TONGUE
DIAGNOSIS
WESTERN MEDICINE UNITED WITH ORIENTAL MEDICINE
MODERN MEDICINE: TONGUE DIAGNOSIS:
Smooth
Tongue: A coated tongue is normal, a
smooth red tongue is not.
The loss of papillae gives the
tongue a red slick
appearance, often beginning
at the edges. It suggests a
Deficiency of Vitamin B12,
niacin or iron.
Hairy
Tongue: Hair on
a Hairy tongue
consists of elongated papillae
on the dorsum of the tongue
and is yellowish to brown to
black. It is clinically benign
with the etiology presently
unknown.
Geographic
Tongue: Scattered red
areas on the
dorsum of the tongue that are
denuded of their papillae and
are smooth. These areas
appear in contrast o the
normal roughened and coated
surface, which yields a map-
like pattern, which changes
with time. The condition is
benign and the etiology
remains unknown.
Fissured
Tongue: Fissures appear in the tongue
with increasing age and at
time become numerous,
yielding the name “scrotal
tongue”. The only known
significance is that food debris
may accumulate in the
crevices and become irritation.
Cranial 12
paralysis: Paralysis of the
Hypoglossal
nerve produces atrophy and
fasciculation’s of the involved
half of the tongue. Deviation
toward the paralyzed side
occurs when the tongue is
protruded.
Varicose
Veins: Small purplish or blue-black
round swellings may appear
under the tongue with age and
are known as “caviar
lesions.” They are considered
not clinically relevant and it is
prudent to reassure the
patient:
Leukoplakia: A
thickened white patch
adherent to the mucous
membrane. Its appearance
looks like “dried white paint.”
Leukoplakia may involve any
part of the oral mucosa. This
is considered a possible signs
of Pre-malignancy.
Carcinoma:
Any ulcer or nodule which
fails to heal in two or three
weeks must be considered
suspicious. Look for it at the
base or edges of the tongue as
Carcinoma is rare on the
dorsum of the tongue.
ORIENTAL MEDICINE TONGUE
DIAGNOSIS
In Oriental Internal
Medicine, the physician is concerned with determining heat, cold, Yin or
Yang Organ and Qi & Blood patterns. There are five fundamental
categories for inspection and observation of the human tongue.
They are Color, Shape and Size, Fur/Coating, Moisture, and Length.:
COLOR
Pale: Yang
deficiency if wet and swollen
Blood deficiency if somewhat dry.
Red: Usually indicates heat. If no coating,
it
will indicate deficiency and
heat. .
Tip: Heart Fire (May also be
swollen).
Sides: Liver
and Gallbladder heat (May also be
swollen).
Center: Stomach
Heat.
Papillae:
Heat.
Points: Stomach heat if around the
center.
Deep Red.
Same clinical significance as Red
tongue, increase severity
Purple: Always indicates blood stasis.
Reddish Purple: Heat and Blood
stasis.
Bluish Purple: Cold and Blood
stasis.
On the sides: Liver Blood stasis.:
BODY COLOR MOISTURE
Normal
Red Moist
Blood
Xu
Pale
Qi Xu
Pale
Shi
Cold Pale
Moist
Heat
Red Dry
Extreme Heat
Scarlet Dry
Heat
Xue Level
Scarlet Dry
Qi/Blood Stagnation
Purple
Cold
Stagnation Pale Purple
Moist
Heat
Injury to Blood Red Purple
Dry
Liv Qi
Stagnation Purple
Stagnation Dark
Tinge:
SHAPE
The shape of the
tongue is indicative of Nutritive Qi and Blood conditions.
Thin: Blood
deficiency (Pale) or Yin deficiency (Red):
Swollen: Damp retention due to Yang deficiency
(pale)
Damp Heat (Red or normal color). Qi or Yang
Deficiency (Teeth marks and Pale
Stiff: Interior Wind
Flaccid: Body
fluid (electrolyte) deficiency.:
Long: Heat tendency (Particularly Heart Heat).
Short: Interior cold if pale and wet Extreme deficiency of
Yin if Red and Peeled.:
Cracked: Heat
of excess or deficiency.
Short Horizontal Crack: Stomach Yin
deficiency.
Long Deep Central: Tendency to a
Heart Heat.
Shallow, Wide and Short at Center: Stomach Yin
Xue
Short transversal at middle: Chronic
Spleen Qi deficiency
SHAPE
SUMMARY
Normal Not Big or Small; Not Swollen or Shivering;
Flexible; Not neither deviated nor
cracked
Deficient Qi Big Puffy, Swollen and Teeth marks
Excess
Fluid Big Puffy, Swollen and Teeth marks.
