Analisis de La Lengua PDF

Tongue Analysis
By Dr Rama Prasad

Collected from various sources

Color of Tongue Body
Firstly, let's start out with the color
of your tongue. Please pick from
one of the following: Just focus on
the color of the tongue body, not
the coating or shape, just the color
of the tongue body. Pick one:=>pink
tongue body=>slightly red
body=>red body=>purple
body=>Pale or White Tongue Body
Congratulations, you're normal. : )
Next, it is common for a tongue to
have a coating. Please pick the
color of the tongue coating that
applies to your tongue. Now in this
question, we're only dealing with
the color of the coating, not the
color of the tongue, not the
thickness of the coating, just the
color of the coating. Pick one:
The red tongue body can be due to
one of two causes. It can be due to
what we call heat which is
generally some sort of infection or
illness that gives you a fever. Or it
can be due to a Yin deficiency in
your body. Yin is body fluids and
they keep the body cool in the
same way that a radiator keeps
your car's engine cool.
The tongue with the purple body

suggests one of two things. Either
there is some blood stagnation, or
there is cold in the body.
Blood stagnation is exactly what it
sounds like. It is a circulatory
disorder that can give rise to a
variety of things such as pains that
are sharp and fixed in location,
chest pains, menstrual cramps,
endometriosis, erectyle disfunction,
benign or malignant tumors,
fibrocystic tissue of the breast or
uterus, etc. Physical trauma can
cause blood stagnation too.
Internal cold is also going to cause
pain. Generally this kind of pain will
cause you to double over in pain.
Cold has a contracting quality to it
that causes muscle spasms and
sever pains.
This tongue body indicates a Yang
deficiency or blood deficiency.
Yang deficiency is a lack of Yang
or warmth in the body. This may be
a hypothyroid condition or other
metabolic deficiency. Symptoms
include cold hands and feet,
diarrhea, frequent urination,
impotence, lack of libido, and
fatigue.
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Tongue Analysis
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Blood deficiency may or may not

be synonymous with "anemia". In
either case, there can be a lack of
red blood cells, neurotransmitters,
and/or hormones to put this into
more common terms. Symptoms
associated with blood deficiency
include dry eyes, dry and itchy skin,
brittle nails, dizziness, insomnia,
irregular periods or lack of periods,
and tremors.
A lack of tongue coating suggests a
Yin deficiency. Now, this Yin
deficiency diagnosis only applies to
the tongue that is so void of coating
as to appear as if it has a mirror
finish. If your tongue has a thin
coating then use the "back" button
and click on "thin coating".
Yin deficiency is a lack of fluids
and/or cooling mechanisms in your
body. The tongue coating tells us
about the fluids in your digestion
specifically, and should there be no
coating, we can assume that not
only is there a deficiency of fluids in
your stomach and intestines but
elsewhere as well.
This may give rise to a constant
gnawing hunger, heartburn, and
constipation. Menopause can
produce a transitory Yin deficiency
as well in which case we might see
hot flashes, night sweats, irritability,

and restlessness.
This coating is the official normal
tongue coating. However this
coating, if it is starting to get thick
can indicate cold dampness
accumulating inside your body.
Cold dampness is like saying the
weather is cold and foggy inside
your body. This can give rise to (or
be caused by) any number of
metabolic problems with symptoms
such as fatigue, edema, inability to
concentrate, or heavy dull aches in
the body that are aggravated by
damp weather or humidity.
Next up, let's look at the thickness
of the tongue coating.
A thin coating is defined as a
coating that is present on the
tongue, but you can still see
through it to the tongue body
beneath.
A thick coating is defined as a
coating that is present on the
tongue which you can not see
through.
A geographic coating is a coating
where there are pieces missing as
in the image below.

