经曰∶脾者，土也，谏议之官，主意与智，消磨五谷，寄在（胸）中，养于四
旁，旺〔于〕四季，正主长夏，与胃为表里，足太阴（阳明），是其经也。扁鹊
云∶脾病则面黄色痿，实则舌强直，不嗜食，呕逆，四肢缓；虚则多 喜吞，注
痢不已。又脾虚，则精不胜，元气乏力，手足缓弱，不能自持。其脉来似流水，曰
太过，病在外（也）；如鸟距，曰不及，病在内。太过令人四肢沉重，言语謇涩；不
及令人中满，不食乏力，手足缓弱不遂，涎引口中，四肢肿胀，溏泄不时，梦中饮
食。脾脉来而和柔者，如鸡践地，曰平；来实而满，〔稍〕数，如鸡举足，曰病；又
如鸟之啄，如鸟之距，如〔屋〕之漏，曰死。中风则翕翕发热，状如醉人，腹中〔烦〕
满，皮肉〔 〕（而起），〔其脉〕阿阿然〔缓〕，曰平；〔反〕弦急者，肝〔来〕克脾
也，真鬼相遇，大凶之兆也。又微涩〔而〕短者，肺乘于脾，不治自愈；又沉而滑
者，肾来乘脾，亦〔为不〕妨。又浮而洪，心来生脾，不为疾耳。脾病色黄体
重，失便，目直视，唇反张，爪甲青，四肢沉，吐食，百节疼痛不能举，其脉〔当〕
浮大而缓，〔今〕反〔弦〕急，其色青，死不治。又脾病，其色黄，饮食不消，〔心〕
腹胀满，体重节痛，大便〔硬〕，（小便）不利，其脉微缓而长者，可治。脾气虚，
则大〔便滑〕，小便〔利〕，汗出不止，五液注下，为五色注痢下也。又积在其中，久
不愈，四肢不收，黄胆，食不为“肌肤”，气〔满〕胀喘喘而不〔定〕也。脾实则
时梦筑墙垣盖屋，盛则梦歌乐，虚则梦饮食不足。厥邪客于脾，则梦大泽丘陵，风雨
〔坏屋〕。脾胀则善哕，四肢急，体〔重〕，不食善〔噫〕。脾病〔日 慧〕，
平旦甚，日中持，下晡静。脉急甚，则螈 ；微急，则膈中不利，食不下而还出。缓
甚，则痿厥；微缓，则风痿，四肢不〔收〕。大甚，〔则〕暴仆；微大，〔则痹疝〕，
气〔裹大脓血〕在肠胃之〔外〕。小甚，则寒热作；微小，则消〔瘅〕。滑甚，则颓
疝；微滑，则虫毒，肠鸣中热。涩甚，则肠 ；微涩，则〔内〕溃下脓血。脾脉至，
大而虚，则有积。脾（气）绝，则十日死。唇焦枯无〔纹理〕，（面）青黑者，脾先
（死）。脾病，面黄目赤〔者〕，〔可治〕；青黑色入口，半年死；色如枳实〔者〕，一
（日）死，吉凶休咎，皆〔见〕其色出〔于〕部〔分〕也。又口噤唇青，四肢重
如山，不能自持，大小便利无休歇，饮食不入，七日死。又唇虽痿黄，语声〔啭啭〕
者，尚可治。脾病，（水）气久不去，腹中痛鸣，徐徐热汗出，其人〔本意宽〕缓，
（今反急，怒语而鼻笑），不能答人，此不过一（日），祸必至矣。又脾中寒热，则
使人腹中痛，不下食，病甚〔舌〕强语涩，转〔筋〕卵〔缩〕，〔阴股〕腹中引痛，身重，
不思食，膨胀，变则水泄不能卧者，十死不治。脾〔土〕热，则面黄目赤，〔季〕胁
痛满；寒则吐涎沫而不食，四肢痛，滑泄不已，手足厥，甚则战栗如疟也。临病之时，
切要〔明〕察脉证，然后投药，此脾脏虚实寒热，生死逆顺脉证之法也。
《主治〔备〕要》云∶是动则病舌本强，食则呕，胃脘痛，腹胀善噫，得后与气，
则快然〔如〕衰，身体皆重。主脾所生病者，舌本痛，体不能动摇，食不下，烦心，
心下急痛，寒疟，溏瘕泄，水闭黄疽，不能卧，强立，股膝内肿厥，足大指不用。
脾苦湿，急食苦以燥之，白术；脾（虚则）以甘草、大枣之类补之，实则以枳壳泻
之，如无他证，虚则以钱氏益黄散，实则以泻黄散。心乃脾之母，炒盐补之；肺乃脾之
子，桑白皮泻之。
《内经》说：脾属土，是谏议之官，主管意念与智慧，负责消化五谷，寄居在胸中，滋养四肢百骸，在四季中的长夏季节最旺盛，正主长夏，与胃互为表里，足太阴脾经是其所属经脉。扁鹊说：脾有病则面色发黄、肢体痿软；实证则舌体僵硬强直，食欲不振，呕吐逆气，四肢松弛无力；虚证则多喜吞唾，久泻痢疾不止。另外脾虚，则精气不足，元气乏力，手足软弱，不能自主支撑。其脉象来势如流水般急迫，称为太过，病在体表；如鸟爪距般短促坚硬，称为不及，病在体内。太过使人四肢沉重，言语蹇涩；不及使人腹部胀满，不思饮食且乏力，手足软弱瘫痪，口中流涎，四肢肿胀，大便溏泄无定时，梦中进食饮水。脾脉来势柔和的，如鸡走路般从容，称为平脉（正常）；来势坚实而满，稍快，如鸡抬脚，称为病脉；又如鸟啄食、鸟爪距、屋漏滴水般断续不匀，称为死脉。中风则微微发热，状如醉酒之人，腹中烦闷胀满，皮肉隆起，脉象缓和大度，称为平脉（预后良好）；若反见弦急之脉，是肝木克伐脾土，真邪相遇，是大凶之兆。又见微涩而短的脉象，是肺金乘袭脾土，虽不治也可自愈；又见沉而滑的脉象，是肾水乘袭脾土，也无妨碍。又见浮而洪大的脉象，是心火生助脾土，不会有大碍。脾病见面色黄、身体沉重、二便失常、两眼直视、口唇反张、指甲发青、四肢沉重、呕吐食物、全身关节疼痛不能抬起，其脉应当浮大而缓，如果反而弦急，面色青，为死证，不可治疗。另外脾病，面色黄，饮食不消化，心腹胀满，身体沉重关节疼痛，大便干硬，小便不利，其脉微缓而长的，可以治疗。脾气虚，则大便滑泄，小便通利，汗出不止，五液下注，表现为五色痢疾。又有积滞在内，久治不愈，四肢不收摄，黄疸，饮食不能化为肌肤之气，气满胀喘促不定。脾实则时常梦见筑墙盖屋，盛时梦见歌舞音乐，虚时梦见饮食不足。厥邪客于脾，则梦见大泽丘陵，风雨毁坏房屋。脾胀则容易呃逆，四肢拘急，身体沉重，不想吃东西且容易嗳气。脾病在白天神志清爽，清晨加重，中午维持稳定，傍晚安静。脉象紧急甚，则出现抽搐；微紧急，则膈中不利，饮食不下而吐出。脉缓甚，则出现痿厥；微缓，则出现风痿，四肢不能收摄。脉大甚，则突然昏倒仆地；脉微大，则出现痹疝，气裹挟大脓血在肠胃之外。脉小甚，则寒热发作；脉微小，则出现消瘅。脉滑甚，则出现颓疝；脉微滑，则有虫毒，肠鸣中热。脉涩甚，则肠内瘀阻；脉微涩，则内部溃烂下脓血。脾脉至大而虚，则有积滞。脾经气绝，则十日死。嘴唇焦枯无纹理，面色青黑的，脾先死。脾病，面色黄目赤的，可治；青黑色入口唇，半年死；面色如枳实色的，一日死，吉凶休咎，都从面部的色泽和部位显现出来。又见口噤唇青，四肢重如山，不能自主支撑，大小便淋漓无休止，饮食不进，七日死。又见嘴唇虽然痿黄，但语声清晰的，还可以治疗。脾病，水气久不去，腹中痛鸣，徐徐出热汗，其人本来意态宽缓，现在反而急躁，怒骂且鼻笑，不能应答他人，这不超过一日，祸患必至。另外脾中有寒热，则使人腹中痛，不能进食，病重则舌强语涩，转筋卵缩，大腿内侧及腹中牵引作痛，身体沉重，不想吃东西，膨胀，变症则为水泄不能卧倒的，十死难治。脾土热，则面色黄目赤，季胁部痛满；寒则吐涎沫而不食，四肢痛，滑泄不止，手足厥冷，甚则战栗如疟疾。临病之时，务必明察脉证，然后投药，这是脾脏虚实寒热、生死逆顺脉证的法则。
