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114 Cards in this Set
- Front
- Back
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Big Picture of Tongue Observation
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1. Spirit/Age Appearance.
• Brightness of tongue as compared to relative age of subject. 2. Tongue Body • Color • Shape • Topographical Anomalies. 3. Tongue Coating • Color • Moisture • Distribution • Thickness • Rooting. 4. Overall Tongue Moisture. |
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Tongue Body Color:
Pale |
Deficiency type:
• Cold syndrome caused by Yang Qi Deficiency • Qi and blood deficiency |
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Tongue Body Color:
Red |
Heat syndrome:
• Interior excess or deficiency |
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Tongue Body Color:
Deep Red (Scarlet) |
Extreme Heat:
• Exogenous - pathogenic heat invasion into the Ying and Blood Level. • Endogenous - Yin deficiency leading to fire. |
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Tongue Body Color:
Purple |
• Blue Purple: Blood stasis due to cold or heat.
• Deep Blue-Purple, Dry and Lusterless: Blood Stasis due to Heat. • Pale Purple. Moist: Blood Stasis due to Cold. • Purplish Spots on the tongue surface: Blood stasis. |
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Tongue Body Shape:
Swollen |
• Delicate in quality, pale in color, teethmarks:
- SP or KD Yang deficiency producing harmful water. • Deep red in color, occupying the entire space of the mouth: - Excessive heat in HT or SP. • Blue Purplish, Dark: - Toxicosis. |
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Tongue Body Shape:
Thin |
• Pale: Qi and Blood Deficiency.
• Deep Red, Dry: Fire due to Yin Deficiency. |
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Tongue Body Shape:
Cracked |
• Deep Red: excess heat.
• Pale: blood deficiency. • Normal: cracks aren't deep and remain there all the time unchanged. |
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Tongue Body Shape:
Thorny |
• Red: internal accumulation of pathogenic heat.
• The more severe the pathogenic heat is, the more enlarged and profuse the thorns will be. |
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Tongue Body Shape:
Deviated |
Wind Stroke or early signs threatening of wind stroke.
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Tongue Body Shape:
Rigid |
Exogenous:
• Invasion of the PC by heat. • Retention of turbid phlegm in the interior. • Excessive pathogenic heat consuming body fluids. Endogenous: • Wind Stroke. • Early signs of wind stroke. |
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Tongue Body Shape:
Flaccid |
• Extreme Qi and Blood deficiency or consumption of Yin fluids.
• Pale: Qi and Blood deficiency. • Deep Red: Yin Collapse. |
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Tongue Coating Quality:
Thick/Thin |
Thin:
• Superficial Progression • Deficiency of anti-pathogenic Qi (Wei Qi) Thick: • Deeper Progression • Retention of damp, food. |
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Tongue Coating Quality:
Moist/Dry |
Dry:
• Consumption of Body Fluids. • Excess Heat. • Yin Deficient Heat. Moist: Excessive moisture, saliva dribbles (Slippery) • Harmful water and damp. |
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Tongue Coating Quality:
Sticky/Granular |
Sticky (hard to scrub, greasy):
• Retention of damp, phlegm, or food. Granular (coarse & soybean curd texture, easily scrubbed off, pasty): • Excessive Yang heat bringing turbid ST Qi upward. • Retention of phlegm or food. |
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Tongue Coating Quality:
Peeled |
• Partially Peeled (Geographic):
- Consumption of ST Qi and Yin. • Entire Coating Peeled (Mirror, Glossy): - Exhaustion of ST Yin. - Severe damage of ST Qi. |
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Tongue Coating Color:
White Tongue Coating |
Thin:
• Normal • Exterior Cold Thick: • Interior Cold |
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Tongue Coating Color:
Yellow Tongue Coating |
Interior Heat:
• The deeper yellow the coating is the more severe the pathogenic heat. • Light Yellow: Mild Heat. • Deep Yellow: Severe Heat. • Burnt Yellow: Accumulation of Heat. |
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Tongue Coating Color:
Gray Tongue Coating |
• Interior heat, cold, or damp.
• Yellowish and Dry: interior excessive heat. • Whitish and moist: retention of cold or damp. • Can develop into Grayish or Black. |
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Tongue Coating Color:
Black Tongue Coating |
• Extreme interior condition: Extreme heat or cold.
