Advanced Naturopathic Case Taking: Naturopathic Evaluation Tools: Tongue

Question 1

Tongue Diagnosis

Answer 1

• Tongue diagnosis in traditional Chinese medicine (TCM) dates to the Shang Dynasty which began circa 1600 B.C. Since that time, it has evolved into a very important assessment tool.
• Tongue diagnosis is also an important ayurvedic assessment tool.

Question 2

Tongue examination

Answer 2

Examination takes into consideration:
* Condition —may indicate nutrient deficiencies.
* Shape.
* Colour.
* Patterns.
* Coating.

Question 3

TCM Tongue Map:

Answer 3

Use the TCM tongue map to help you identify dysfunctional areas:
* Root / back: Lower abdomen - kidneys, bladder, intestines and reproductive organs.
* Centre: Central abdomen - Stomach and spleen.
* Sides: Liver and gall bladder.
* Tip and front: Chest - heart and lungs.

Question 4

Colour: Pale

Answer 4

• Excess cold, Qi or Yang deficiency, blood deficiency
• Medically a pale tongue can indicate iron deficiency anaemia.

Question 5

Colour: Red:

Answer 5

• Excess heat, inflammation, infection.
• Use the tongue map i.e. a red tip of the tongue (heart area) indicates disturbance of the ‘shen’ (spirit) and often indicates underlying anxiety.
• Medically, a red and painful tongue / glossitis can indicate deficiency of folate, B12, B2, B3, B6.

Question 6

Colour: Purple

Answer 6

• Blood stagnation, reduced Qi, poor circulation
• Medically a purple tongue can indicate cyanosis (low oxygen).

Question 7

Condition and Taste: Prominent red papillae (spots)

Answer 7

Excess heat.

Question 8

Condition and Taste:
Excess papillae

Answer 8

• ‘Hairy tongue’ with a thick coating may follow antibiotic treatment.
• Probiotics and prebiotics required.

Question 9

Condition and Taste:
Dry and cracked

Answer 9

Yin deficiency (not enough fluids, not ‘holding’ fluids, or dried out due to excess heat).

Question 10

Condition and Taste: Wet

Answer 10

Excess moisture and fluids.

Question 11

Condition and Taste: Impaired Taste

Answer 11

Zinc deficiency.

Question 12

Tongue shape: Thin

Answer 12

Blood deficiency.

Question 13

Tongue shape: Swollen

Answer 13

Qi or Yang deficiency causing fluid retention; dampness.

Question 14

Tongue shape: Scalloped (teeth marks on sides)

Answer 14

Weak digestion (spleen Qi deficiency), pancreatic insufficiency.
In Ayurveda this will lead to build up of ‘ama’ (undigested food toxins).

Question 15

Tongue shape: Raised / upturned edges

Answer 15

A sign of high stress.

Question 16

Mobility of the tongue: Tremor / quiver:

Answer 16

Spleen Qi deficiency.
In Ayurveda it indicates excess ‘vata’ —nervous energy and anxiety.
Nutritionally it can indicate magnesium deficiency.

Question 17

Ayurvedic Tongue Analysis / Map

Answer 17

• In ayurvedic tongue analysis, the midline of the tongue, also known as the ‘sulcus’, represents the spine.
• The tip of the tongue is the top (cervical region) and the back the bottom (lumbar region).
• Cracks or fissures can correspond to painful areas of the spine.

Question 18

Cracks / Fissures

Answer 18

Cracks in the tongue (called ‘fissures’) are signs of potential health issues and may indicate imbalances in the area where located.

Question 19

Medial fissure:

Answer 19

A shallow vertical crack through middle of tongue (not to the tip) —can be a sign of deficiency of digestion. This indicates an under-secretion of digestive juices.

Question 20

Midline fissure at the tip:

Answer 20

• Tendency to constitutional heart problems.
• May also indicate thyroid issues.

Question 21

Geographical (or mapped) tongue:

Answer 21

• Yin deficiency
• Nutritionally it can indicate a B vitamin deficiency.
• Often seen in psoriasis sufferers.

Question 22

Tongue Coating

Answer 22

• Tongue coating reflects the state of the digestive system & potential toxicity
• When looking at the coating of the tongue, use the tongue map to identify the affected organs.

Question 23

Coating: Thin white:

Answer 23

• Normal.

Question 24

Coating: Brown:

Answer 24

• Chronic excess heat (leading to degenerative changes).

Question 25

Coating: Greasy yellow

Answer 25

• Damp heat (inflammation and infection).

Question 26

Coating: Greasy white:

Answer 26

• Damp cold (excess mucus / phlegm).

Question 27

Tongue Coating: No coat:

Answer 27

• Yin deficiency.