治趺阳脉浮而涩。浮则胃气强。涩则小便数。浮涩相搏。大便则难。其脾为约。此
之。
麻仁（二升） 芍药（半斤） 枳实（半斤 炙。） 大黄（一斤 去皮。） 浓朴（一
尺去
上六味为末。炼蜜为丸。如梧桐子大。饮服十丸。渐加。以知为度。
歌曰 一升杏子二升麻。枳芍半斤效可夸。黄朴一斤丸饮下。缓通脾约是专家。（一本。
浓
男元犀按。脾为胃行其津液也。今胃热而津液枯。脾无所行而为穷约。故取麻仁、杏仁
多脂
治在脾而取缓。欲脾不下泄其津液。而小便数已还津液于胃中。而大便难已也。
蔚按。古今权量尺寸不同。考之内台方。麻仁四两。杏仁六两。芍药、枳实各二两。浓
朴三
治伤寒身发黄发热。
栀子（十五枚） 甘草（一两） 黄柏（二两）
上三味。以水四升。煮取一升半。去滓。分温再服。
歌曰 里郁业经向外驱。身黄发热四言规。（身黄发热之外无他证。）草须一两二黄柏。
十五
治伤寒瘀热在里。身必发黄。此汤主之。
麻黄（二两 去节。） 连翘（二两） 赤小豆（一升） 甘草（二两） 生梓白皮（一
升
上八味。以潦水一斗。先煮麻黄再沸。去上沫。内诸药。煮取三升。去滓。分温三服半
日服
歌曰 黄病姜翘二两麻。一升赤豆梓皮夸。枣须十二能通窍。四十杏仁二草嘉。
蔚按。栀子柏皮汤。治湿热已发于外。止有身黄发热而无内瘀之证。此治瘀热在里。迫
其湿
豆利水
奠安太阴。俾病气合于太阴而为黄者。仍助太阴之气。使其外出下出而悉去也。潦水者雨后
水行 地。取其同气相求。地气升而为雨。亦取其从下而上之义也。
治疗趺阳脉（足背动脉，反映脾胃状况）浮而涩。脉浮说明胃气强盛，脉涩说明小便频数。浮脉与涩脉相互搏结，导致大便困难，这就是脾约证。这是治疗脾约证的方剂。
麻仁（二升）、芍药（半斤）、枳实（半斤，炙制）、大黄（一斤，去皮）、厚朴（一尺，去粗皮）。
以上六味药研成细末，用炼蜜制成丸药，大小如梧桐子。每次用温水送服十丸，逐渐增加剂量，以见效为度。
歌诀说：一升杏仁、二升麻仁，枳实和芍药各半斤，疗效值得夸耀。大黄和厚朴各一斤，制成丸药用水送下，是缓通脾约的专家。（另一版本中，厚朴用量不同。）
男元犀按语：脾为胃传输津液。现在胃热导致津液枯竭，脾无法传输津液而陷入穷困约束的状态。所以选用多脂质的麻仁、杏仁，治疗重点在脾，取缓治之法，希望脾不向下泄漏其津液，从而使小便频数停止，津液回流到胃中，大便困难也就解决了。
蔚按语：古今的重量和尺寸标准不同。考证《内台方》，麻仁四两，杏仁六两，芍药、枳实各二两，厚朴三两……
以上三味药，用水四升，煮取一升半，去掉药渣，分两次温服。
歌诀说：里热郁结业经向外驱散，身黄发热有四个字的规律。（除了身黄发热外没有其他症状。）甘草需用一两，黄柏二两，栀子十五枚。
麻黄（二两，去节）、连翘（二两）、赤小豆（一升）、甘草（二两）、生梓白皮（一升）、大枣（十二枚）、杏仁（四十枚，去皮尖，另研）、生姜（二两）。
以上八味药，用雨水（潦水）一斗，先煮麻黄至再次沸腾，去掉上面的沫，加入其他药物，煮取三升，去掉药渣，分三次温服，半天内服完。
歌诀说：黄疸病用姜、翘、麻各二两，一升赤小豆、梓白皮值得夸。大枣十二枚能通窍，四十枚杏仁配二两甘草很好。
蔚按语：栀子柏皮汤，治疗湿热已经发于体表，只有身黄发热而没有体内瘀滞的症状。此方治疗瘀热在体内，逼迫湿气……赤小豆利水……安定太阴，使病气合于太阴而发黄者，仍助太阴之气，使其从外出和下出而完全去除。雨水是雨后的积水，行于地面，取其同气相求之意。地气上升变为雨，也取其从下而上的意义。
Treats the Fuyang pulse (the dorsal pedal artery, reflecting the condition of the Spleen and Stomach) being floating and choppy. Floating indicates strong Stomach Qi, while choppy indicates frequent urination. The interaction between floating and choppy pulses leads to difficult defecation; this is called Pi Yue (Spleen Constriction). This is the formula for treating Pi Yue.