• Usually a progression from yellow or gray coating. • Yellowish and Dry, Possibly with Thorns: Extreme Heat. • Pale and Slippery: Excessive Cold due to Yang deficiency. |
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Significance of Tongue Observation:
Tongue Spirit |
Significance: Overall Prognosis.
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Significance of Tongue Observation:
Tongue Body: • Color • Shape |
Color:
• Significance: Condition of Yin organs, Blood and Ying Qi, Stagnation of Qi and Blood. • Eight Principles: Heat/Cold, Yin/Yang. Shape: • Significance: Yin organs, Qi and Blood. • Eight Principles: Deficiency/ Excess. |
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Significance of Tongue Observation:
Tongue Coating: • Color • Moisture • Thickness • Distribution • Root |
Color:
• Significance: Heat/Cold condition. • Eight Principles: Cold/Heat, Yin and Yang. Moisture: • Significance: Condition of body fluids. • Eight Principles: Cold/Heat, Yin/Yang. Thickness: • Significance: Strength of pathogenic factor or weakness of body's Qi. • Eight Principles: Deficiency/Excess. Distribution: • Significance: Location and progression of pathogenic factor. • Eight Principles: Interior/Exterior. Root: • Significance: Strength of body's Qi, esp ST and KD Qi. • Eight Principles: Deficiency/Excess. |
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Tongue Diagnosis Feasibility.
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• Tongue body color almost always reflects the true 8 principle pattern.
• Most useful gauge for monitoring the improvement or decline of the patient's condition. • The topography of the tongue is subject of fairly general agreement. • Relatively objective in comparison with other techniques. • Rather easy to learn, compared to pulse diagnosis. |
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Effects of Medicine
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• Antibiotics: tends to injure ST Yin, peeled in patches.
• Corticosteroids: red and swollen (after about one month of administration). • Bronchodilators: Tongue tip to become red (after prolonged and continued use) • Diuretics: Peeled coating (reflecting Yin Xu). • Anti-Inflammatory: red points, make the tongue body thinner, peeled (after prolonged use). • Anti-Neoplastics (Cytotoxic Drugs): very thick brown or even black and dry coating. (Generally causes peeling of coating as sign of ST Yin Injury and with more powerful drugs affect the tongue body and create a darker coating) |
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Tongue Body Color
Normal Tongue Body Color |
• Pale: Sufficient fluids from ST reaching the tongue.
• Red: Supply of blood from HT. |
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Tongue Body Color
Pale Tongue Body Color |
• Slightly Dry: Blood Deficiency.
• Wet: Yang Deficiency. (Young children's tongues are naturally paler and redder than those of adults). • Bright, Shiny: Qi and Blood deficiency particularly of SP/ST. |
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Tongue Body Color
Red Tongue Body Color |
• With coating: Heat in Nutritive or Blood Levels.
• Without Coating: Yin Deficiency with Heat. • Wet: Heat with Damp Retention. • Dry: Deficiency heat and Body Fluid exhaustion. • Shiny: ST/KD Yin Deficiency. • Red Points or Spots: Heat with Blood Stasis. • Prickles: Heat in Ying Level or UJ or LJ. • Purples Spots in Center: Blood Stasis and Heat in ST. • Peeled: Heat from ST/KD Yin Deficiency. • Purple: Heat and Blood Stasis. • Purple Distended: Extreme Heat with Blood Stasis and Toxin from alcohol injuring in HT. |
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Tongue Body Color
Deep Red (Scarlet) |
• Dark Red: LU or HT Yin Deficiency.
• Dark Red with a Dry Center: ST Fire Blazing, ST Yin Deficiency with Heat. |
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Tongue Body Color
Purple Reddish Body Color |
• Reddish: Blood Stasis from Internal Heat.
• Reddish, Distended: Extreme Heat with Blood Stasis and Toxin from alcohol injuring in HT. |
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Tongue Body Color
Purple Bluish Body Color |
• Bluish: Blood Stasis from internal Cold.
• Bluish, Moist: Blood Stasis from internal LV/KD, Cold stiffening tendons/bones. |
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Tongue Body Color
Blue Tongue Body Color |
• Blue: Severe Internal Cold with Blood Stasis.
