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Tongue Diagnostics
General
Easily learned and verifiable
Proper lighting critical
sun light best
incandescent better than florescent
Only ask for 15-20 sec sticking out of tongue with out force
Check what patient has eaten on affect of tongue color
Ask patient not to brush or scrape tongue, eat coloring foods etc. before
Drugs can affect tongue, e.g. antibiotics create peeling in coating, long term dampness
Vitality
general look of health
proper size, free in motion, light red, thin white coating that is not too dry or moist
Body
Body color always reflects true pattern of patient
Short term changes have less affect on body
Body demonstrates changes in chronic conditions
Meridians
divergent meridian of heart enters tongue root
spleen reaches tongue root and under surface
kidney reaches to root of tongue
Color
state of Zang and to some degree Fu
pale
less than light red
deficiency
blood
Qi
Yang
cold
red
heat
exogenous
endogenous
dark red / scarlet
endogenous to ying/xue level
long term yin deficiency
little to no coat
purple
blood stasis (long term)
started with pale or blue from cold -> blue purple
some moistness
started with red -> red purple
dried fluids causing stagnation
purple hugh
Qi stagnation
blue
extreme yang deficiency causing blood stasis
Underside
ask patient to roll back tongue on to back of top teeth
size and color of veins
distended but not dark
Qi stagnation
distended and dark
Blood stasis
one vein alone
one side of body
veins indicate all three jiao but in particular upper jiao
thick
extreme blood stasis from excess
think
blood stasis from deficiency
red/purple shiny
damp heat
yellow
damp
pale
cold or deficiency (in particular blood)
Coating
Demonstrates acute issues
Formed by residual dirty damp from stomach and intestines
normal
thin white even
moister
state of body fluids
dry
fluid consumption
moist/slippery
fluid transformation issues
more for Fu
"has root"
coating grows like grass and not easily wiped away
with out - painted on or powered on
stomach, spleen, kidney not functioning
thick
can not see body
pathogenic factor or excess
thickness indicates strength and depth of pathogen
thin
less than normal
thickness indicates strength and depth of pathogen
sticky
dampness in stomach and intestines
doesn't brush off easy
retention of dampness, phlegm or food
granular
loose thick coarse material easily removed
heat in the stomach
retention of phlegm or food
pealed
if patches - geographic
if entire - glossy
extreme Yin and Qi deficiency of stomach
color
white
thin
normal or exterior cold
thick
interior cold
yellow
heat
gray
further progression of white or yellow
dry
from heat
lighter / moist
cold damp / phlegm fluid retention
black
severe
moist
cold from def. of yang
dry (with horns)
extreme heat
Shape
thin / shrunken
deficiency
pale
blood
Qi
red / dry
yin deficiency
too little fluid
swollen
larger than normal
too much fluid
heat
pushes fluid up to tongue
pale, delicate, very swollen
yang Qi def.
spleen fails to transport and transform fluids
Spleen and Kidney
pale with teeth marks
Spleen Qi def.
causes dampness
slightly swollen
red
excess heat in heart, spleen and stomach
purple
toxicosis / damp heat from alcoholism / poisons
possibly just parts
observe location correspondence
cracks
check to see if crack is congenital
if long term and shallow - nothing
if deep and short term, pathology
red
heat consuming fluids
pale
blood deficiency
start and end checked against location correspondence
horizontal
red / normal
yin deficiency
iceflow crack
older people
yin deficiency
wet cracks
spleen def
dry cracks
yin def. in spleen
papilary buds
hotter the person the more they are raised
Deviation
indicates wind
could be indication of internal wind - stroke, high blood pressure
rigid
loss of flexibility and free movement
acute
high fever
chronic
yin deficiency (red)
non-substantial phlegm (pale)
flabby
red
extreme yin deficiency in stomach
pale
extreme Qi and Blood deficiency
tip rolls
down
heart deficiency
up
heart/lung excess
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