth. However, its nature prefers dryness and dislikes dampness. Once soaked by dampness, the power of Earth weakens, and Liver Wood will take the opportunity to overcome and insult it (Wood overcoming Earth). Located in the Middle Jiao, the eyelids, the tip of the nose, and the four limbs are all its domains. It forms an interior-exterior relationship with the Stomach, so its medicinal prescriptions are roughly similar. Spleen diseases have no exterior syndromes; all belong to the interior.
For patients with Spleen Deficiency, the pulse at the Right Guan position must be fine and soft. Their symptoms include vomiting, diarrhea, chronic dysentery, abdominal pain, limb weakness, sallow complexion, edema, emaciation, distension (Gu Zhang), aversion to cold, spontaneous sweating, asthma, stagnation not resolving, dietary retention transforming into phlegm-damp, rectal prolapse, and intestinal bleeding.
Vomiting is due to emptiness in the middle. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Wei Jiang (Baked Ginger). Diarrhea is due to Earth failing to overcome dampness. It is treated with Wu Wei Yi Gong San (Five Ingredients to Enrich the Work Powder) plus Mu Xiang (Aucklandiae Radix). Chronic dysentery is due to Qi deficiency sinking downward. It is treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Abdominal pain is due to Liver Wood overacting on Spleen Earth. It is treated with Shao Yao Gan Cao Tang (Peony and Licorice Decoction) plus Mu Xiang. Limb weakness is because Spleen governs the four limbs. It is treated with Wu Wei Yi Gong San (Five Ingredients to Enrich the Work Powder). A sallow complexion is the deficiency manifestation of the true color. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction). Edema, characterized by shiny skin that pits upon pressure, is treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) without Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix). Emaciation is because Spleen governs muscles. It is treated with Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction). Distension (Gu Zhang), where the abdomen feels empty but is distended, is due to Qi deficiency. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction). Aversion to cold is due to Yang deficiency failing to reach the exterior. It is treated with Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction). Spontaneous sweating is because Spleen governs muscles, and exterior deficiency fails to secure. It is treated with Wu Wei Yi Gong San (Five Ingredients to Enrich the Work Powder) plus Huang Qi (Astragali Radix) and Wu Wei Zi (Schisandrae Fructus). Asthma is due to Earth failing to generate Metal (Spleen deficiency failing to nourish Lung). It is treated with Wu Wei Yi Gong San (Five Ingredients to Enrich the Work Powder) plus Bei Wu Wei Zi (Schisandrae Fructus) and Niu Xi (Achyranthis Bidentatae Radix). Stagnation not resolving is due to insufficient power to transform grain. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Gu Ya (Setariae Germinatus) and Sha Ren (Amomi Fructus Rotundus) plus Rou Gui (Cinnamomi Cortex). Dietary retention transforming into phlegm-damp is due to Earth failing to overcome dampness. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction). Rectal prolapse is due to Qi deficiency sinking downward. It is treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Intestinal bleeding is due to Spleen failing to control blood. It is treated with Gui Shao Liu Jun Zi Tang (Angelica Sinensis and Peony Six Gentlemen Decoction).
For Spleen Excess patterns, the pulse at the Right Guan position must be surging and solid. Symptoms include Qi accumulation, Blood accumulation, Food accumulation, Pi accumulation (mass), Worm accumulation, Phlegm-fluid retention, Gu distension, abdominal pain, and inability to eat.
Qi accumulation is Qi stagnation causing chest oppression. It is treated with Chen Xiang Jiang Qi Wan (Aquilaria Descending Qi Pill). Blood accumulation involves stasis causing stabbing pain with a fixed location. It is treated with Ze Lan Tang (Lycopus Decoction). Food accumulation involves hardness, stagnation, and fullness. It is treated with Da He Zhong Yin (Great Harmonize the Middle Infusion). Pi accumulation involves blood stasis forming masses, such as Jia and Pi masses that can be palpated. It is treated with Tai Wu Shen Gong San (Tai Wu Divine Power Powder) and He Zhong Wan (Harmonize the Middle Pill). Worm accumulation is transformed from damp-heat, indicated by white spots inside the lips. It is treated with Hua Chong Wan (Expel Worms Pill). Phlegm-fluid retention may stay under the heart or hide in the hypochondrium with audible sounds, causing pain when coughing. It is treated with Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia plus Poria Decoction). Gu distension involves solidity in the middle, which is either Gu pathogen or blood stasis. It is treated with He Zhong Wan (Harmonize the Middle Pill). Abdominal pain is due to internal stagnation. It is treated with Xiang Sha Er Chen Tang (Costus and Amomum Two Old Decoction) plus Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus), and Hou Po (Magnoliae Officinalis Cortex). Inability to eat is due to undigested food. It is treated with Bao He Wan (Preserve Harmony Pill).