• Without Coating: Severe Internal Cold with Stasis and Exhaustion of Blood. • Central Surface: SP Yang deficiency with Phlegm retention in the chest. • In Pregnancy: Danger of Imminent Miscarriage. • Distended veins on underside of tongue: Deficiency, Qi Stagnation, or Blood Stasis (if dark). |
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Tongue Body Shape
Normal Tongue Body |
• Soft, Supple, Extends Easily, Form tapers off toward tip, no cracks, not too thin/swollen, no quivers.
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Tongue Body Shape
Thin Tongue Body |
• Shrunken, Red: Yin Deficiency.
• Shrunken, Pale: Blood Deficiency. |
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Tongue Body Shape
Swollen Tongue Body |
• Whole Tongue:
- SP/KD Yang deficiency with Damp - SP/ST DH. - HT/ST Heat (red). - Alcoholic Toxic (red) - Toxin • Edges: SP Qi/Yang deficiency. • Sides: Ascendant LV Yang or LV Fire. • Tip: HT Fire Blazing (red color) or HT Qi deficiency (normal color). • Between tip and center: LU Qi deficiency with phlegm retention. • Along Central Crack: HT Fire (red color) or HT Qi deficiency (normal color) • Half Tongue Swollen: Weakness of the Channels. • Localized swelling on one side: Deficiency or Qi Stagnation in chest. • Half Surface Swollen: LU Qi Deficiency. • Hammer Shaped: ST, SP, KD Deficiency. |
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Tongue Body Shape
Stiff Tongue Body |
• Stiff: HT Fire Blazing
• Red, or Dark Red: Exterior Heat Invading PC. • Red: Heat injuring Body Fluids. • Normal Color: Internal Wind. |
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Tongue Body Shape
Flaccid Tongue Body |
• Pale Body: Exhausted Qi and Blood.
• Red Body: Extreme Heat injuring fluids. • Limp, Deep Red: KD Yin Deficiency with Heat. |
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Tongue Body Shape
Long Tongue Body |
• Blazing HT Fire.
• HT Phlegm Fire. |
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Tongue Body Shape
Short Tongue Body |
• Pale Body: SP Yang deficiency, Internal Cold.
• Red Body: Heat Stirring LV Wind. • Red Body with Coating: Body Fluid insufficiency due to excess Heat. • Red Body without Coating: Deficiency Heat. • Pale with Slippery Coating: SP Yang deficiency with damp and phlegm. |
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Tongue Body Shape
Cracked Tongue Surface |
• Horizontal Cracks: Yin Deficiency.
• Cracked Like Ice Floes: Yin Deficiency from old age. • Irregular Cracks: ST Yin Deficiency. • Transverse on the Side: SP Qi/Yin deficiency. • Vertical in the Center: SP Qi Deficiency. • Long Vertical Cracks Reaching Tip: HT, emotional disorders. • Transverse behind tip: Prior LU Dz, Present LU Yin Deficiency. • Deep Central and Small Cracks: KD Yin Deficiency with Heat. |
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Tongue Body Shape
Loose Tongue Body |
• Red Body: Interior Excess Heat.
• Red Body, Slippery Coating: Phlegm Fire clouding HT. • Pale Body: HT Qi Deficiency. |
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Tongue Body Shape
Deviated Tongue Body |
• Normal Color: Exterior Wind Invading Channels.
• Red or Normal Color: Interior LV Wind. • Pale Body: HT Qi Deficiency. |
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Tongue Body Shape
Numb Tongue Body |
• Pale Body: HT Blood Deficiency.
• Red or Normal Color: Interior LV Wind. • Slippery Coating: Wind Phlegm. |
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Tongue Body Shape
Moving Tongue Body |
• Red Body: HT Fire and Internal Wind.
• Red and Dry Body: SP Heat with Body Fluids Exhaustion. |
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Tongue Body Shape
Quivering Tongue Body |
• Pale Body: SP Qi deficiency.
• Red Body: Extreme Heat generating internal wind. • Pale Body: HT and SP collapse. • Pale and Thin: Yang Collapse. |
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Tongue Body Shape
Rolled Tongue Body |
• Tip Rolled Over: Excess Heat.
• Tip Rolled Down: Deficiency Heat. |
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Tongue Body Shape
Tooth Marked Tongue Body |
• SP Qi Deficiency.
