inspection of tongue

Question 1

4 methods and precautions for tongue diagnosis

Answer 1

1. adequate natural light
2. posture of tongue: protrude, relaxed, flatly, open mouth
3. diagnostic sequence order
4. duration: no more then 15-20 seconds

Question 2

correspondences

tip/center/root/sides

Answer 2

tip: heart/Lu
sides: GB left/ Liv right
middle: ST/SP
root: kid

Question 3

Normal tongue appearance

Answer 3

Pale red, thin white coat, moist

Question 4

Where does tongue coat come from

Answer 4

Stomach: receives food: rotting and ripening process- a little dampness is produced, comes up and out in tongue coat–NORMAL

Question 5

tongue coat color

Answer 5

White: normal or cold
yellow: on the heat side

Question 6

Pale or white tongue

Answer 6

lighter in color then normal pale red/may not have any red hue
deficient cold pattern-yang pattern
cold pattern
deficiency or exhaustion of qi

Question 7

Red tongue

Answer 7

bright red, more red then normal red
heat pattern
deficient heat: bright red/ cracks fissures/little or no coating because not enough fluids
excessive heat: bright red, thick yellow gray or black and dry coating
**difference in coating

Question 8

crimson/ scarlet red tongue

Answer 8

deeper red color then red tongue
heat pattern
deficient heat: crimson tongue/ possible fissures/ little or no coating
excessive heat: crimson, possible red spots and yellow dry coating
blood stasis with heat: crimson tongue w/ purple dots

Question 9

blue green purple tongue

Answer 9

blood stasis in general from a variety of causes

Question 10

crimson purple tongue with possible cracks and dry

Answer 10

Interior heat excess :heat makes abundance of blood in vessels w/ stasis and damage to body fluids

Question 11

Pale -purple slippery and wet tongue

Answer 11

Interior cold excess

Question 12

blue green purple dim, “stasis macules”

Answer 12

blood stagnation

Question 13

bright red, cracks, fissures, little or no coating

Answer 13

deficient heat

Question 14

bright red , thick yellow coating, dry

Answer 14

excessive heat

Question 15

crimson tongue, possible fissures little or no coating

Answer 15

deficient heat

Question 16

crimson tongue, possible red spots, yellow dry coating

Answer 16

excess heat

Question 17

crimson tongue, purple dots

Answer 17

blood stasis with heat

Question 18

Puffy tongue: bigger then normal,possibly filling mouth with possible teeth marks

Answer 18

retention of dampness, phlegm, or phlegm fluid

-often qi or yang qi deficiency

Question 19

small tongue with pale-red

Answer 19

deficiency of both qi and blood

Question 20

small tongue: emaciated, dry, crimson with little or no coating

Answer 20

yin deficiency with empty fire

Question 21

prickled tongue with prominent spots(red/purple/blk) commonly seen on the tip and sides

Answer 21

toxic heat entering the blood level-larger and greater the number of prickles, the stronger the heat
severe heat causing blood stasis

Question 22

stasis macules patches or spots on tongue: bluish purple, purplish-black patches

Answer 22

blood stasis (location on tongue relative to the part of body

Question 23

cracked or fissured tongue

Answer 23

generally caused by yin deficiency causing blood deficiency

Question 24

dry crimson scant coat cracks

Answer 24

heat damaging yin fluids: blood/body fluids

Question 25

red scant coat or cracks

Answer 25

yin deficiency

Question 26

pale red smooth with cracks

Answer 26

blood deficiency-usually elderly folks

Question 27

pale-white w/ cracks

Answer 27

dryness due to blood deficiency

Question 28

pale white, wet, slippery white coat, TOOTH MARKS

Answer 28

retention of dampness

Question 29

pale red, smooth, TOOTh Marks

Answer 29

spleen qi deficiency

Question 30

loss of flexibility, difficulty in stretching, retracting, or even rigidity, with inability to move, slurred speech

Answer 30

stiff tongue

Question 31

dark-red or crimson stiff and dry tongue

Answer 31

invasion of the PC by exuberant pathogenic heat

Question 32

pale-red or green blue, puffy, stiff tongue with thick, greasy coating, unconsciousness, deviated mouth and eye, hemiplegia

Answer 32

wind phlegm obstructing collaterals in the tongue

Question 33

flaccid tongue-soft with out strength, inability to move easily

Answer 33

deficiency patterns(yin, qi, body fluids)

Question 34

involuntary trembling, rapid movement when extended

Answer 34

liver wind

Question 35

crimson, purple and quivering tongue

Answer 35

exuberant heat

Question 36

pale or white, slightly trembling tongue

Answer 36

qi and blood deficiency

Question 37

red, quivering, with little or no coating

Answer 37

yin deficiency

Question 38

tongue deviated to one side when extended

Answer 38

wind patterns

Question 39

deviated pale red tongue, facial paralysis, inability to raise eyebrows

Answer 39

external wind obstructing collaterals(more acute situations)

Question 40

purplish-red and deviated tongue, dizziness, numbness, spasms

Answer 40

internal wind (more chronic situations)

Question 41

white tongue coating

Answer 41

exterior patterns/cold patterns

Question 42

yellow tongue coating

Answer 42

heat or interior patterns

Question 43

gray coating

Answer 43

interior heat cold

Question 44

black coating

Answer 44

interior extreme heat extreme cold

Question 45

thin tongue coating

Answer 45

normal or disease in exterior mild disease evil qi on surface

Question 46

thick tongue coating

Answer 46

disease is interior more severe disease evil qi deeper in body

Question 47

thickness of tongue coating shows

Answer 47

depth and severity of disease

Question 48

moisture of the tongue coating shows

Answer 48

existence or collapse of body fluids

Question 49

moist tongue coating

Answer 49

normal

Question 50

slippery tongue coating: excessive fluids on tongue, tendency to flow downward when tongue is protruded

Answer 50

yang deficiency with retention of phlegm fluid and water-damp

Question 51

dry tongue coating

Answer 51

body fluids damaged by heat yin deficiency yang qi deficiency failing to steam body fluids pathogenic dryness attacking the lung

Question 52

greasy tongue coating: relatively small fine particles sticking together making a shiny surface, cannot be scraped away easily

Answer 52

turbid dampness phlegm fluids food retention damp-heat

Question 53

curd like tongue coating: relatively large loose thick granules( like bean curd) can easily be scraped away

Answer 53

phlegm dampness without weakened yang-qi and/or heat food retention causing damp heat phlegm dampness with heat

Question 54

sublingual veins; purple black distended

Answer 54

blood stasis

Question 55

sublingual veins: dark purple and thin

Answer 55

yin deficiency

Question 56

sublingual veins very pale and not visible

Answer 56

qi and blood deficiency

Question 57

sublingual veins filmy and creamy

Answer 57

dampness