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Tongue Analysis
By Dr Rama Prasad

A dirty white coating is the same as

a light yellow coating. This indicates
some low-grade heat in either your
entire body such as a low grade
fever or in your digestive system in
particular. This could be something
as meaningless as having just
drunk some tea or coffee. Or it
could indicate some stagnation in
your digestion such as what
happens when you eat to much.
It could also indicate that your cold
is becoming a flu or that you are
developing a fever or that you like
yellow colored candy.
Internal heat damaging Yin is what

we call it when a high fever or other
source of heat causes dehydration.
I've seen this coating in conjunction
with a heavy smoker as well. That's
another example of heat damaging
the Yin, in this case, the Yin is the
healthy fluids of the lungs.
A bismuth based antacid can give
rise a brown or even black tongue
coating, not to mention some funny
looking stools as well. Pepto-Bismol
is an example of this kind of
product. It does not indicate a
pathology, its just a unique reaction
to the bismuth in the medicine.
Yellow Tongue Coating

This sign indicates internal heat
which means that you have a fever,
or else metabolic functions are
operating in some other state of
hyperactivity.
A yellow coating could also indicate
that you just had a cigarette or
coffee or tea or you just had a big
meal.
This coating suggests Internal
heat that is damaging the Yin or
that you're taking a bismuth based
antacid.
A thick coating indicates an

accumulation of dampness and
phlegm.
Dampness and phlegm means
some sort of fluid metabolism
problem giving rise to any one of a
number of moist, oozing or sticky
pathologies. It can be aggravated or
even caused by dietary problems,
in particular items that are difficult
to digest including cold raw foods in
excess, dairy, deep fried or
otherwise fatty foods. In short, all
the good stuff.
This tongue suggests phlegm and
dampness in the Middle Jiao. So,

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Tongue Analysis
By Dr Rama Prasad

what's a Jiao and where's the

middle one? Chinese medicine
breaks up the abdomin and chest
into three Jiaos or "burners" or
"ovens" or "heaters". The upper
Jiao is the cardiovascular system or
the Lungs and Heart. The middle
Jiao is the pancreas and stomach.
For some strange reason, we call
the pancreas the "spleen". Finally,
the lower Jiao is all the organs
below the belly button, give or take.
Dampness and phlegm indicates
a fluid metabolism problem giving
rise to any one of a number of
moist, oozing or sticky pathologies.
The Middle Jiao is to say that the
phlegm and dampness are limited
in location to the digestive organs
from which phlegm and dampness
tend to arise. Key symptoms
associated with this pathology
include nausea, motion sickness,
lack of appetite, intestinal gurgling,
fatigue.
A thick coating indicates an
phlegm.
Dampness and phlegm means
some sort of fluid metabolism
problem giving rise to any one of a
number of moist, oozing or sticky
pathologies. It can be aggravated or

even caused by dietary problems,
in particular items that are difficult
to digest including cold raw foods in
excess, dairy, deep fried or
otherwise fatty foods. In short, all
the good stuff.
This coating suggests a stomach
Yin deficiency.
Stomach Yin is the fluids in your
stomach and intestines. Should
they become deficient, symptoms
such as heartburn, constipation or
chronic gnawing hunger can arise.
Next step is to take a look at where
your tongue coating is most
concentrated, it'll tell us where your
problem is likely to be most
evident.=>
Coating Distributed Evenly Over
Entire Tongue
Indicates systemic dampness or
phlegm.
Dampness is a wet pathology that
arises from weak digestion or
damp-producing diet. Dampness
can manifest as any foggy feeling,
like heaviness in the limbs or a
headache that feels heavy.
Dampness can clog up your

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Tongue Analysis
By Dr Rama Prasad

acupuncture meridians giving rise

to arthritis that is aggravated by
damp weather. Dampness can
accumulate and look like water in
the body. Edema or water
accumulations are good examples
of dampness.
Phlegm can arive after dampness
has had time to get thicker and
stickier. Phlegm comes in two
forms. Substantial phlegm is the
stuff that you cough up.
Insubstantial phlegm can clog up
your meridians and give rise to
parasthesias or neuropathies,
making parts of your body go numb
or tingle and feel funny for no
reason. Menier's disease is
sometimes caused by phlegm with
wind in the body.
I've also seen thick tongue coatings
evenly distributed as a result of
anti-depresant drugs. I'm not sure if
the tongue coating is causing the
depression, as phlegm in the body
can cause certain emotional
problems, or if the drug itself
causes the tongue coating to get
thicker, but in any case, there is
some relationship there.
Next, we'll take a look to see if you
have any cracks in your tongue
body.=>no cracks=>central crack=>
Means that you have a normal

