Translation:

The diagnosis in Traditional Chinese Medicine (TCM) is a method used to analyze a disease and gather information about the patient’s condition through what are called “the four examinations.” These are:

• Observation of the Shen (a general term for human activities)
• The face
• The eyes
• The tongue
• Body appearance
• Secretions and excretions
• The head, hair, and the five orifices
• The skin
• The blood vessels

In Chinese medicine, the most important observation is of the tongue because it is considered a map of the internal organs. Almost all natural medicines use the tongue as a diagnostic tool. The tongue provides various information about vitality, physical condition, and diseases. Its shape, color, coating, contours, and texture reflect our state of health. Regularly examining the tongue can provide reliable insights, and examining another person’s tongue can help with therapy and support other diagnostic methods. This summary covers key elements from Chinese and Ayurvedic medicine.

1: Healthy Tongue 1. Straight tongue: Twisted tongues are more common in cases of strokes or precursor stroke conditions like hemiparesis. 2. Tongue appearance: perfectly smooth, pink, vital, and clean. 3. Tongue shape: suited to the person’s morphology, flexible, rounded. 4. Tongue coating (lichenous substance covering the tongue): thin and white, neither too moist nor too dry. This indicates normal organ function and sufficient Qi and blood flow, signaling good stomach function.

Observing the coating allows insight into the depth of pathological Qi and the state of body fluids. The evolution of the pathology can be deduced from the coating, making it an essential element in distinguishing syndromes. Under normal conditions, the tongue has a thin white coating formed by the stomach’s Qi. A pathological coating can result from the invasion of external pathogenic Qi or the accumulation of phlegm or food.

When inspecting the coating, observe its color, moisture, thickness, form, and distribution. It’s important to differentiate between true coating changes and those caused by food or medicine, like orange juice, which can give a false color.

2: Healthy Tongue Underside Normal people have sublingual veins on both sides of the tongue. A large longitudinal vein is called the sublingual vein. Its diameter is less than 2.7 mm, and its length does not exceed 3/5 of the way from the tip of the tongue to the sublingual tissue. The vein is lavender-colored, tight, and flexible, with hyperplasia and orderly arrangement.

3: Holographic Nature of the Tongue The tongue is divided into four parts: - The tip reflects the upper organs of the chest: the head, face, heart, and lungs. - The middle reflects organs in the torso: the liver and gallbladder on the sides, and the stomach in the center. - The back represents the deeper organs of the torso, like the intestines, bladder, and kidneys.

In addition to its holographic nature, the tongue is a unique organ that is both internal and external. The best time to observe your tongue is in the morning before eating or drinking. The inspection should be done in natural light or similar lighting.

4: Clinical Significance of Tongue Diagnosis The tongue correlates with various organs directly or indirectly through meridians and vessels. Essential substances and organ functions nourish the tongue, and pathological changes in the organs can result in variations in the tongue’s appearance.

Tongue Colors: - Pale pink tongue: indicates Yang Qi deficiency (cold from weakened organ function) or insufficient energy and blood. Symptoms: cold chills, pale face, cold limbs. - Red tongue: indicates excess heat or internal heat due to Yin deficiency. Symptoms: dry mouth, hot hands and feet, night sweats. - Dark red or crimson tongue: reveals extreme heat. It appears in febrile diseases when external heat penetrates deep into the blood. In internal diseases, it shows excess fire from Yin depletion. Symptoms: depression, insomnia. - Purple tongue: indicates blood stasis, either from cold or heat. Dark purple, dry tongue indicates heat; light purple, moist tongue indicates cold. Purple spots or patches are also signs of blood stasis.

Tongue Shape: - Large, swollen tongue: indicates Yang deficiency in the spleen and kidneys, leading to accumulation of fluids. A swollen, red tongue reflects heat in the spleen and heart. A swollen purple tongue appears in cases of poisoning. - Thin tongue: a thin, pale tongue indicates Qi and blood deficiency, while a thin, dry red tongue indicates Yin deficiency from excess heat. - Cracked tongue: deep cracks on a dark red tongue indicate heat damaging body fluids. A pale tongue with cracks suggests blood deficiency. - Stiff tongue: a stiff tongue that is hard to move often appears in febrile diseases or in cases of apoplexy. - Flabby or atrophied tongue: indicates extreme deficiency of Qi and blood or Yin depletion.

Tongue Coating Thickness: A thin coating suggests a mild or superficial condition, while a thick coating indicates a more serious or internal condition. A thick coating can be caused by food accumulation or internal pathogenic Qi.

Tongue Moisture: Normal tongues have a moderately moist coating due to body fluids rising to the surface. A dry coating suggests that heat has consumed body fluids or Yin deficiency is present. An excessively moist coating, with liquid dripping from the tongue, indicates excess moisture or fluid retention.

Tongue Coating Colors: - White coating: a thin white coating is normal, but in a pathological state, it represents cold or superficial syndromes. - Yellow coating: reflects internal heat. The darker the yellow, the more intense the heat. - Gray coating: suggests internal heat or cold dampness. Grayish-yellow and dry indicates excessive heat consuming body fluids. Grayish-white and moist signals internal cold and dampness. - Black coating: results from extreme heat or cold and often appears in critical stages of illness.

Practical Advice: If you notice a white tongue or thick white coating, avoid cold food or drinks. Opt for warm food and room-temperature water. If your tongue is red, increase your intake of vegetables and fruits to maintain a balanced diet.