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）
实脉，无论浮取还是沉取都能触及，脉形大而长且略微带弦象，手指下感觉坚实有力（《脉经》）。“然”字，形容坚实的样子。《脉诀》中说：像绳子一样应指而来，那是紧脉，不是实脉。
〔体状诗〕浮取和沉取都能感到脉大且长，手指下没有虚弱感而显得强劲。热邪蕴结在三焦形成壮火，通过通利肠道、发汗的方法才能使身体安康。
〔相类诗〕实脉在浮取和沉取时都显得有力强劲，紧脉像弹动的绳索一样转动无常。必须知道牢脉是依附于筋骨之间的，实脉则是大而略微带弦且更长。浮取和沉取都有力为实脉，弦急且弹击人为紧脉，沉取而实大、略微带弦且长为牢脉。
〔主病诗〕实脉是由阳热之火郁结而成，症状包括发狂、说胡话、频繁呕吐。或者是阳毒之邪，或者是饮食积滞，导致大便不通或气机疼痛。寸部出现实脉，应当知道是面部发热、咽喉疼痛、舌体僵硬、气塞胸中。关部出现实脉，说明脾热导致中焦脘腹胀满；尺部出现实脉，说明腰部肠道疼痛不通。《内经》说：血实则脉实。又说：脉实者，是水谷停滞为病。还说：脉气来势实强，这叫做太过。《脉诀》说尺部实脉会导致小便失禁，这与《脉经》中尺部实脉导致小腹痛、小便困难的说法为何相反？洁古（张元素）不知道这是谬误，将实脉当作虚寒证治疗，用药用干姜、附子，这就更加错误了。
长脉，不大不小，悠长自然（朱氏）。如果像顺着长竹竿的末梢那样柔和，属于平脉（正常脉象）；如果像拉着绳子，或者像顺着长竹竿那样硬直，属于病脉（《素问》）。长脉有三部皆长和一部独长的区别。在季节上对应春季，在脏腑上对应肝脏；心脉长，表示神气强盛；肾脉长，表示根基稳固。《内经》说：长则气治，这些都是指平脉。
〔体状相类诗〕超过本位长度的脉称为长脉，弦脉则不然，只是饱满张开。弦脉与长脉相比距离较远，高明的医生自能衡量判断。（实脉、牢脉、弦脉、紧脉都兼有长脉的特征）
〔主病诗〕长脉悠长且大小均匀，反常成为病脉时就像牵拉的绳子。如果不是阳毒或癫痫病症，就是阳明经的热势深重。（长脉主要主有余的病证）
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).