tongue. There is no damage to your
Yin.
Yin is all of the substance of your
body. There's substance and then
there are all the functions. Yin is
substance. Yang is function. In
clinical terms, we tend to deal
mostly with the fluid substance.
Once the fluids are working
correctly, they can give rise to
denser things like organs and
bones.
Slight Teethmarks
The tongue is a muscle, and when
there is a deficiency of Qi energy
in the body, this muscle can get
flaccid, lose its ability to maintain its
own shape and begin to take on the
shape of its container, namely, the
teeth in your mouth.
Teethmarks can indicate that your
digestion isn't strong enough to get
all the Qi from your food that you
need, or it may be simply that you
didn't get enough sleep last night.
The tongue is a muscle, and when
there is a deficiency of Qi energy
in the body, this muscle can get
flaccid, lose its ability to maintain its

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Tongue Analysis
By Dr Rama Prasad

own shape and begin to take on the

shape of its container, namely, the
teeth in your mouth.
your tongue extend past the 50%

mark of the length of your tongue,
chose the second option below.
Teethmarks can indicate that your

digestion isn't strong enough to get
all the Qi from your food that you
need, or it may be simply that you
didn't get enough sleep last night.
This indicates Heat or blood

Stagnation in the lower Jiao.
No spots? That's good news. There

are no spots on your tongue.
Had there been spots on your
tongue, you'd be reading about
them right now. If you think you've
got them, but aren't really that sure,
you can always click on the
backwards button and make a
different choice here. This test is a
two way street.
It's a taoism thing, I guess.
Okay, so you're tongue is normal
when it comes to spots. Next, we're
going to look underneath your
tongue at that big blue pair of veins.
When you lift up your tongue, you
may see a couple of veins. They
should be a little blue or purple. If
the length of this purple line doesn't
pass the 50% mark of the length of
your tongue, chose the first option
below. If the blue veins beneath
The "lower Jiao" suggest that the

location of your heat or blood
stagnation is in the organs or in the
body below the belly button, give or
take.
Heat suggests that there is some
sort of infection going on. It could
also indicate a little gunk in your
large intestine which isn't all that
uncommon or even a problem for
many people. It can indicate that
your diet isn't that great, but I've
also seen individuals with great
dietary habits with some heat down
yonder.
If these dots are purple or brown
instead of red, this would indicate
some blood stagnation which
suggests some circulatory issue
that can give rise to sharp pain
always in the exact same spot,
most likely below the belly button.
Spots on the Lateral Edges of
the Tongue

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Tongue Analysis
By Dr Rama Prasad

This indicates either heat or blood

stagnation in the Liver. This
particular "Liver" doesn't
necessarily mean that there's
anything wrong with the organ that
we call the liver. The TCM "Liver" is
a little different.
If the dots are red as in the picture
you chose to get to this page would
indicate Liver heat. This suggests
that there's some dull pain beneath
the ribs, perhaps associated with
mood swings, irritability, red eyes,
migraines, or perhaps you're just
getting ready for your period. I'm
not being funny on this one. Liver
heat may be nothing but the body
preparing to push out some blood.
If the dots are purple or brown on
one or both sides of the tongue, this
indicates Liver blood stagnation.
This can give rise to sharp, fixed
pains in the abdomen. In women,
this can also give rise to painful
periods, endometriosis, tumors,
fibrocystic tissue in the uterus or
breasts. In men, this could give rise
to either heart disease or erectyle
disfunction.
veins less than 50%
get longer and extend further up to

the tip of the tongue. This doesn't
seem to be the case with your
tongue.
veins more
Certain problems with blood
circulation will cause these veins to
get longer and extend further up to
the tip of the tongue.
Blood circultion problems can
manifest in any of the following
conditions: cold hands and feet,
chest pains, pains that are sharp in
nature and fixed in location,
headaches, tumors (both benign
and malignant), masses, fibrocystic
tissue, endometroisis.
Blood stagation may also give rise
to pathologies of the central
nervous system, especially when
the etilogical factor is a
cerebralvascular accident.
Imagine, you don't need a battery of
tests to find out what part of your
digestive tract is in stress. You can
diagnosis the whole GI tract and
corresponding organ integrity all in
one easy view- just stick your
tongue out.
Certain problems with blood

circulation will cause these veins to
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Tongue Analysis
By Dr Rama Prasad

