Classica Sinica Medica

脾約 简体 脾约

pí yuē

The spleen's bond · pi yue

Also rendered: The spleen constrained (Literal) · The spleen's fluids bound (Clinical)

Pathology

Reviewed · 2026-10-31

At a glance

Pinyin
pí yuē
Simplified
脾约
Literal
脾 pí is the spleen, which in this physiology spreads the stomach's fluids through the body; 約 yuē is a binding, a constraint. The spleen is 'bound' in that its fluids, instead of being spread, are drawn off to the bladder: urine becomes frequent, the stool hard. The hardness is the sign, not the disease.
Shuowen
**《說文》：「約，纏束也。」** 脾約之名，**六至十篇二見**：一作「脾約」（太陽陽明者，脾約是也），一作「其脾爲約」（趺陽脉浮而濇……）。**底本同段「濇」「澀」兩形並見**（「浮而濇」「澀則小便數」），各依本字，不并軌。成無己注：「脾約者，脾氣弱，約束津液不得四布，但輸膀胱，小便數而大便鞕。」**本書以麻仁丸治之**，潤而不攻，與胃家實之大承氣相對。

In brief

One of the three ways into yang brightness: the spleen’s fluids are bound and no longer spread, so they run to the bladder. Urine becomes frequent and the stool hard — hard in the way that dryness makes it, not the knotted stool of 胃家實. The chapter’s own prescription is 麻仁丸, a moistening pill of hemp seed, peony, bitter orange, rhubarb, magnolia bark and apricot kernel, which lubricates rather than purges. The entry is therefore the counterweight to 胃家實: same channel, same hardness, opposite treatment, and the difference lies in whether the fluids have been consumed or merely misdirected.

Senses in the classical corpus

1
太陽陽明之目 太陽陽明者，脾約是也
太陽病誤汗吐下，津液偏滲於膀胱，小便數而大便鞕，謂之太陽陽明，其證不盡屬胃實
The first of the three entries: taiyang disease wrongly treated, its fluids diverted to the bladder, urine frequent and stool hard. It is called taiyang yang brightness, and its repletion is not the repletion of the stomach's household.
答曰：“太陽陽明者，脾約是也。” — 辨陽明病脉證并治第八
2
脉與病機 其脾爲約
趺陽脉浮爲胃氣強，濇爲小便數；浮濇相搏，津液偏滲，大便因鞕，其脾爲約
The mechanism in the pulse: at the instep, floating means the stomach qi is strong, astringent means urine is frequent; the two together draw the fluids off and the stool hardens. The spleen is 'bound' because what it should spread it cannot. The treatment is moistening, not purging — hemp seed, peony, bitter orange, rhubarb, magnolia bark and apricot kernel in a honey pill. Rhubarb is present, but the whole is a lubricant; this is how the chapter distinguishes 脾約 from 胃家實 in practice.
趺陽脉浮而濇，浮則胃氣強，澀則小便數，浮澀相搏，大便則難，其脾爲約，麻仁丸主之。 — 辨陽明病脉證并治第八

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

Display
2 passages
辨陽明病脉證并治第八·辨陽明病脉證并治第八 Read in context →
問曰：“病有太陽陽明，有正陽陽明，有少陽陽明，何謂也？”答曰：“太陽陽明者，脾約是也。” 问曰：“病有太阳阳明，有正阳阳明，有少阳阳明，何谓也？”答曰：“太阳阳明者，脾约是也。”
wèn yuē bìng yǒu tài yáng yáng míng yǒu zhèng yáng yáng míng yǒu shào yáng yáng míng hé wèi yě dá yuē tài yáng yáng míng zhě pí yuē shì yě
A question: the disease has Taiyang-yangming, true yangming-yangming, and Shaoyang-yangming; what does that mean? The answer: Taiyang-yangming is the splenic constraint.
三陽明之首：脾約居其一，與胃家實、少陽陽明鼎立。
辨陽明病脉證并治第八·辨陽明病脉證并治第八 Read in context →
趺陽脉浮而濇，浮則胃氣強，澀則小便數，浮澀相搏，大便則難，其脾爲約，麻仁丸主之。 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，麻仁丸主之。
fū yáng mài fú ér sè fú zé wèi qì qiáng sè zé xiǎo biàn shuò fú sè xiāng bó dà biàn zé nán qí pí wéi yuē má rén wán zhǔ zhī
When the instep pulse is floating and rough, the floating means strong stomach qi and the rough means frequent urine; the two striking together make the stool difficult, and the spleen is constrained. Hemp Seed Pill governs it.
趺陽脉以候脾胃；浮濇相搏，便是脾約之形。方用麻仁丸，潤而不猛。

Compounds built on this term

脾約
pí yuē
the spleen's bond
辨陽明病脉證并治第八
趺陽脉
fū yáng mài
the instep pulse
辨陽明病脉證并治第八
浮濇相搏
fú sè xiāng bó
floating and astringent contending
辨陽明病脉證并治第八
麻仁丸
má rén wán
hemp seed pill
辨陽明病脉證并治第八

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

This sitethe spleen's bondkeeps 約 as a binding, not a contraction
Literalthe spleen is constrainedexact, and passive where the Chinese is not
Clinicalsplenic fluid-binding constipationclear, and longer than a headword

Entry status

Review pending — who reviews this?

2026-10-31

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