脾者土也，为谏议之官，主意与智。消磨五谷，寄在其中，养于四旁，王于四季，正王
长夏。与胃为表里，足太阴是其经也。扁鹊云∶“脾病则面色萎黄，实则舌强直不嗜食，呕
逆四肢缓，虚则多病，喜吞酸，痢不已。其脉来似水曰太过，病在外；如鸟之距曰不及，病
在内。太过则令人四肢沉重，言语謇涩；不及则令人中满不食，乏力，手足缓弱不遂，涎引
口中，四肢肿胀，溏泄不时，梦中饮食。脾脉来时缓柔，去似鸟距践地者曰平脉。来实而满
稍数，似鸡举足曰病。又如鸟之队，如鸟之距，如屋之漏曰死。中风则翕翕发热，状若醉人，
腹中烦满，皮肉 而短气者也。王时其脉阿阿然，缓曰平。若弦急者肝克脾，真鬼相逢，大
凶之兆。”又微涩而短者，肺来乘脾，不治自愈。反软而滑者，肾来从脾，亦为不妨。反浮
而洪者，心来生脾，不及而脾病也。色黄体重，失便，目直视，唇反张，爪甲青，四逆吐食，
百
饮食不消，腹胀满，身体重，骨节痛，大便硬，小便不利，其脉微缓而长者可治。脾气虚则
大便活，小便利，汗出不止，五液注下，为五色注下利也。又积在中，久不愈，则四肢不收
，黄胆，食不为肌肤，气满喘而不足也。又脾实则时梦筑墙盖屋，盛则梦歌乐，虚则梦饮食
不足，厥邪客于脾，则梦大泽丘陵，风雨坏室。脾胀则喜哕，四肢急，体重不食，善噫。脾
病则曰昧慧，平日甚，日中持，下晡静。脉急甚则螈 ，微急则隔中不利，食不入而还出，
脉缓甚则痿厥，微缓则风痿，四肢不持，大甚则寒热作，微大则消瘅，滑甚则 疝，微滑则
虫毒，肠鸣中热，涩甚则肠 ，微涩则内溃下脓血。脾脉至大而虚有积，脾气绝则十日死。
又脐出者亦死，唇焦枯无纹理而青黑者死，脾先死也。脾病面黄目赤者可治，青黑色入节，
半岁而死。色如枳实者一月死。凶吉休咎，皆见其色出部分也。又口噤唇黑，四肢重如山，
不能自持，大小便利无休歇，饮食不入，七日死。又口虽痿黄，语声啭啭者可治。脾病疟
气久不去，腹中鸣痛，徐徐热汗出。其人本意宽缓反急怒者，语时以鼻笑，不能答人者，此
过一月，祸必至矣。又脾中寒或热，则皆使人腹中痛不下食。又病时舌强语涩，转卵缩牵阴
股中引痛，身重不思食，膨胀变则水泄不能卧者，死不治。脾正热则面黄目赤，胁痛满。寒
则吐涎沫而不食，四肢痛，滑泄不已，手足厥，甚则颤栗如疟。临病之时，要在明证详脉，
然后投汤药期瘳耳。
脾在五行中属土，被称为“谏议之官”，主管意念与智慧。它负责消化五谷，寄居在体内，滋养四肢百骸，在四季中旺于长夏时节。脾与胃互为表里，足太阴脾经是其所属经脉。扁鹊说：“脾有病则面色萎黄，实证表现为舌体僵硬强直、食欲不振、呕吐逆气、四肢弛缓；虚证则容易患病，喜欢吞酸水，痢疾久治不愈。脉象如果像水流一样急迫称为‘太过’，病邪在外；像鸟爪距一样短促称为‘不及’，病邪在内。‘太过’会导致四肢沉重、言语蹇涩；‘不及’会导致腹部胀满、不能进食、乏力、手足弛缓无力、口水自流、四肢肿胀、大便稀溏不时、梦中饮食。脾的平脉（正常脉象）来时缓柔，去时像鸟爪轻触地面。脉来充实饱满且稍快，像鸡抬脚一样的节奏是病脉。如果脉象像鸟群坠落、像鸟爪距、像屋漏滴水，则是死脉。患中风病则身体翕翕发热，状如醉酒之人，腹中烦闷胀满，皮肤肌肉松弛而短气。在脾旺之时，脉象柔和舒缓为平脉。如果脉弦急，则是肝木克伐脾土，如同真鬼相逢，是大凶之兆。”又若脉微涩而短，是肺金乘袭脾土，虽不治也能自愈。若脉反见软滑，是肾水顺从脾土，也无妨碍。若脉反见浮洪，是心火生助脾土，但脾本身不足而生病。若面色黄、身体沉重、大小便失常、两眼直视、嘴唇反张、指甲发青、四肢厥冷、呕吐食物、百谷饮食不消化、腹胀满、身体沉重、骨节疼痛、大便干硬、小便不利，脉象微缓而长的可以治疗。脾气虚弱则大便滑泄、小便通利、汗出不止、五液下注，导致五色痢疾。又有积滞在中焦，久不痊愈，则四肢不收摄、黄疸、饮食不能化为肌肤之气、气满喘促且不足。脾实证则时常梦见筑墙盖屋，盛实则梦见歌舞音乐，虚证则梦见饮食不足。厥邪客居于脾，则梦见大泽丘陵、风雨毁坏房屋。脾胀则喜欢呃逆，四肢拘急，身体沉重不想吃东西，容易嗳气。脾病则神志昏昧不明，白天加重，中午维持稳定，傍晚安静。脉紧急甚则出现抽搐，微紧急则胸膈痞塞不通，食物吃进去又吐出来；脉缓甚则出现痿厥，微缓则风痿，四肢不能支撑；脉大甚则寒热发作，微大则消瘅（消渴类疾病）；脉滑甚则疝气，微滑则有虫毒，肠鸣中焦发热；脉涩甚则肠道闭塞，微涩则内部溃烂下脓血。脾脉大而虚且有积滞，脾气绝则十日死。又有肚脐外突的也是死证，嘴唇焦枯无纹理且呈青黑色的也是死证，这是脾先死的表现。脾病面色黄、眼睛赤红的可以治疗，若青黑色侵入关节，半年后死亡。面色像枳实颜色的一个月后死亡。吉凶祸福，都通过观察面色及其出现的部位来判断。又有口噤唇黑、四肢重如泰山、不能自主、大小便失禁不止、饮食不进，七天后死亡。又若口虽萎黄，但语声清晰可辨的可以治疗。脾病疟疾之气久不去，腹中鸣响疼痛，慢慢出汗发热。其人原本性情宽缓却反而急躁易怒，说话时鼻子发笑，不能回答别人问题的，这超过一个月，灾祸必然降临。又有脾中寒或热，都会使人腹中疼痛、不能进食。又发病时舌体僵硬、言语蹇涩，睾丸上缩牵引大腿内侧疼痛，身体沉重不想吃东西，膨胀变症则水泻不能卧倒的，属于死证，无法治疗。脾正热则面色黄、眼睛赤红、胁肋疼痛胀满。寒则呕吐涎沫而不进食，四肢疼痛，滑泄不止，手足厥冷，严重则颤抖战栗像疟疾一样。临证治病之时，关键在于明确证候、详查脉象，然后投用汤药才能痊愈。
The Spleen belongs to Earth in the Five Elements, is referred to as the "Official of Remonstrance," and governs intention (Yi) and wisdom. It is responsible for digesting the five grains, resides within the body, nourishes the four limbs, and prospers during the late summer season among the four seasons. The Spleen and Stomach are exterior-interior pairs, with the Foot-Taiyin Splein Meridian being its governing channel. Bian Que stated: "When the Spleen is diseased, the complexion becomes