《主治备要》说：脾经发生变动则病舌根强硬，进食则呕吐，胃脘痛，腹胀善嗳气，得后气（排便或排气）后，则感觉轻松舒缓，身体皆重。主治脾所生病者，舌根痛，身体不能动摇，饮食不下，心烦，心下急痛，寒疟，溏泄夹有块状物，水闭黄疸，不能卧倒，强立，股膝内侧肿痛厥冷，足大趾不能用。脾苦湿，急需吃苦味药以燥湿，如白术；脾虚则以甘草、大枣之类补益，脾实则以枳壳泻之，如果没有其他证候，虚证用钱氏益黄散，实证用泻黄散。心是脾之母，炒盐补之；肺是脾之子，桑白皮泻之。
The *Classic* states: The Spleen belongs to Earth, is the official of remonstrance, governs intention and wisdom, digests the five grains, resides in the chest, nourishes the four limbs, is prosperous in the late summer season, directly governs late summer, and forms an interior-exterior relationship with the Stomach. The Foot-Taiyin (Spleen) Meridian is its channel. Bian Que said: When the Spleen is diseased, the face turns yellow and the limbs become flaccid; in excess conditions, the tongue becomes stiff and straight, there is a lack of appetite, vomiting and regurgitation, and the limbs are relaxed and weak; in deficiency conditions, there is frequent swallowing of saliva, and chronic dysentery does not cease. Furthermore, when the Spleen is deficient, essence cannot be sufficient, Yuan Qi (Original Qi) lacks strength, the hands and feet are weak and unable to support themselves. Its pulse coming like flowing water is called "Excessive," indicating disease in the exterior; like a bird's spur, it is called "Deficient," indicating disease in the interior. Excess causes heaviness in the four limbs and slurred speech; deficiency causes fullness in the middle jiao, lack of appetite and fatigue, paralysis and weakness of the hands and feet, drooling, swelling of the four limbs, irregular loose stools, and dreaming of eating and drinking. A Spleen pulse that comes gently and softly, like a chicken walking on the ground, is called Normal; one that comes solid and full, slightly rapid, like a chicken lifting its foot, is called Diseased; one like a bird pecking, a bird's spur, or a leaking roof is called Death. Wind-stroke presents with slight fever, resembling a drunken person, internal restlessness and fullness, raised skin and flesh, and a pulse that is large and slow, which is considered favorable (Ping); if it reverses to string-taut and rapid, it indicates Liver Wood overcoming Spleen Earth, a meeting of true pathogen, a sign of great misfortune. If slightly choppy and short, it indicates Lung Metal attacking Spleen Earth, which may heal without treatment; if deep and slippery, it indicates Kidney Water attacking Spleen Earth, which also poses no hindrance. If