丹溪云∶脾具坤静之德，而有干健之运，夫胃阳也，主气，脾阴也，主血，胃司纳受，脾司运化，一纳一
运，化生精气，清气上升，糟粕下降，纳五谷，化津液，其清者为荣，浊者为卫，阴阳得此，谓之橐 ，故东垣
以脾胃为五脏之根本也。脾气既弱，则健运之令不行，化生之功已失职，而嗜卧多困，所由生焉，法当温补
其脾，脾气既旺，则脏腑清阳之气升举，易于营运，又何困倦之有，海藏用四君子加木香、砂仁、半夏，白术倍
之，姜枣煎服，诚良法也。若脾虚好睡多惊，则是心血虚而火动之，宜安神养血。若因心脾气虚，有痰者，宜
用人参、五味子、茯苓以补心气，当归、芍药、酸枣仁以养心血，橘红、半夏以开痰。若因脾肺气虚，
胸膈有痰，用补中益气汤以健脾胃，胆星天竺丸（痰涎）以化痰涎。若因饮食停滞而作，用四君子汤以益脾土，
山楂、神曲以消饮食。若因脾虚而好睡，用五味异功散（吐泻）以补脾气，当归、芍药以生脾血，芍药须用酒拌炒
黄，不则酸寒伤脾，此假热
以对假寒也。若乳母饮酒，致儿昏醉好睡者，以干姜、陈皮煎汤解之，不应，用异功散加干葛即愈矣。
〔海藏〕脾胃不和，四君子加白术一倍，姜枣煎。脾困，四君子加木香、砂仁、人参各半钱煎。脾胃虚
弱，生气多困，四君子加炒半夏曲、没石子等分，为末，入冬瓜子少许同煎。
〔本〕治脾风多困。用人参散。入慢惊参用
人参 冬瓜仁（各半两） 南星（切片，用浆水姜汁煮、存性，一两）
上为细末。每一钱，水半盏，煎二三分，温服。
丹溪说：脾具有坤卦安静柔顺的德行，同时具备乾卦刚健运行的功能。胃属阳，主管气；脾属阴，主管血。胃负责受纳食物，脾负责运化水谷。一纳一运，从而化生精气。清轻之气上升，重浊之糟粕下降，受纳五谷，化生津液，其中清的部分成为营气（营养血液），浊的部分成为卫气（防御外邪）。阴阳依靠这些物质基础，被称为“橐龠”（风箱，比喻气化运动的动力源泉），所以李东垣将脾胃视为五脏的根本。
既然脾气虚弱，那么健运的功能就无法正常行使，化生精气的职责已经失职，嗜睡和多困倦的症状由此产生。治疗法则应当温补脾脏。脾气旺盛后，脏腑的清阳之气就能升举，易于营运，又怎么会有困倦呢？张元素（海藏）使用四君子汤加入木香、砂仁、半夏，白术加倍用量，加生姜、大枣煎服，这确实是良法。
如果是脾虚导致好睡且多惊悸，这是心血虚而虚火内动所致，适宜安神养血。如果是因为心脾气虚且有痰湿，适宜用人参、五味子、茯苓来补益心气，当归、芍药、酸枣仁来滋养心血，橘红、半夏来化痰开结。如果是因为脾肺气虚，胸膈有痰，用补中益气汤来健运脾胃，用胆星天竺丸（主治痰涎）来化解痰涎。如果是因为饮食停滞而引起，用四君子汤来补益脾土，山楂、神曲来消食导滞。如果是因为脾虚而嗜睡，用五味异功散（主治吐泻）来补益脾气，当归、芍药来生养脾血，芍药必须用酒拌炒至黄色，否则其酸寒之性会损伤脾脏，这是以假热来应对假寒的方法。如果是乳母饮酒，导致婴儿昏醉嗜睡，用干姜、陈皮煎汤解毒，若无效，用异功散加葛根即可痊愈。
〔张元素〕脾胃不和，用四君子汤加一倍量的白术，加生姜、大枣煎服。脾困倦，用四君子汤加木香、砂仁、人参各半钱煎服。脾胃虚弱，生气后感到困倦，用四君子汤加炒半夏曲、没石子等分，研为细末，加入少许冬瓜子同煎。
〔本书〕治疗脾风导致的困倦。用人参散。治疗慢惊风时用人参。
人参、冬瓜仁（各半两）、南星（切片，用浆水和姜汁煮，存其本性，一两）。
以上研为细末。每次取一钱，加水半盏，煎至剩余二三分量，温服。
Danyu stated: The spleen possesses the virtue of stillness and yielding akin to Kun (Earth), yet it has the function of vigorous movement akin to Qian (Heaven). The stomach is Yang, governing Qi; the spleen is Yin, governing Blood. The stomach is responsible for receiving and accepting food, while the spleen is responsible for transportation and transformation. Through this combination of reception and transformation, essence and qi are generated. Clear and light Qi ascends, while turbid waste descends. By receiving the five grains and transforming fluids, the clear portion becomes Ying Qi (Nutritive Qi), and the turbid portion becomes Wei Qi (Defensive Qi). With these Yin and Yang substances, the body functions like a bellows (Tuoyue, metaphorically referring to the mechanism of Qi movement); thus, Li Dongyuan regarded the Spleen and Stomach as the root of the five Zang organs.