sallow; excess conditions manifest as a stiff tongue, aversion to food, vomiting and regurgitation, and flaccidity of the limbs; deficiency conditions lead to frequent illness, a desire to swallow acid fluids, and persistent dysentery. If the pulse comes rapidly like flowing water, it is termed 'Excessive,' indicating pathogenic factors outside; if it comes short and abrupt like a bird's spur, it is termed 'Deficient,' indicating pathogenic factors inside. Excess causes heaviness in the four limbs and slurred speech; deficiency causes abdominal fullness, anorexia, fatigue, flaccid weakness of hands and feet, drooling, swelling of the four limbs, intermittent loose stools, and dreams of eating. The normal pulse of the Spleen arrives slowly and softly, and departs lightly like a bird's foot touching the ground. A pulse that arrives solid and full, slightly rapid, resembling a chicken lifting its foot, indicates disease. Pulses resembling falling birds, bird spurs, or leaking roofs indicate death. In wind-stroke, there is slight fever, a state resembling drunkenness, abdominal irritability and fullness, lax skin and muscles, and shortness of breath. During the prosperous time of the Spleen, a soft and slow pulse is normal. If the pulse is wiry and urgent, Liver Wood overacts on Spleen Earth, akin to a true ghost meeting, which is a sign of great misfortune." Furthermore, if the pulse is slightly choppy and short, Lung Metal attacks Spleen Earth; although untreated, it may heal spontaneously. If the pulse is reversely soft and slippery, Kidney Water follows Spleen Earth, which is also harmless. If the pulse is reversely floating and surging, Heart Fire generates Spleen Earth, but this indicates Spleen deficiency leading to disease. If the complexion is yellow, body heavy, bowel and bladder functions abnormal, eyes staring straight, lips retracted, nails cyanotic, four extremities cold, vomiting food, inability to digest all grains and foods, abdominal distension, body heaviness, joint pain, hard stool, and difficult urination, a pulse that is slightly slow and long is treatable. Spleen Qi deficiency leads to loose stools, clear urine, continuous sweating, downward leakage of the five fluids, resulting in dysentery of five colors. Accumulation in the middle jiao, if prolonged, leads to inability to control the four limbs, jaundice, failure of food to transform into muscle and flesh, Qi fullness, asthma, and insufficiency. Spleen excess manifests as dreams of building walls and houses; when excessive, dreams of singing and music; when deficient, dreams of insufficient food. When Jue pathogens lodge in the Spleen, one dreams of large marshes, hills, and storms destroying houses. Spleen distension