The Common Method Of TCM Tongue Diagnosis And Pre-requisites.

The Common Method Of TCM Tongue Diagnosis And Pre-requisites.

 

 

1.  Lighting:  soft and natural lighting is a pre-requisite.  Patient should face the source of light so that it shines directly on the tongue of the patient.  Avoid colored wall or curtain which might reflect on the tongue.

 

2.  Posture:  patient could either sit or lie down in bed.  Tongue should be protruded in a natural and relax manner, shown fully without effort.  It is better to repeat extension of tongue rather than exhibiting it for a prolong period.

 

3.  Systematic observation:  starting from the tip, following by the center, then the root and finally the 2 sides of the tongue.  8-ways of observing: (1) tongue coating, (2) texture, (3) tip of the tongue, (4) front portion, (5) wet/dry, (6) looking at its sides, (7) looking at the root, and finally (8) looking for changes.

 

4.  Artificial colored coating:  some food or medicine may affect the color coating of the tongue, covering and confusing the real color coat.

 

       -      Drugs on hyper-thyroid may redden the texture of tongue.

       -       Chemotherapy may reduce tongue coating and making it drier.

       -      Wide spectrum anti-biotic may produce tongue coating that is brownish                     yellow or grayish black.

       -       Licorice herbal pattern formula may blacken the tongue coat.

       -        Hydrastis and lactoflavin can turn normal coating into yellow.

       -       Consumption of peanuts may increase white coating as well as thicken it.

       -       Consuming green vegetable may also color coating the tongue green.

       -       Chewing gum, cold dish or soft drinks may also produce various colored                coats on the tongue.

 

            In addition, lightings could also affect the color of the coating or the texture of the tongue.  E.g. bright outdoor sunlight can lighten yellow coating of the tongue.  Dark red color texture may appear light red.  Indoor artificial light may turn tongue texture light red or rosy appearance.

 

5.  Scraping and wiping:  in order to find out the wetness or dryness, the firmness of the coating, and whether it is rooted or not, the practitioner may need to scrape or wipe the coating.  Scraping may be carried out with a piece of sterile wood with suitable effort.  Scraping is done slowly from inside out.  The practitioner may also wipe the coating with a sterile gauze damp with saline water.  This would reveal the true texture of the tongue, and also facilitate understanding on the degree of cracks in the tongue.

 

6.  Seasonal variation:  normal tongue appearance may also vary slightly with the seasons:

-           Summer season:  summer dampness would thicken tongue coating with tendency of yellowish color.

-           Autumn season:  dryness prevails with thin and dry coating as a norm.

-           Winter season:  wintry cold often witness wet but young looking tongue.

 

            Day-night variation:

 

            - The coating tends to be thicker and darker in the morning.

            -  Consumption of food may also normalizes tongue into red texture and thin   coating.

            -  Breathing with the mouth tends to produce dry coating.

            -  Forcefully extending tongue tends to turn its texture red.

-           Excessive smoking or consumption of alcohol may also affect the color of the texture.

 

7.       Age and body:  as one ages the tongue also varies in appearance.

 

            -   Youthful body:  with the young Yin and Yang, full of vitality, the tongue   also depicts a young and fresh look.

-           A disease stricken person quickly enters into a state of insufficiency or excess       of Qi, coolness or heatiness.  The tongue may then show exfoliative coating, red dots, or thick fur.  It is common to see the youthful tongue coated white as if it is clothed, or powdery fur.

-           The Aged body:  tends towards insufficiency of Qi, especially the kidney and spleen.  It is usual to see cracks on the tongue surface, with little or no fur on it.

 

The differences between male and female:

 

-           In general, the adult male tends to be stronger with more Qi and thus less likely to have stagnant blood.  Thus when signs of stagnation of blood or when black tongue appears the disease is usually at a critical stage.

-           The adult female’s tongue varies according to the wanes and fax of her monthly period cycle.  It is also more common to see stagnant blood amongst the females.

-           In general, it is also usual to find that obese person tends to have a fatter tongue with paler color, whilst the under-weight person tends to have a slimmer and redder tongue.

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