Excess
Heat Big & Red Puffy, Swollen and Teeth
marks.
Blood Xu
Thin and Small Slender.
Yin ye
xu Thin and Small Slender.
Heart
mucus Stiff and non-flexible.
Deficient Qi Trembling and Pale.
Internal
Wind Trembling and
red.
Cold Contracted. Pale/Purple
Damp/Mucus Contracted. Swollen.
Heat
injury Contracted Red
Heat
excess Raised papillae
Blood
Stagnation
Raised
FUR/COATING:
Usually reflects the
state of Yang organs, particularly Stomach.
Color:
Indicates conditions of Heat or Cold.
White: Cold Patterns (Thin and White is
normal.)
Yellow: Heat Patterns.
Gray & Black: Extreme cold or
heat (Depending on
wetness or dryness).
Thickness: Indicative or relative state of
deficiency
of the body or excess of the pathogen
and its manifestations.
No
Coating: Yin deficiency
Thick:
Wetness or congestion.
Distribution: Shows progression of the pathogen,
especially in spleen and stomach
patterns.:
MOISTURE
Excessive
Wet: The Yang Qi is not transforming and
transporting fluids harmoniously resulting
in accumulation of dampness.
Dry: Excess of deficiency heat damaging the
fluids.
Sticky/slippery
Coating: Accumulation of Phlegm or Dampness.
LENGTH
Long: Blazing
Heart Fire.
Short: Spleen
Yang deficiency if
especially pale.
Heat stirring Liver Wind if
Red. Deficiency of fluids from
excess heat if red with coating.
Distention of the sublingual veins
is indicative of Qi stagnation whereas presence of blue lines may
indicate blood stasis.
MOSS
THICKNESS COLOR TEXTURE APPEARANCE
Normal
Thin White Uniform
Deficiency Thin White
Excess Thick
Excess Fluid/damp
Puddled
Yang
Deficiency Puddled
Excess Yang
Fire Puddled
Deficiency Fluid Dry Sandpaper
Strong Middle Jiao Dry Sandpaper
Weak Middle
Jiao
Firmly rooted
"moss"
Mucus
and damp
Greasy Oily butter
Extreme Mucus/Damp
Thick pasty Lumpy/oily/flour
Jin-Ye/Spleen
Peeled
Skinless Chicken
Cold Thick White
Excess moisture
Stomach Heat Thick White
Tofu
Cottage Cheese Heat Black/Gray
Red Body
Extreme Heat Black/Gray
Red Body
Extreme
Cold Black/Gray
Pale Body
TONGUE PATTERNS OF
DISHARMONY:
The following is your first introduction to
the Study of patterns of Disharmony. Know these purified lists, and you
will have achieved years of study. However, you must spend the time
learning and refining your ever growing knowledge. The following is
your first introduction to the Study of patterns of Disharmony by your
knowledge of these tongue patterns. Later in the text, this will be but
one of many signs you must consistently organize in your minds eye with
the various symptoms associated with the Disharmonies which plague
mankind.
Cold:
Deficiency:
Acute: Tongue is pale with a
thin moist coating which has increased moisture.
Chronic: Tongue is pale with a
thin white coating that is dry.
Excess/External: White
fur that is thick.:
Heat: Degree of redness is
an indication of the
amount of heat that is present.
Dark Red: Excess heat with
accompanying yellow
fur: the fur is the key identifying point of
the excess or deficiency. No coating
or scanty coating is deficiency.
Raised and Red
Papillae: Indicates heat.
Presence of Spots (Red): Heat
congestion.
Organ Heat:
Heart Fire: Red beefy, red tip and raised
papillae (Usually Excess)
Liver Fire: Sides are
more red with swelling
(Usually Excess)
Stomach Fire:
Thick yellow fur in the center that
is dry (Excess) Red starts to
show with little to no coating.
(Deficiency)
Lung
Fire: Redness of the anterior 1/3 of
the tongue. Excess of deficiency
based on the coating.:
Deficiency:
Qi:
General: Tongue is little thicker than normal
with Teeth marks.
Spleen: Paler than normal, thick center
coating and Teeth marks.
Stomach:
Pale with thinner center coating.
Heart: Tip pale and perhaps thicker or
flabby.
Lungs: Upper 1/3 swollen with
Teeth marks.