As a whole the tongue reflects the

condition of the digestive system
and the organs associated with
blood, nutrient assimilation, and
excretion. You can also see how
'hot' or how 'cold' your internal
organs are. Therefore it has a high
value as a diagnostic tool.
Specific sections of the tongue
mirror the condition of particular
parts of the digestive system and
the digestion related internal
organs.
Like each particular area of the
body, the tongue can be used to
evaluate one's overall condition.
Zetsu Shin as it is called in
Japanese, is one of the most
important forms of diagnosis used
in Chinese medicine. Two main
aspects are considered in tongue
diagnosis.
First is the structure of the tongue.
Is it wide or narrow, thick or thin,
pointed or rounded? Such qualities
convey information concerning the
individual's basic constitution and
overall strengths and weaknesses
of body and mind.
Width:
a wide tongue reflects an

overall balanced physical and
psychological disposition.
a narrow tongue reflects a
lack of physical adaptability
with pronounced strengths
and weaknesses. Mentally,
thinking may be sharp but
tend toward seeing a narrow
view.
a very wide tongue reflects a
generally loose and expanded
physical condition and a
tendency toward more
psychological concerns.
Tip:
a rounded tip reflects a
flexible yet firm physical and
mental condition.
a pointed tip reflects a tight,
perhaps even rigid physical
condition and an aggressive
or even offensive mentality.
a very wide tip reflects an
overall weakness of the
physical body and a flaccid or
even "spaced out" mental
condition.
a divided tip reflects a
tendency toward physical and
mental imbalances with the
possibility of sharp
fluctuations in thinking and
mood.

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Tongue Analysis
By Dr Rama Prasad

Thickness:
a flat tongue reflects a
balanced condition and the
ability to flexibly adapt to
circumstances.
a thin tongue reflects a more
mental orientation, with a
tendency to be more gentle
and easy going.
a thick tongue reflects a more
physical orientation, with the
tendency to be assertive or
even aggressive.
In comparison to structure, the
condition of the tongue is influenced
more by daily lifestyle and provides
information about an individual's
current state of health. Qualities to
look for include:
Color:
Dark red: indicates
inflammation; lesions or
ulceration; and sometimes a
degeneration of the related
organ.
White: indicates stagnation of
blood; fat and mucus
deposits; or a weakness in
the blood leading to such
conditions as anaemia.
Yellow: indicates a disorder of
the liver and gallbladder,
resulting in an excess
secretion of bile; deposits of
animal fats, especially in the

middle organs of the body;
and possible inflammation.
Blue or Purple: indicates
stagnation of blood circulation
and a serious weakening of
the part of the digestive
system that corresponds to
the area of the tongue where
the color appears.
The color on the underside of the
tongue can also be used to
determine the internal condition. In
general, the colors and their
indications listed above are the
same, with the following
exceptions:
Blue or Green: In excess,
either of these color reflect
disorders in the blood vessels
and in blood quality and
circulation.
Purple: In excess, this color
reflects disorders of the
lymphatic and circulatory
system. It indicates a
weakening of the immune
ability and of the blood
vessels.
Texture:
a swollen or enlarged tongue:
indicates a Jitsu, or full state.

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Tongue Analysis
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By Dr Rama Prasad

a shrivelled or witheredlooking tongue: indicates a

Kyo, or empty state.
Movement:
the flexibility of the tongue
also reflects the condition of
the digestive system.
Characteristics to look for
include:
a flexible, supple, smoothly
moving tongue.
a stiff, tense, or inflexible
tongue.
a loose or lolling tongue.
a tongue with a pronounced
slant to the left or right when it
is extended.
Qualities are again divided into

antagonistic pairs, and include
moist and dry, excessive and
deficient, thick or thin. The color of
the coating reveals a precise
information concerning specific
internal conditions.
Pimples or projections of the

tongue's surface indicate the
discharge of fat, protein, and sugar.
Where in the body this discharge is
coming from can be determined by
the specific area of the tongue on
which it appears. You can find the
correlation between the areas of the
tongue and the digestive tract.
The second major aspect
considered in tongue diagnosis is
the coating, or moss, as it is called
in Chinese medicine, on the
tongue's surface.

