约者结约之约。又约束之约也。内经曰。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。是脾主为胃行其津液者也。
今胃强脾弱。约束津液。不得四布。但输膀胱。致小便数而大便硬。故曰其脾为约。
麻仁味甘平。杏仁味甘温。内经曰。脾欲缓。急食甘以缓之。麻仁杏仁。润物也。本草
曰。润可去枯。脾胃干燥。必以甘润之物为之主。是以麻仁为君。杏仁为臣。枳实味
苦寒。浓朴味苦温。润燥者必以甘。甘以润之。破结者必以苦。苦以泄之。枳实浓朴
为佐。以散脾之结约。芍药味酸微寒。大黄味苦寒酸。苦涌泄为阴。芍药大黄为使。
以下脾之结燥。肠润结化。津液还入胃中。则大便软。小便少而愈矣。
麻子仁（君一两） 杏仁（臣一升去皮尖熬别作脂） 枳实（佐
半斤炙） 浓朴（佐一尺炙去皮） 大黄（使一斤去皮） 芍药（使半斤）
上六味。蜜和丸。梧桐子大。饮服十丸。日三服。渐加。以知为度。
人之所有者。气与血也。气为阳气。流而不行者则易散。以阳病易治故也。血为阴
血。蓄而不行者则难散。以阴病难治故也。血蓄于下。非大毒峻剂。则不能抵当其
甚邪。故治蓄血曰抵当汤。水蛭味咸苦微寒。内经曰。咸胜血。血蓄于下。胜血者。必
以咸为主。故以水蛭为君。虻虫味苦微寒。苦走血。血结不行。破血者必以苦为助。
是以虻虫为臣。桃仁味苦甘平。肝者血之源。血聚则肝气燥。肝苦急。急食甘以缓
之。散血缓急。是以桃仁为佐。大黄味苦寒。湿气在下。以苦泄之。血亦湿类也。荡血
通热。是以大黄为使。四物相合。而方剂成。病与药对。药与病宜。虽苛毒重疾。必获
全济之功矣。
水蛭（君三十个炙熬） 虻虫（臣三十个去翅足熬） 桃仁（佐三十个去皮熬） 大黄（使三两去皮酒洗）
上四味。锉如麻豆大。以水五升。煮取三升。去渣。温服一升。未利再服。
“约”字意为约束、限制。《内经》说：“饮食进入胃中，精气游溢而出，向上输送给脾；脾气将精微物质散布，上归于肺；肺通调水道，向下输送至膀胱；水液精微四布全身，五脏经脉并行运行。”这说明脾的主要功能是协助胃传输津液。如今胃气强盛而脾气虚弱，脾对津液的约束能力失常，导致津液不能正常布散全身，只能偏渗于膀胱，从而造成小便频数而大便干硬。因此称为“脾约”。
麻子仁味甘、性平；杏仁味甘、性温。《内经》说：“脾喜缓急，急需食用甘味食物来缓和它。”麻子仁和杏仁都是润燥之物。《本草》说：“润可以去除枯槁。”脾胃干燥，必须以甘润的药物为主治。所以用麻子仁作为君药，杏仁作为臣药。枳实味苦、性寒；厚朴味苦、性温。润燥必须用甘味，甘能滋润；破除结聚必须用苦味，苦能泄降。所以用枳实和厚朴作为佐药，以消散脾气的结滞与约束。芍药味酸、性微寒；大黄味苦、性寒且带酸味。苦味具有涌泄作用，属于阴。所以用芍药和大黄作为使药，以攻下脾的结燥。肠道得到滋润，结滞化解，津液回归胃中，大便就会变软，小便减少，病就好了。
麻子仁（君药，一两） 杏仁（臣药，一升，去皮尖，炒后另研成脂） 枳实（佐药，半斤，炙） 厚朴（佐药，一尺，炙，去皮） 大黄（使药，一斤，去皮） 芍药（使药，半斤）
以上六味药，用蜂蜜调和制成丸剂，大小如梧桐子。空腹时送服十丸，每日三次，逐渐增加剂量，以见效为度。
人体所拥有的，主要是气和血。气属于阳气，流动不息，如果不运行则容易耗散，因为阳病容易治疗。血属于阴血，蓄积而不运行则难以消散，因为阴病难治。瘀血蓄积在下焦，如果不是大毒峻猛之剂，就不能抵挡其严重的邪气。所以治疗蓄血证使用抵当汤。
水蛭味咸、苦，性微寒。《内经》说：“咸味能胜血。”瘀血蓄积在下焦，能克制血的药物，必须以咸味为主。所以用水蛭作为君药。虻虫味苦，性微寒。苦味入血分，对于血结不行，破血必须借助苦味。所以用虻虫作为臣药。桃仁味苦、甘，性平。肝是血的源头，血液积聚则肝气燥急。肝苦于急迫，急需食用甘味来缓和它。桃仁能散血并缓和急迫，所以作为佐药。大黄味苦，性寒。湿气在下焦，用苦味来泄降。血也属于湿类，大黄能荡涤瘀血、通泄热邪，所以作为使药。这四味药配合，方剂便形成了。病与药相对，药与病适宜，即使是严重恶毒的重症，也一定能获得痊愈的功效。
水蛭（君药，三十个，炙熬） 虻虫（臣药，三十个，去翅足，熬） 桃仁（佐药，三十个，去皮，熬） 大黄（使药，三两，去皮，酒洗）
以上四味药，锉碎如麻豆大小。用水五升，煮取三升，去渣。温服一升，若未通便再服一次。
The character "Yue" (Constraint) refers to binding or restricting. The *Neijing* 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 Lung. The Lung regulates the water passages, transmitting them downward to the Bladder. Water and essence are distributed in all directions, and the five meridians run in parallel." This indicates that the Spleen is primarily responsible for transporting body fluids on behalf of the Stomach. Currently, the Stomach is strong while the Spleen is weak. The Spleen's ability to constrain body fluids is impaired, preventing them from being distributed throughout the body. Instead, they are directed solely to the Bladder, resulting in frequent urination and hard stools. Hence, this condition is called "Pi Yue" (Spleen Constraint).