floating and surging, it indicates Heart Fire generating Spleen Earth, causing no major illness. Spleen disease manifests as yellow complexion, heavy body, dysfunction of bowels and urine, fixed gaze, retracted lips, cyanotic nails, heavy limbs, vomiting food, pain in all joints unable to lift them; the pulse should be floating, large, and slow. If it reverses to string-taut and rapid, and the color is green, it is a death case, untreatable. Additionally, in Spleen disease, with yellow complexion, indigestion, abdominal fullness, heavy body and joint pain, hard stool, and difficult urination, if the pulse is slightly slow and long, it is treatable. Spleen Qi deficiency leads to slippery stools, free urination, incessant sweating, downward flow of the five fluids, manifesting as dysentery of five colors. Accumulation within, lingering and unhealed, leads to limbs unable to gather, jaundice, food failing to transform into muscle and flesh, Qi fullness, distension, panting, and instability. Spleen excess causes dreams of building walls and houses; abundance causes dreams of singing and music; deficiency causes dreams of insufficient food and drink. Jue pathogens lodging in the Spleen cause dreams of large marshes and hills, wind and rain destroying houses. Spleen distension causes frequent hiccups, limb stiffness, heavy body, anorexia, and frequent belching. Spleen disease brings clarity during the day, worsening at dawn, holding steady at noon, and quiet in the afternoon. Pulse extremely urgent causes convulsions; slightly urgent causes obstruction in the diaphragm, inability to eat leading to regurgitation. Extremely slow causes flaccidity and cold limbs; slightly slow causes wind-flaccidity, limbs unable to gather. Extremely large causes sudden collapse; slightly large causes Bi-Hernia, with Qi wrapping large amounts of pus and blood outside the intestines and stomach. Extremely small causes alternating cold and heat; slightly small causes Xiao-Dan (Wasting-Thirst). Slippery excessively causes Tu-Hernia; slightly slippery causes insect toxins, intestinal borborygmus, and internal heat. Choppy excessively causes intestinal obstruction; slightly choppy causes internal ulceration and discharge of pus and blood. Spleen pulse arriving large and void indicates accumulation. Spleen Qi exhaustion leads to death in ten days. Lips dry and cracked without texture, face blue-black, indicate the Spleen dies first. Spleen disease with yellow face and red eyes is treatable; blue-black color entering the mouth predicts death in half a year; color