一长者。阳也。指下寻之。三关如持竿之状。举之有余曰长。过于本位亦曰
长。主浑身壮热。夜卧不安。
长者。阳也。干之象也。易曰。干之九五。亢龙有悔。此之谓也。经曰。长则气
治。何病之有。今则三关如持竿之状。举之有余。过于本位。是长之太过
者矣。故主阳邪热毒之气。乘其三焦。阳盛则热。故其见证为浑身壮热
也。阳盛则乘其阴。故夜卧不安也。
按洁古曰。长法干。此阳明脉。故尺寸俱长。身热目疼鼻干。不得卧。当汗。
阳化气也。
长脉迢迢度三关。指下来时却又还。阳毒在脏三焦热。徐徐发汗始能安。
长脉迢迢度三关者。言脉三关通度。迢迢而长也。指下寻之却又还者。
言脉往来甚盛也。长脉为阳。三关通度。则知阳邪热毒。客于三阴之标。
三焦之内皆热也。夫既曰阳毒在脏。而曰汗者何也。洁古曰。在三阴经
络中有邪者。是也无汗乃阴中之阳。可汗而已。是经络无形受邪。法当
去之。为三阴标之病也。今阳邪为患。若得微汗。则阴气复舒。阳毒随汗
而解矣。正如夏月炎蒸。亢旱得雨。即清凉也。云岐子曰。徐徐发汗者。为
在标之深远。急则邪不能出。发之以升麻汤。发在阳明标。一法加羌活
麻黄中。治法以地骨皮散。治浑身壮热。
按脉经云。寸口脉中手长者。曰足胫痛。
The Long pulse (Chang Mai) belongs to Yang. When palpated with light pressure, the pulse at the three positions (Cun, Guan, Chi) extends straight like holding a bamboo pole. It is felt as excessive when lifted (Ju), and extending beyond its normal position is also called Long. It indicates high fever throughout the body and restlessness during sleep.
The Long pulse belongs to Yang and symbolizes the Qian trigram (Heaven). The *I Ching* states: "Qian's Nine at the Fifth Place: The arrogant dragon has cause for regret." This refers to this condition. The classics state: "A Long pulse indicates harmonious Qi; what disease would there be?" However, now the pulse at the three positions resembles holding a pole, feeling excessive when lifted, and extending beyond its normal position. This represents an excess of the Long pulse. Therefore, it indicates pathogenic heat-toxin of Yang nature invading the San Jiao (Triple Burner). Excess Yang generates heat, hence the manifestation is high fever throughout the body. Excess Yang invades Yin, hence restlessness during sleep.
According to Jiegu: The Long pulse corresponds to the Qian trigram; this is the pulse of the Yangming channel. Thus, both the Cun (inch) and Chi (cubit) positions are Long. Symptoms include body heat, eye pain, nasal dryness, and inability to sleep. Sweating should be induced. Yang transforms into Qi.
The Long pulse stretches far across the three positions; when pressed, the pulse qi returns. Yang toxin in the Zang organs and heat in the San Jiao can be relieved only by gradual sweating.
"The Long pulse stretches far across the three positions" means the pulse extends smoothly through the three positions. "When pressed, the pulse qi returns" means the pulse movement is vigorous. The Long pulse is Yang. Since the three positions are connected, it is known that Yang pathogenic heat-toxin resides in the exterior aspects of the Three Yin channels, and heat fills the interior of the San Jiao. If it is said that Yang toxin is in the Zang organs, why is sweating mentioned? Jiegu stated: If pathogens reside in the meridians of the Three Yin channels, this results in absence of sweating, which is Yang within Yin, and can be treated by inducing sweating. This is because the meridians have received formless pathogens, and the treatment method should eliminate them, constituting a disease of the exterior aspects of the Three Yin channels. Now, if Yang pathogens are the issue, obtaining slight sweating allows Yin Qi to recover comfort, and Yang toxin is resolved with the sweat. Just as in summer, under scorching sun, rain after a long drought brings immediate coolness. Yunqi Zi stated: Gradual sweating is used because the pathogens in the exterior aspects are deep-seated; urgent sweating cannot expel them. Use Shengma Tang to induce sweating, targeting the exterior aspect of Yangming; another method adds herbs to Qianghuo and Mahuang. Treat with Digupi San for high fever throughout the body.
According to the *Mai Jing*: If the pulse at the Cun Kou feels Long upon palpation, it indicates pain in the lower legs.