Hemp Seed (Ma Ren, *Cannabis Semen*) (2 sheng), White Peony Root (Shaoyao, *Paeoniae Radix Alba*) (0.5 jin), Immature Bitter Orange (Zhishi, *Aurantii Fructus Immaturus*) (0.5 jin, honey-fried), Rhubarb (Dahuang, *Rhei Radix et Rhizoma*) (1 jin, peeled), Magnolia Bark (Houpo, *Magnoliae Officinalis Cortex*) (1 chi, outer bark removed).
The above six herbs are ground into powder, mixed with refined honey to form pills, sized like Chinese quince seeds. Take ten pills with warm water initially, gradually increasing the dose until the desired effect is achieved.
Song verse: One sheng of Apricot Seeds, two sheng of Hemp Seeds; Zhishi and Shaoyao at half a jin each, efficacy is praiseworthy. Dahuang and Houpo at one jin each, taken as pills with water; experts in gently relieving Pi Yue. (Another version has different dosage for Houpo.)
Annotation by Nan Yuanxi: The Spleen transports fluids for the Stomach. Now, due to Stomach heat causing fluid depletion, the Spleen cannot transport fluids and falls into a state of constrained poverty. Therefore, fatty-seeded herbs like Ma Ren and Xingren (Apricot Seed, *Armeniacae Semen Amarum*) are selected. The treatment focuses on the Spleen, adopting a slow-acting approach, hoping that the Spleen will not leak its fluids downward, thereby stopping frequent urination, allowing fluids to return to the Stomach, and resolving the difficulty in defecation.
Note by Wei: Ancient and modern standards for weight and length differ. Consulting the *Neitai Fang*, Ma Ren is four liang, Xingren is six liang, Shaoyao and Zhishi are each two liang, Houpo is three liang...
Treats jaundice and fever resulting from Taiyang disease.
Gardenia Fruit (Zhizi, *Gardeniae Fructus*) (15 fruits), Licorice Root (Gancao, *Glycyrrhizae Radix et Rhizoma*) (1 liang), Phellodendron Bark (Huangbai, *Phellodendri Chinensis Cortex*) (2 liang).
The above three herbs are boiled in four sheng of water to obtain one and a half sheng. Strain the dregs and take half warm, twice daily.
Song verse: Internal stagnation has been driven outward; jaundice and fever follow a four-character rule. (Apart from jaundice and fever, there are no other symptoms.) Gancao must be one liang, Huangbai two liang, Zhizi fifteen fruits.
Treats turbid heat retained internally due to Taiyang disease, which inevitably causes jaundice. This decoction is indicated.
Ephedra Stem (Mahuang, *Ephedrae Herba*) (2 liang, nodes removed), Forsythia Fruit (Lianqiao, *Forsythiae Fructus*), Adzuki Bean (Chixiaodou, *Vigna angularis*), Licorice Root (Gancao, *Glycyrrhizae Radix et Rhizoma*) (2 liang), Catalpa Bark (Sheng Zibapi, *Catalpae Cortex*) (1 sheng), Jujube (Dazao, *Ziziphi Jujubae Fructus*) (12 fruits), Apricot Seed (Xingren, *Armeniacae Semen Amarum*) (40 grains, skin and tips removed, pounded separately), Fresh Ginger (Shengjiang, *Zingiberis Rhizoma Recens*) (2 liang).
The above eight herbs are boiled in ten dou of rainwater (Liaoshui). First, boil Mahuang until it boils again, remove the foam on top, then add the remaining herbs. Boil to obtain three sheng, strain the dregs, and divide into three warm doses, taken within half a day.
Song verse: For jaundice, use Mahuang, Lianqiao, and Shengjiang, each two liang; one sheng of Chixiaodou and Zibapi are praised. Twelve Dazao can open orifices; forty Xingren paired with two liang of Gancao are excellent.
Note by Wei: Zhizi Baipi Tang treats damp-heat that has already manifested externally, presenting only with jaundice and fever without internal retention. This formula treats turbid heat retained internally, forcing dampness... Chixiaodou promotes diuresis... Stabilizes the Taiyin, assisting the Qi of the Taiyin so that pathogenic factors combined with Taiyin to cause jaundice may exit through the exterior and inferior, thus being completely eliminated. Liaoshui refers to rainwater collected after rainfall flowing on the ground, utilizing the principle of similar energies attracting each other. Earth qi rising becomes rain, also reflecting the meaning of moving from below to above.