Dr. Angelica Kokkalis, O.M.D L.Ac.

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Tongue Diagnosis in Chinese Medicine

Tongue Diagnosis

The diagnostic value of observation of tongue can be fully manifested only in clinical treatments in T.C.M. by using differentiation of syndromes. The facts verify that excess or deficiency of Qi and blood in viscera organs, depth of invasion of pathogenic factor, tendency of transmission and change in a disease can be understood through observation of tongue.

It is declared by the modern research work that appearance of tongue looks like a window for seeing into internal organs of the body, can objectively reflect various physiological changes in the interior of the body, manifests the reaction and function of the body at the moment and brings the information of plentiful vital activities.

The content of tongue diagnosis

Observation of tongue proper (body)
Observation is mainly focused on three aspects : color, appearance and mobility of the tongue. A normal tongue is light red in color, lustrous and moist, free in motion, and of proper size which is neither flabby nor thin and neither tough nor too tender.

Tongue color

  • Pale tongue: Is often seen in severe malnutrition, anemia chronic nephritis, etc.
  • Light red tongue: Is often seen in a healthy person or a person with a mild disease. Sometimes it may also seen in a chronic disease which is not so severe.
  • Red tongue: Is often seen in the middle stage of a febrile disease with virus or bacteria in blood.
  • Deep red tongue: Is often seen in the advance stage of a febrile disease in which high fever, septicemia and some other severe conditions are present.
  • Green, blue or purple tongue: Is often seen in severe infection, extreme weakness in respiration or circulation, oxygen difficulty diffuse intravascular clotting, etc

Appearance of tongue

  • Sheen-withered tongue: A sheen tongue indicates vigor of the anti-pathogenic factor and adequacy of the body fluids. Withered tongue is often seen in wasting diseases, severe malnutrition, pernicious anemia, and the advanced stage of infectious febrile diseases.
  • Tough-tender tongue: A tough tongue indicates heat syndrome often seen in the peak stage of acute disease. A tender tongue indicates cold syndrome mostly seen in the advanced stage of chronic disease.
  • Cracked tongue: A cracked tongue is often seen in high fever, dehydration and malnutrition.
  • Thorny tongue: A thorny tongue indicates hyperactivity of pathogenic heat, which is often seen in high fever, severe pneumonia, scarlet fever etc.
  • Spotty tongue: Like red bayberry gathers at the front and in the middle of the tongue. Is often seen in the advanced stage of a febrile disease, burns etc
  • Tooth printed tongue: Tooth prints appearing at the edges of the tongue is often seen in edema, anemia, chronic nephriris etc.
  • Double tongue: The vessels of the underside of the tongue are swollen up like another small tongue. Is often seen in inflammation or abscess of glandula sublingualis, tumor etc.
  • Haemorrhagic tongue: A tongue bleeding on the surface is often seen in leukemia and aplastic anemia.
  • Carbuncle tongue: Is seen in glossitis, tongue tumor and pyogenic infection.
  • Furuncle tongue: Which is hard and painful with a size of a soybean is often seen in glossitis and infections.
  • Boils tongue: Protruding painful boils on the surface of the tongue is often seen in ulcerous glossitis and stomatitis.
  • Fungus tongue

Mobility of tongue

  • Rigid tongue: Difficult to protrude is often seen in cerebrovascular accidents and nerve system damage of various causes.
  • Flaccid tongue: Is often seen in nerve dysfunction of tongue, nerve system damage or extreme weakness in the advanced stage of diseases.
  • Shrunken tongue: Shrunken and unable to protrude denotes a fatal sign. Is often seen in cerebrovascular accidents, severe lingual muscle atrophy, and extreme weakness in the advanced stage of diseases.
  • Deviated tongue: Which is deviated to a side is often seen in facial paralysis, hypoglossus paralysis, and some other nerve damage.
  • Tremulous tongue: Uncontrollable trembling often appears in tremulous paralysis and some severe nerve system damage.
  • Protruding and wagging tongue: Is often seen in high fever, blood disease with bacteria or virus, protruding tongue like dementia.
  • Numb and paralyzed tongue: Is a tongue without ability to move. They are seen in nerve system damage due to various causes