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Tongue Body Shape
Ulcerated Tongue Body |
• Red Body: HT Fire Blazing, SP and KD Heat.
• Red and Peeled: HT Heat, from KD Yin Deficiency. |
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Tongue Body Shape
Sore Covered Tongue Body |
• Red Body: Heat Toxin in Heat.
• Red and Peeled: Deficiency Heat. |
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Tongue Coating Quality
Normal Tongue Coating Moisture |
Slightly Moist
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Tongue Coating Quality
Wet Tongue Coating |
• Coating puddled with moisture/wet/glossy: Excess fluids or fluids stagnation.
• White: Yang Deficiency with Damp Retention. • White, Thin: Exterior Wind Cold. |
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Tongue Coating Quality
Dry Tongue Coating |
• Heat: Excess Heat or Yin Deficiency.
• Yang Xu: Yang Deficiency with Damp Retention, mouth is dry with no thirst, absence of thirst. |
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Tongue Coating Quality
Slippery Tongue Coating |
• Excessive Wetness with an oily appearance: Yang deficiency, Damp Cold internal or external origin.
• White: Pathogen is beginning to go into the interior. • Greasy: Damp Phlegm. • Greasy, Thick: Damp Phlegm retention and Cold. |
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Tongue Coating Quality
Slimy/Greasy |
Thicker in the center than on the edges and cannot b scrapped off (rooted): Qi cannot transform fluids and then accumulates to form phlegm (or DH or DC), caused by Yang Deficiency.
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Tongue Coating Quality
Moldy Tongue Coating: |
Thick and Patchy (crumbly like cottage cheese) and can be scrapped off (no root): ST Heat, ST Yin Deficiency.
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Tongue Coating Quality
Peeled Tongue Coating |
Geographic: ST Yin Deficiency.
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Tongue Coating Distribution
Exterior Coating Distribution |
The coat will be on the outside around the center or on front of the tongue.
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Tongue Coating Distribution
Interior Coating Distribution |
Reflects the location of the factor in accordance with tongue topography (organ correspondence).
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Tongue Coating Thickness
Normal Coating Thickness |
Thin White Coating
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Tongue Coating Thickness
Thick Coating |
Pathogenic factor, a condition of excess. The thicker the coating the stronger the pathogen.
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Tongue Coating Thickness
Thin Coating |
Pathogenic factor is weak, the illness is in the initial stage.
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Tongue Coating Root
Rooted Tongue Coating |
Cannot be scraped off. Normal coat is rooted.
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Tongue Coating Root
Unrooted Tongue Coating |
Can be scraped off easily.
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Tongue Coating Color
Normal Coat Color |
Thin White, Moist.
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Tongue Coating Color
Thin White Coat |
• Thin: Wind, Cold or Damp in the Exterior (or normal).
• Thin and Slippery: Exterior attack of Damp Cold. • Thin and Dry (pale body): Blood Deficiency. • Thin and Dry (normally wet): Yang Deficiency. • Thin and Dry (normal body color): Exterior attack of WC or WH, LU Fluid injured, Exterior Dryness attack. |
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Tongue Coating Color
Thick White Coat |
• Thick and Wet: Exterior attack of Wind Cold, Interior Damp Cold in MJ.
• Thick and Dry: Dirty Fluids in the interior with Heat. • Thick and Slippery: Damp in MJ, Cold with ST, Food Retention. • Thick and Greasy: Yang Deficiency with food or Damp retention. • Thick, Greasy, Slippery: SP Yang Deficiency with Damp Cold, or Slippery Phlegm. • Thick, Greasy, Dry: Damp with exhaustion of body fluids or Heat. |
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Tongue Coating Color
Rough White Coating |
• Rough and Cracked: Attack to the Qi Level from Summer Heat injuring Qi.
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Tongue Coating Color
Sticky White Tongue Coating |
• Sticky and Greasy: Damp or Phlegm in MJ (Interior), Exterior attack of Damp at the Qi Level (Exterior).
• Cottage Cheese/Tofu: ST Heat. |
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Tongue Coating Color
Powdery White Tongue Coating |
• Like Powder and slight red body on tip or sides: Exterior Heat.
• Like Powder and red/scarlet body: Interior Heat. • Like Powder and red body: Damp with exhaustion of Body Fluids or Heat. |
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Tongue Coating Color
Snowy White Tongue Coating |
• Like Snow: SP Yang exhaustion with Damp Cold in MJ.
