Long Pulse (长脉)

Appearance (体象歌)

长脉迢迢，首尾俱端；直上直下，如循长竿。

Clinical Indications (主病歌)

长主有余，气逆火盛。左寸见长，君火为病；右寸见长，满逆为定。左关见长，木实之殃；右关见长，土郁胀闷。左尺见之，奔豚冲兢；右尺见长，相火专令。

Clinical Significance

The Long Pulse indicates excess conditions with ascending qi and exuberant fire. Its form is straight from beginning to end, extending beyond its normal position, like feeling a long bamboo pole. It usually reflects yang heat rising internally or qi rebelling upward with abundant blood and qi. A long pulse that is soft and harmonious can be a normal sign of ample qi and blood in robust individuals. A long pulse that is wiry and hard is pathological, suggesting liver yang rising, liver fire, or rebellious qi. At the left inch position, long pulse indicates heart fire disease with restlessness, insomnia, and mouth sores. At the right inch, it points to lung qi rebelling upward with cough, asthma, chest fullness, and shortness of breath. At the left guan, it reflects liver wood excess with headache, dizziness, red eyes, irritability, and rib pain. At the right guan, it indicates spleen-stomach stagnation with abdominal fullness, belching, and poor appetite. At the left chi, it reflects lower burner qi rebellion such as running piglet qi rushing upward. At the right chi, it indicates ministerial fire acting on its own with seminal emission, leukorrhea, and hot painful lower legs. A long pulse that becomes hard and forceful warns of possible internal stirring of liver wind or stroke.

Treatment and Care

For a pathological Long Pulse, treatment aims to subdue liver yang, clear fire, regulate qi, and direct rebellious qi downward. For liver yang rising with headache and dizziness, use Tian Ma Gou Teng Yin or Zhen Gan Xi Feng Tang. For liver fire, clear liver fire with Long Dan Xie Gan Tang or Dang Gui Long Hui Wan. For heart fire with restlessness and insomnia, clear heart fire with Dao Chi San or Huang Lian E Jiao Tang. For lung qi rebelling upward with cough and asthma, direct qi downward and transform phlegm with Su Zi Jiang Qi Tang or Ding Chuan Tang. For spleen-stomach stagnation with abdominal fullness, regulate qi and harmonize the middle with Chai Hu Shu Gan San or Bao He Wan. For ministerial fire stirring, nourish yin and drain fire with Zhi Bai Di Huang Wan. Daily care emphasizes emotional calm, avoiding anger that injures the liver; a light diet avoiding spicy, alcohol, and fried foods that fan fire; and adequate sleep to protect yin. Tai chi and ba duan jin help regulate qi and blood, and acupuncture at Tai Chong, Xing Jian, and Feng Chi helps subdue liver yang. Regular practice of calming exercises helps prevent liver yang from rising and maintains stable blood pressure over time.