like Zhi Shi (Immature Bitter Orange) predicts death in one day. Auspicious and inauspicious signs are all seen in the color emerging from specific facial areas. Jaw lock, cyanotic lips, limbs heavy as mountains, unable to support oneself, continuous incontinence of urine and feces, inability to take food, predicts death in seven days. Although lips are flaccid and yellow, if the voice is clear, it is still treatable. In Spleen disease, if Water Qi lingers for a long time, abdominal pain and borborygmus occur, followed by slow hot sweats. If the person, originally calm, suddenly becomes irritable, curses, laughs at their nose, and cannot respond to others, disaster will arrive within one day. Cold and heat in the Spleen cause abdominal pain, inability to eat; severe cases present with stiff tongue, slurred speech, tendon contraction, testicular retraction, pulling pain in the inner thigh and abdomen, heavy body, anorexia, distension. Transformation into watery diarrhea preventing lying down indicates ten deaths, untreatable. Spleen Earth Heat causes yellow face, red eyes, and hypochondriac pain/fullness; Cold causes spitting of saliva, anorexia, limb pain, continuous slippery diarrhea, cold hands and feet, and even shivering like malaria. At the time of illness, one must clearly observe the pulse and symptoms before administering medicine. This is the method of pulse and symptom differentiation for Spleen organ deficiency/excess, cold/heat, life/death, and reversal/favorability.
The *Zhu Zhi Bei Yao* states: When the meridian moves, disease involves a stiff tongue root, vomiting after eating, epigastric pain, abdominal distension with frequent belching. After defecation or passing gas, one feels relieved, but the whole body is heavy. It treats diseases generated by the Spleen: painful tongue root, inability to move the body, inability to eat, vexation, urgent pain below the heart, cold malaria, loose stools with masses, water closure jaundice, inability to lie down, standing forcibly, swelling and cold in the inner thigh and knee, uselessness of the big toe. The Spleen dislikes Dampness; urgently eat bitter substances to dry it, such as Bai Zhu (Atractylodis Rhizoma). For Spleen deficiency, tonify with Gan Cao (Glycyrrhizae Radix), Da Zao (Jujubae Fructus), etc.; for excess, drain with Zhi Ke (Aurantii Fructus). If no other symptoms, use Qian Shi Yi Huang San for deficiency and Xie Huang San for excess. The Heart is the Mother of the Spleen; fried salt tonifies it. The Lung is the Child of the Spleen; Sang Bai Pi (Mori Cortex) drains it.