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Tongue Coating Color
Moldy White Tongue Coating |
• Moldy: KD/ST Yin Deficiency, Damp Toxin in the interior.
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Tongue Coating Color
Half White Tongue Coating (left and right sides) |
• Half White and Slippery (Right): Half exterior and Half Interior.
• Half White and Slippery (Left): LV Heat. |
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Tongue Coating Color
Yellow Tongue Coating |
• Yellow or Pale Yellow: Exterior attack of WH, WC turning to heat, DH in the chest and MJ.
• Slippery/Slimy: Damp Heat. • Deep: Damp Heat in ST/LI. • Yellow Root, White Tip: Exterior Pathogenic Factor just changing into Heat and Penetrating to the Interior. • Bilateral Yellow Strips, Remainder Yellow: LV/GB Heat. • Bilateral Yellow Strips, Remainder White: Exterior Pathogen Penetrating to the Interior, Heat in ST/LI. • Half Yellow, Half White (longitudinally): LV/GB Heat. • Sticky and greasy: Heat and Phlegm. • Dry: Heat Injured Fluids. |
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Tongue Coating Color
Gray Tongue Coating |
• Wet, Slippery: SP Damp Cold.
• Dry: Excess Heat. |
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Tongue Coating Color
Black Tongue Coating |
• Slippery and Greasy: Damp Cold in ST/LI.
• Bilateral Black on White (Wet): Cold from deficiency of MJ. • Bilateral Black on White (Dry): Excess Heat from ST/SP. • White Coating, Black Points: Exterior Penetrates to the Interior and is transforming to Heat. • White Coating, Black Prickles: True Cold and False Heat, Cold turned into Heat. • Black in the center and white and slippery on sides: SP Yang deficiency with Damp Cold in the Interior. • Dry and Cracked: Exhaustion of KD, Yang deficiency with Interior Cold. |
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Tongue Coating Color
Combined Tongue Coating (White + Yellow) |
• White in center and Yellow around: Pathogens penetrating the interior and changing into Heat.
• Yellow in center and White around: Interior Heat just starting to clear. |
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Tongue Coating Color
Combined Tongue Coating (White + Gray) |
• White, Gray and Moist: Damp Cold in the Interior.
• White, Gray and Dirty: Damp Cold or Phlegm of long standing. • Half White and Half Gray: Half Exterior and Half Interior. |
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Tongue Coating Color
Combined Tongue Coating (White + Black) |
• White, Black: SP Damp.
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Tongue Coating Color
Combined Tongue Coating (Yellow + Black) |
• Yellow in center + Black, Slippery and Greasy around: SP Damp Heat.
• Yellow on sides + Black Prickles in center: Heat in the Yang Brightness Stage. • Yellow, Dry and Black in center to tip: Heat in ST/LI. |
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Tongue Coating Color
Tongue Coating Color Combinations (White + Gray, Black) |
• White in center + gray and black around: SP Damp.
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Tongue Coating Color
Tongue Coating Color Combinations (Yellow + Gray) |
• Yellow in center + gray around: Damp Heat with Heat Injured Fluids.
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Eight Principles ID
Interior Conditions |
• Tongue body color and shape is altered.
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Eight Principles ID
Exterior Conditions |
• WC: thin, white coating.
• WH: thin, white coating in the initial stage, then yellow. |
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Eight Principe ID
Half Interior Half Exterior Condition of Tongue |
• White and slightly slippery coating on the right side.
• Red tongue body with white coating on the tip only. • White coating on the tip and black/gray coating on the root. |
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Eight Principle ID
Cold Condition Indication of Tongue |
• White Coating
• Pale Body (if deficiency) |
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Eight Principle ID
Heat Condition Indication of Tongue |
• Red body, yellow coating.
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Eight Principle ID
Qi Deficiency Indications of Tongue |
• LU Qi Xu: slightly flaccid body, slightly swollen anterior.
• SP Qi Xu: tooth marked. • ST Qi Xu: lack of coating in the center. • HT Qi Xu: pale body. |
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Eight Principle ID
Yang Deficiency Indications of Tongue |
• SP Yang Xu: pale body, white and wet coating.