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Tongue Analysis
11
By Dr Rama Prasad

Tongue Diagnosis
The tongue is the organ of taste
and speech. Size, shape, contour,
surface, margins, and color are the
characteristics one can observe on
the tongue. A pale tongue may
indicate an anemic condition or lack
of blood in the body. An yellowish
tongue may suggest that excess
bile present in the gallbladder or a
possible liver disorder. A blue
tongue is normally an indication of
problems with the heart.
coated, it will indicate that toxins

are present in the large intestine. If
the middle of the tongue is coated,
the toxins are present in the
stomach and in the small intestine.
Different areas of the tongue

corresponds to different organs of
the body. Hence by correlating the
location of the blemishes on the
tongue, the Ayurvedic practitioner
can determine which organs of the
body are out of balance.
A whitish tongue indicates Kapha
imbalance and mucus
accumulation. A red or yellow green
tongue indicated a Pitta imbalance.
A vata imbalance is manifested by
a black to brown coloration on the
tongue.
If the tongue is covered by a
coating, it may indicate the
presence of toxins in the stomach,
small intestine or large intestine. If
the posterior part of the tongue is
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Tongue Analysis
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By Dr Rama Prasad

Can Tongue Diagnosis Predict

Colon Cancer? Scientists
Embark on Groundbreaking U.S.
Study
By Michael Devitt, Managing Editor
While many poets believe the eyes
are the windows to the soul, many
acupuncturists and doctors of
Oriental medicine believe that the
tongue provides a window to the
inner workings of the body. For
thousands of years, tongue
diagnosis has played an
indispensable role in the practice of
traditional Chinese medicine. TCM
practitioners rely on tongue
diagnosis to differentiate one
syndrome from another, and use
variations in the tongue's color,
texture, shape and coating to
evaluate a patient's condition.
Researchers at Carnegie Mellon
University and the University of
Pittsburgh Medical Center are
taking a scientific approach to the
usefulness of tongue diagnosis. In
what is believed to be the first study
of its kind in the United States, the
investigators have begun taking
computerized images of patients'
tongues to see if an examination
can provide an early indication of
colon cancer.
Yang Cai, PhD, a native of Suzhou,

China and a systems scientist at
Carnegie Mellon, is responsible for
taking and analyzing the tongue
images. He also has a vested
interest in the subject, having lost a
close friend to ovarian cancer and
an aunt to brain cancer only four
months after being diagnosed.
Determined to learn more about the
relationship between the
appearance of the tongue and
certain cancers, Dr. Cai talked to
Chinese medical experts and
collected volumes of medical
literature. He found several studies
dating as far back as the 1960s that
showed a correlation between the
characteristics of the tongue and
health conditions such as fever,
dehydration and assorted internal
diseases. For example, one
intriguing paper, published in the
Chinese-language Journal of
Oncology in 1987, examined the
tongues of more than 12,000
patients and found "significant
changes" in color, coating and
texture in the tongues of cancerous
patients compared to those without
cancer.
The results of Cai's informal
investigation led him to Dr. Robert
Schoen, director of colorectal and

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Tongue Analysis
13
By Dr Rama Prasad

gastrointestinal cancer prevention

and control research at the
University of Pittsburgh Cancer
Institute (UPCI). After initial
discussions, Schoen warmed to the
idea of tongue diagnosis and
allowed Cai to add his research
project to Schoen's ongoing study
with the Early Detection Research
Network.
"I'm a big proponent of applying
rigorous scientific methodology to
things like traditional Chinese
medicine," said Dr. Schoen.
Like Cai, Schoen's work centers
around the early detection of
colorectal cancer. However, while
the bulk of Schoen's research
consists of collecting blood and
tissue samples from people who
have already undergone a
colonoscopy or surgery, Cai studies
only patients in the preparation
stages of a colonoscopy, an
examination of the large intestine.
Patients about to receive a
colonoscopy aren't allowed to eat
for a minimum of six hours before
undergoing the procedure. This
benefits Cai in that it prohibits the
patients from consuming something
that would affect the color of the
tongue. Using a digital camera, Cai
takes two photographs of each