Symptoms of Spleen Cold involve a Right Guan pulse that is deep and slow, and white lips and tongue. Symptoms include vomiting, diarrhea, white dysentery, abdominal pain, body pain, jaundice, damp swelling, cold limbs, and Jue collapse.
Vomiting is food indigestion leading to regurgitation. It is treated with Ping Wei San (Calm the Stomach Powder). Diarrhea is Spleen failing in its duty. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Pao Jiang (Prepared Ginger). White dysentery is accumulated cold damaging Qi. It is treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Mu Xiang (Aucklandiae Radix). Abdominal pain is continuous and unceasing. It is treated with Xiang Sha Li Zhong Tang (Costus and Amomum Regulate the Middle Decoction). If accompanied by food retention and tenderness upon pressure, use Mu Xiang Wan (Aucklandiae Pill). Body pain: cramping is Wind, heaviness is Damp. For Wind, use Xiang Su San (Aquilaria and Perilla Powder); for Damp, use Cang Bai Er Chen Tang (Atractylodes Macrocephala and Chinensis Two Old Decoction). Jaundice is Earth constrained by Damp, showing Yin-Cold signs, with dark yellow hue. It is treated with Yin Chen Wu Ling San (Artemisiae Scopariae Five Ling Powder). Damp swelling involves no thirst, preference for heat. It is treated with Wu Ling San (Five Ling Powder). Cold limbs are due to Yang Qi failing to nourish the four extremities. It is treated with Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction). Jue collapse is due to Qi decline and Fire extinguishing. It is treated with Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) with a large dose of Ren Shen (Ginseng Radix).
Symptoms of Spleen Heat involve a Right Guan pulse that is rapid, thin yellow tongue coating, and red lips. Symptoms include hot vomiting, salivation, severe diarrhea, watery stool, red dysentery, abdominal pain, swollen and painful eyelids, Wine Jaundice, vertigo, and Yang Jaundice.
Hot vomiting is food unable to enter the stomach. It is treated with Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shaving Decoction) plus Jiang Zhi Chao Huang Lian (Ginger Juice-fried Coptidis Rhizoma). Salivation is drooling during sleep, caused by Spleen Heat steaming Dampness. It is treated with Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction). Severe diarrhea is Summerheat-Damp overpowering Earth, flowing like a torrent. It is treated with Si Ling San (Four Ling Powder) plus Yi Yuan San (Benefit Primordial Powder). Watery stool is Summerheat-Damp clashing internally, resembling crab roe discharge, likely to become dysentery. It is treated with Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction). Red dysentery is Summerheat-Heat damaging Blood. It is treated with Zhi Li Qi Fang (Miraculous Formula for Dysentery) or Ge Gen Zhi Li San (Kudzu Root Dysentery-Resolving Powder). If mouth is closed (anorexia), use Kai Jin San (Open the Mouth Powder). Abdominal pain comes and goes intermittently. It is treated with Shao Yao Gan Cao Tang (Peony and Licorice Decoction) plus Huang Lian (Coptidis Rhizoma) to clear heat. Swollen and painful eyelids are due to Fire rising. It is treated with Chai Qin Jian (Bupleurum and Scutellaria Decoction). Wine Jaundice is Jaundice formed by accumulation of Wine-Damp. It is treated with Jia Wei Zhi Zhu Tang (Modified Immature Bitter Orange and Atractylodes Macrocephala Decoction) plus Yin Chen (Artemisiae Scopariae Herba) and Ge Gen (Puerariae Lobatae Radix). Vertigo is due to Heat steaming upward from Wine-Damp. It is treated with Ge Hua Qing Pi Tang (Kudzu Flower Clear Spleen Decoction). Yang Jaundice presents with bright orange-yellow skin luster, yellow eyes and urine. It is treated with Zhi Zi Bai Pi Tang (Gardeniae and Phellodendri Bark Decoction). If constipation occurs, use Yin Chen Da Huang Tang (Artemisiae Scopariae and Rheum Decoction).