• KD Yang Xu: pale and swollen body, white coating. • HT Yang Xu: pale body, bluish purple if severe. |
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Eight Principle ID
Blood Deficiency Indications of Tongue |
• SP: pale body, slightly dry.
• HT: pale body, paler tip. • LV: pale body, paler sides. |
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Eight Principle ID
Yin Deficiency: |
• ST Yin Xu: no coating in center, dry, wide crack in the center.
• KD Yin Xu: red body, no coating, dry, cracks. • HT Yin Xu: red body, no coating anteriorly, redder tip. LU Yin Xu: red body, no coating, cracks anteriorly. |
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Eight Principle ID
Interior Excess Indications of Tongue |
• Heat: red body, thick yellow coating.
• Blood Stasis: purple body. • Phlegm: thick, slippery, greasy coating. |
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Eight Principle ID
Exterior Excess Indications of Tongue |
• Thick Coating.
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Shang Han Lun Tongue Observation
Tai Yang |
• Body: unchanged.
• Coating: thin and white, possibly more around the center or in the front third. |
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Shang Han Lun Tongue Observation
Yang Ming |
• Body: Red.
• Coating: yellow, thick and dry. |
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Shang Han Lun Tongue Observation
Shao Yang |
• Body: unchanged.
• Coating: white and slippery on one side only, or white nd gray or white and black. |
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Shang Han Lun Tongue Observation
Tai Yin |
• Body: pale.
• Coating: white. |
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Shang Han Lun Tongue Observation
Shao Yin Cold |
• Body: pale.
• Coating: white. |
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Shang Han Lun Tongue Observation
Shao Yin Heat |
• Body: Red.
• Coating: no coating. |
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Shan Han Lun Tongue Coating
Jue Yin |
• Body: pale.
• Coating: white and yellow (because of both heat and cold signs together) |
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Wen Bing Tongue Observation
Wei Level Signs |
• Body: slightly red on front and/or edges.
• Coating: thin, white. |
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Wen Bing Tongue Observation
Qi Level Signs |
• Body: red or normal.
• Coating: yellow. |
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Wen Bing Tongue Observation
Ying Level Signs |
• Body: deep red.
• Coating: no coating. |
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Wen Bing Tongue Observation
Xue Level Signs |
• Body: deep red or reddish purple.
• Coating: no coating. |
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San Jiao Tongue Observation
Upper Jiao: LU Wind Heat. |
• Body: slightly red on front and/or edges.
• Coating: yellow coating. |
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San Jiao Tongue Observation
Upper Jiao: LU Heat. |
• Body: red.
• Coating: yellow. |
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San Jiao Tongue Observation
Upper Jiao: PC Heat. |
• Body: deep red, red points.
• Coating: no coating. |
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San Jiao Tongue Observation
Middle Jiao: Yang Ming Heat. |
• Body: red.
• Coating: yellow, dry. |
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San Jiao Tongue Observation
Middle Jiao: SP Damp Heat. |
• Body: red.
• Coating: sticky, yellow. |
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San Jiao Tongue Observation
Lower Jiao: KD. |
• Body: deep red.
• Coating: no coating. |
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San Jiao Tongue Observation
Lower Jiao: LV. |
• Body: deep red.
• Coating: no coating. |
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Tongue Observation: Imbalance Between Tip/Root and Left/Right.
Body Color: • Tip-Root. • Left-Right. |
• Tip and Root of different color: Qi or Blood Stagnation.
• Left and Right different color: Qi Stagnation. |
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Tongue Observation: Imbalance Between Tip/Root and Left/Right.
Body Shape: • Tip-Root. • Left-Right. |
Tip-Root:
• Whole tongue swollen, more at tip: long term problem, imbalance between HT and KD. Left-Right: • Only one side swollen, with red points: ipsilateral malnourishment of channels. |
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Tongue Observation: Imbalance Between Tip/Root and Left/Right.
Coating: • Left-Right. |
Left-Right:
• Yellow coating on one side only: GB Heat affecting ST • Ipsilateral Phlegm in chest. |
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Tongue Observation: Imbalance Between Tip/Root and Left/Right.
Moisture: • Tip-Root. • Left-Right. |
Tip-Root:
• Tip Red and Dry, root dirty and swollen: defective transformation of body fluids. Left-Right: • One side wetter: movement of Fluids in the chest, LU Qi Problem. |