tongue, with a color calibration
chart for confirmation. He then uses
vision technology software to
isolate the tongue's image from
other features in the mouth, and
documents the color, texture and
shape to create a mathematical
model of each tongue, which is
stored in a computer database.
To date, Cai has personally

photographed more than 30
tongues, and has provided a
camera and instructions on tongue
imaging to Xingming Lin, a
traditional Chinese medical doctor
who oversees a cancer unit at
Anhui Medical School in Hefei,
China. In addition, Schoen has
offered to share diagnostic
information to determine whether
the patients Cai photographed are
diagnosed as normal, precancerous
or cancerous.
While Schoen admits to some
skepticism, he believes that Cai's
research has merit. If tongue
screening proves accurate, it would
give providers an inexpensive,
noninvasive alternative to a
traditional colonoscopy.

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Tongue Analysis
14
By Dr Rama Prasad

"From a clinical standpoint, it's not

really much of a burden to the
patients to stick out their tongue
and have a picture taken," Schoen
explained. "If one could see some
characteristics of the tongue
correlated to the presence of
adenomatous polyps that have the
potential to transform into cancer,
that would be great. Then you could
just go around and take pictures of
people's tongues. That's a lot
simpler than doing colonoscopies."
Schoen noted that the tongue plays
an important role in the diagnosis of
Western-trained physicians as well.
The color of the tongue, for
instance, could indicate nutritional
deficiencies, or conditions ranging
from anemia to scarlet fever. An
enlarged or inflamed tongue,
meanwhile, could be a sign of
infection elsewhere in the body.
"The tongue is one of the first parts
of the GI tract that's visible,"
Schoen said.
Dr. Ronald Herberman, UPCI's
director, is responsible for
overseeing the work of Cai and
Schoen. If tongue diagnosis proves
useful, Herberman feels it could be
used as part of a routine cancer
screening at the institute.
"There may be valuable insights to

come from the traditional Chinese
experience," offered Herberman. "I
can't dismiss out of hand what's
been going on for hundreds of
years because many of the drugs
that actually are used in the United
States and Europe started out as
folk medicines."
For Dr. Cai, the goal of his project is
not to replace the conventional
means of detecting colorectal
cancer simply by looking at the
tongue, but rather as an alternative
screening method that can
accurately and effectively produce
an early warning sign. That sign
may be as simple as having a
patient see a physician for a more
complete evaluation, but it may
make a significant difference in
terms of cancer treatment,
intervention, and a positive
outcome of care.
For more information on the tongue
diagnosis research project, contact
Dr. Cai at ycai@cmu.edu.

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Tongue Analysis
15
By Dr Rama Prasad

TONGUE DIAGNOSIS 1
Tongue diagnosis dates to the
Shang Dynasty which began c.1600
B.C. and ended c.1000. Throughout
the time since it has evolved into a
very important tool of diagnosis.
The tongue is considered to be an
exterior part of the body because
it's in almost contact with the air the exterior. This is certainly
different from the American view
but extremely productive. An
acupuncturist or herbalist will, in the
minds eye, overlay a tongue with
several different maps. Each map is
shaped by the diagnostic model or
system which it represents.
The diagram on the left represents
the internal organs. The center
diagram represents the body as
having three parts - upper burner,
middle burner, and lower burner.
The diagram on the right represents
the body as having two parts interior and exterior.
The practitioner examines the

general and local shape, and the
color of both the tongue body and
coat. A healthy tongue will be pink
(like a kitten or puppys tongue) and
moist with a thin clear or white coat.

