实脉，浮沉皆得，脉大而长微弦，应指 然（《脉经》）。 ，坚实貌。《脉诀》言∶如绳应指来，乃紧脉，非实
脉也。
〔体状诗〕浮沉皆得大而长，应指无虚 强。热蕴三焦成壮火，通肠发汗始安康。
〔相类诗〕实脉浮沉有力强，紧如弹索转无常。须知牢脉帮筋骨，实大微弦更带长。浮沉有力为实，弦急弹人为紧，
沉而实大，微弦而长为牢。
〔主病诗〕实脉为阳火郁成，发狂谵语吐频频。或为阳毒或伤食，大便不通或气疼。寸实应知面热风，咽疼舌强气
填胸。当关脾热中宫满，尺实腰肠痛不通。《经》曰∶血实脉实。曰∶脉实者，水谷为病。曰∶气来实强是谓太过。《脉
诀》言尺实小便不禁，与《脉经》尺实小腹痛、小便难之说何反。洁古不知其谬，诀为虚寒，药用姜附，愈误矣。
长脉，不小不大，迢迢自若（朱氏）。如循长竿末梢为平；如引绳，如循长竿，为病（《素问》）。长有三部之长，一
部之长，在时为春，在人为肝；心脉长，神强气壮；肾脉长，蒂固根深。《经》曰∶长则气治，皆言平脉也。
〔体状相类诗〕过于本位脉名长，弦则非然但满张，弦脉与长争较远，良工尺度自能量。（实、牢、弦、紧皆兼长
脉）
〔主病诗〕长脉迢迢大小匀，反常为病似牵绳。若非阳毒癫痫病，即是阳明热势深。（长主有余之病）
The Shi (Excess) pulse can be felt at both superficial and deep levels; it is large, long, and slightly wiry, feeling firm and solid under the finger (Mai Jing). The character "ran" describes a firm appearance. Mai Jue states: "Like a rope responding to the finger," this refers to the Jin (Tight) pulse, not the Shi pulse.
[Body Form Poem] Superficial and deep levels both reveal a large and long pulse; under the finger, there is no deficiency but rather strength. Heat accumulates in the Sanjiao (Triple Burner), forming vigorous fire; only by purging the intestines and inducing sweating can health be restored.
[Similarity Poem] The Shi pulse is forceful and strong at both superficial and deep levels; the Jin pulse resembles a snapping cord, turning irregularly. One must know that the Lao (Deep-Firm) pulse adheres to the sinews and bones; the Shi pulse is large, slightly wiry, and longer. Superficial and deep with force indicates Shi; wiry, urgent, and striking like a projectile indicates Jin; deep, large, slightly wiry, and long indicates Lao.
[Main Disease Poem] The Shi pulse arises from the stagnation of Yang fire, manifesting as madness, delirious speech, and frequent vomiting. It may indicate Yang Du (Yang Toxin) or food retention, leading to constipation or Qi pain. At the Cun (Inch) position, one should know it indicates wind-heat in the face, sore throat, stiff tongue, and Qi filling the chest. At the Guan (Bar) position, Spleen heat causes fullness in the Middle Jiao; at the Chi (Cubit) position, it indicates pain and obstruction in the waist and intestines. The Classic says: "When blood is excess, the pulse is excess." It also says: "An excess pulse indicates disease caused by water and grain [food stagnation]." It further states: "A pulse coming forth strongly and forcefully is called Tai Guo (Excessive)." Mai Jue claims that a Chi excess pulse leads to urinary incontinence, which contradicts the Mai Jing's statement that Chi excess causes lower abdominal pain and difficult urination. Jiegu (Zhang Yuansu) failed to recognize this error, treating the pulse as Deficiency-Cold and using Ginger and Aconite, thereby compounding the mistake.
The Chang (Long) pulse is neither small nor large, stretching out naturally and effortlessly (Zhu Shi). If it feels like tracing the tip of a long bamboo pole, it is a Ping (Normal) pulse; if it feels like pulling a tight rope or tracing a rigid long pole, it is a Bing (Disease) pulse (Su Wen). There are cases where all three positions are long, or only one position is long. In terms of seasons, it corresponds to Spring; in terms of organs, it corresponds to the Liver. A Long Heart pulse indicates strong spirit and robust Qi; a Long Kidney pulse indicates a solid foundation and deep roots. The Classic says: "Long means Qi is regulated," referring to normal pulses.
[Body Form and Similarity Poem] A pulse extending beyond its original position is named Chang; the Xian (Wiry) pulse is different, merely appearing full and distended. The distinction between Wiry and Long pulses is far apart; skilled physicians can measure and judge them accurately. (Shi, Lao, Xian, and Jin pulses all accompany the Chang pulse characteristic).
[Main Disease Poem] The Chang pulse stretches out, uniform in size; when abnormal and pathological, it resembles a pulled rope. Unless it is Yang Du or epilepsy, it indicates deep Heat in the Yangming channel. (Chang primarily indicates Excess conditions).