Hemp Seed (Cannabis Fructus) is sweet and neutral; Apricot Seed (Armeniacae Semen) is sweet and warm. The *Neijing* states: "The Spleen desires relaxation; urgently consume sweet substances to relax it." Hemp Seed and Apricot Seed are moistening agents. The *Bencao* states: "Moistening can remove dryness." When the Spleen and Stomach are dry, sweet and moistening substances must be used as the main treatment. Therefore, Hemp Seed is used as the Sovereign drug, and Apricot Seed as the Minister drug. Immature Bitter Orange (Aurantii Fructus) is bitter and cold; Magnolia Bark (Magnoliae Officinalis Cortex) is bitter and warm. To moisten dryness, one must use sweet flavors, as sweetness moistens. To break up accumulations, one must use bitter flavors, as bitterness drains. Thus, Immature Bitter Orange and Magnolia Bark are used as Assistant drugs to dissipate the Spleen's constraint and stagnation. White Peony Root (Paeoniae Radix Alba) is sour and slightly cold; Rhubarb (Rhei Radix et Rhizoma) is bitter and cold, with a sour note. Bitterness induces vomiting and draining, belonging to Yin. Therefore, White Peony Root and Rhubarb are used as Envoy drugs to purge the Spleen's dryness and accumulation. Once the intestines are moistened and the accumulation dissolves, body fluids return to the Stomach, the stool becomes soft, urination decreases, and the disease is cured.
Hemp Seed (Sovereign, 1 liang); Apricot Seed (Minister, 1 sheng, skin and tips removed, stir-fried and ground into paste separately); Immature Bitter Orange (Assistant, 0.5 jin, processed with heat); Magnolia Bark (Assistant, 1 chi, processed with heat, bark removed); Rhubarb (Envoy, 1 jin, peeled); White Peony Root (Envoy, 0.5 jin).
These six herbs are mixed with honey and formed into pills the size of Chinese bayberry seeds. Take 10 pills with water, three times a day. Gradually increase the dose until the desired effect is achieved.
What humans possess are Qi and Blood. Qi belongs to Yang energy; if it flows without obstruction, it disperses easily. Because Yang diseases are easy to treat... Blood belongs to Yin blood; if it accumulates without flowing, it is difficult to disperse. Because Yin diseases are difficult to treat. When blood stasis accumulates in the lower jiao, only potent and harsh agents can withstand the severe pathogenic factors. Therefore, Di Dang Tang is used to treat blood stasis.
Leech (Hirudo) is salty, bitter, and slightly cold. The *Neijing* states: "Saltiness overcomes blood." When blood stasis accumulates in the lower jiao, substances that overcome blood must be primarily salty. Therefore, Leech is used as the Sovereign drug. Dragonfly Larva (Ephippigeridae Insect) is bitter and slightly cold. Bitterness enters the blood level. For blood clots that do not move, breaking blood stasis requires the assistance of bitterness. Therefore, Dragonfly Larva is used as the Minister drug. Peach Kernel (Persicae Semen) is bitter, sweet, and neutral. The Liver is the source of blood; when blood gathers, Liver Qi becomes dry and urgent. The Liver suffers from urgency, requiring sweet substances to relieve it. Peach Kernel disperses blood and relieves urgency, thus serving as an Assistant drug. Rhubarb is bitter and cold. Dampness in the lower jiao is drained by bitterness. Blood also belongs to the category of dampness. Rhubarb sweeps away blood stasis and clears heat, thus serving as an Envoy drug. These four substances combined form the prescription. The disease matches the medicine, and the medicine suits the disease. Even in cases of severe toxicity and critical illness, complete recovery can surely be achieved.
Leech (Sovereign, 30 individuals, processed with heat); Dragonfly Larva (Minister, 30 individuals, wings and legs removed, processed with heat); Peach Kernel (Assistant, 30 individuals, skin removed, processed with heat); Rhubarb (Envoy, 3 liang, peeled, washed with wine).
These four herbs are chopped like hemp seeds. Boil in 5 sheng of water to obtain 3 sheng of decoction. Strain the dregs. Take 1 sheng warm. If bowel movement is not achieved, take another dose.