Since Spleen Qi is weak, the command for healthy transportation fails, and the function of generating essence and qi is neglected, leading to drowsiness and lethargy. The treatment principle should be to warm and tonify the Spleen. Once Spleen Qi is robust, the Clear Yang Qi of the Zang and Fu organs will ascend and facilitate circulation, eliminating any sense of fatigue. Zhang Yuansu (Haizang) utilized Si Jun Zi Tang (Four Gentlemen Decoction) with added Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), and Banxia (Pinelliae Rhizoma), doubling the dosage of Baizhu (Atractylodis Macrocephalae Rhizoma), decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus); this is indeed an excellent method.
If drowsiness is accompanied by palpitations due to Spleen deficiency, it indicates Heart Blood deficiency with stirring of deficient fire, requiring calming the Spirit and nourishing Blood. If caused by deficiency of both Heart and Spleen Qi with phlegm-dampness, Renshen (Ginseng Radix), Wuweizi (Schisandrae Fructus), and Fuling (Poria) should be used to tonify Heart Qi, while Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), and Suanzaoren (Ziziphi Spinosae Semen) should be used to nourish Heart Blood, along with Juhong (Citri Reticulatae Pericarpium Rubrum) and Banxia (Pinelliae Rhizoma) to resolve phlegm. If caused by deficiency of Spleen and Lung Qi with phlegm in the chest and diaphragm, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to strengthen the Spleen and Stomach, and Dansheng Tianzhu Wan (Asari and Buddha's Hand Pill) [indicated for phlegm-saliva] should be used to transform phlegm-saliva. If caused by food stagnation, Si Jun Zi Tang (Four Gentlemen Decoction) should be used to benefit Spleen Earth, and Shanzha (Crataegi Fructus) and Shenqu (Massa Medicata Fermentata) should be used to digest food. If caused by Spleen deficiency leading to drowsiness, Wuyi Gong San (Five-Effort Powder) [indicated for vomiting and diarrhea] should be used to tonify Spleen Qi, and Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix Alba) to generate Spleen Blood. Shaoyao must be stir-fried with wine until yellow; otherwise, its sour and cold nature will damage the Spleen. This approach uses false heat to counteract false cold. If the infant’s drowsiness and drunken stupor are caused by the nursing mother consuming alcohol, Ganjiang (Zingiberis Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) decocted in water can resolve it. If ineffective, Yigong San (Efficient Powder) with Gegen (Puerariae Lobatae Radix) will cure it.
[Haizang] For disharmony between Spleen and Stomach, use Si Jun Zi Tang (Four Gentlemen Decoction) with double the amount of Baizhu (Atractylodis Macrocephalae Rhizoma), decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus). For Spleen lethargy, use Si Jun Zi Tang (Four Gentlemen Decoction) with Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), and Renshen (Ginseng Radix), each half qian, decocted. For Spleen and Stomach weakness causing lethargy after anger, use Si Jun Zi Tang (Four Gentlemen Decoction) with equal parts of Chao Banxia Qu (Stir-fried Pinellia and Mass Medicateda Fermentata) and Meishi Zi (Myrobalani Fructus), powdered, with a small amount of Dongguazi (Benincasae Semen) added during decoction.
[This Book] Treats Spleen Wind causing lethargy. Use Renshen San (Ginseng Powder). For slow convulsions, use Renshen (Ginseng Radix).
Renshen (Ginseng Radix) and Dongguaren (Benincasae Semen) (each half liang), Nanxing (Arisaematis Rhizoma) (sliced, boiled in Jiangshui [fermented rice water] and Jiangzhi [ginger juice], retaining its nature, one liang).
Grind into fine powder. Take one qian each time, add half zhan of water, decoct until only two or three fen remain, and take warm.