leads to frequent hiccups, limb stiffness, body heaviness, anorexia, and easy belching. Spleen disease causes mental dullness, worsening during the day, stability at noon, and calmness in the afternoon. An extremely urgent pulse causes convulsions; a slightly urgent pulse causes epigastric obstruction where food enters and returns; an extremely slow pulse causes flaccidity and cold limbs; a slightly slow pulse causes wind-flaccidity with inability to support the limbs; an extremely large pulse causes alternating chills and fever; a slightly large pulse causes Xiao Dao (wasting-thirst); a slippery pulse indicates hernia; a slightly slippery pulse indicates insect toxicity, borborygmus, and heat in the middle jiao; a choppy pulse indicates intestinal obstruction; a slightly choppy pulse indicates internal ulceration with pus and blood discharge. A Spleen pulse that is large and void with accumulation indicates pathology; if Spleen Qi is exhausted, death occurs in ten days. Umbilical eversion is also a death sign; dry, cracked lips without texture and turning cyanous-black indicate death, representing the Spleen dying first. Spleen disease with yellow complexion and red eyes is treatable; if cyanous-black color penetrates the joints, death occurs in half a year. A complexion like Zhi Shi (immature bitter orange) indicates death in one month. Auspiciousness and misfortune are all revealed by observing the complexion and its specific locations. Mouth lock, black lips, limbs heavy as mountains, inability to hold oneself, unceasing incontinence of urine and feces, and inability to take food indicate death in seven days. If the mouth is sallow but the voice is clear, it is treatable. Spleen malaria qi lingering for a long time causes abdominal borborygmus and pain, followed by slow sweating and fever. If a person who was originally relaxed becomes irritable, laughs through the nose while speaking, and cannot answer others, disaster will inevitably occur after more than one month. Cold or heat in the Spleen both cause abdominal pain and anorexia. Disease onset with a stiff tongue and slurred speech, retraction of the testicles pulling pain into the inner thighs, body heaviness, anorexia, and bloating transforming into watery diarrhea with inability to lie down indicates a fatal, untreatable condition. Spleen proper heat manifests as yellow complexion, red eyes, and hypochondriac pain and fullness. Cold manifests as vomiting saliva and phlegm, anorexia, limb pain, unceasing diarrhea, cold hands and feet, and severe tremors resembling malaria. In clinical practice, the key lies in clearly identifying the syndrome and meticulously examining the pulse before administering decoctions to achieve recovery.