Thin is defined as a coat through
which the tongue body can be
seen. Some signs of imbalance or
pathology are red body, yellow
coat, thick coat like mozzarella
cheese, very dry body or cracks in
the coat or body itself.
Chinese medicine update:
tongue diagnosis in Chinese
medicine
Save a personal copy of this article
and quickly find it again with
In last month's issue of The
Townsend Letter, I described the
role of pulse diagnosis in standard
professional Chinese medicine.
This month I would like to discuss
tongue diagnosis or, more properly,
tongue examination (she zhen) in
Chinese medicine. While
practitioners of acupuncture and
Chinese medicine take into
consideration the patient's disease
diagnosis, they mainly base their
treatment on the patient's
individualized Chinese medical
pattern or zheng. A pattern is a
named and recognized standard
group of signs and symptoms, and
there are more than 300 such
patterns in professional Chinese
medicine. Each pattern is defined
by a group of general signs and

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Tongue Analysis
16
By Dr Rama Prasad

symptoms, tongue signs, and pulse

signs. Therefore, one can say that
tongue examination comprises one
third of the Chinese medical
process of pattern discrimination. In
terms of the four examinations (si
zhen) of Chinese medicine, tongue
examination is a special
subcategory of visual inspection
(wang zhen).
The history of tongue diagnosis
in Chinese medicine
Descriptions of diagnostically
significant pathological changes in
the tongue and its fur in the
Chinese medical literature date
back to the Nei Jing (Inner Classic),
the "Bible" of Chinese medicine
which was compiled in the late Han
dynasty (circa 200 A.D. or C.E.).
Throughout the succeeding
dynasties, famous Chinese doctors
added more and more tongue
observations to the Chinese
medical literature. However, the first
surviving Chinese medical text to
deal exclusively with tongue
examination dates from 1341 during
the Yuan or Mongol dynasty. This
book was written by Du Qing-bi and
was based, in part, on an earlier
book by a Master Ao which has not
survived. This book contained 36
color illustrations of the tongue and
its fur corresponding to various
patterns of disharmony and their

pulses. Since that time, numerous
such books have been published
with an ever-increasing number of
illustrations until today, when we
have books full of color
photographs of tongues, sets of
colored slides of tongues, and even
sets of colored plastic tongue
models to help students and
practitioners learn this important
diagnostic art. For instance, in
1906, Liang De-yan wrote She Jian
Bian Zheng (Pattern Discrimination
by Examining the Tongue). This
book describes 148 tongue types
and their pattern indications. Today,
tongue examination is taught at all
colleges of Chinese medicine in the
People's Republic of China and is
the frequent subject of articles
published in Chinese medical
journals.
The relationship of the tongue to
the interior of the body
In Chinese medicine, it is believed
that every part of the body contains
a "holographic" image of the entire
rest of the body. This holographic
image is sometimes referred to in
English as a homunculus or little
man. Therefore, there is a "map" of
the entire body on the ear, hand,
foot, face, eye, and even the lateral
edge of the first metacarpal bone.

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Tongue Analysis
17
By Dr Rama Prasad

Sites on these maps reflect

pathological changes in the
corresponding body parts and, at
least in some cases, stimulation of
these sites can be used to treat
those corresponding body parts.
Anyone familiar with foot
reflexology will understand this
concept. Unlike the nose, hands,
and feet, the tongue is an internal
organ which can be seen from the
outside of the body. Therefore, in
Chinese medicine, the tongue is
believed to be a hologram or
homunculus of the organs located
in the cavity of the torso. This
means that Chinese medical
practitioners believe that certain
areas of the tongue correspond to
specific viscera and bowels.
Pathological changes in a given
area of the tongue are thus
believed to indicate pathological
changes in the corresponding
viscus or bowel. The accompanying
diagrams show these
correspondences.
Tongue body and fur

Chinese medical practitioners look
at two main things when they look
at the tongue. These two things are
1) the tongue body, and 2) the
tongue fur. Inspection of the tongue
body is also divided into two:
inspection of the tongue shape and
inspection of the tongue color.
Inspection of the tongue fur is
divided into inspection of the
thickness of the fur and consistency
and inspection of its color and
moisture. According to Chinese
medical textbooks, the normal
tongue color is pale red similar to a
skinned chicken. The normal
tongue body or shape is neither too
thick nor too thin and is not cracked
or crevassed. The normal tongue
fur is thin in thickness and white in
color, thus appearing almost
transparent. Further, the sublingual
veins are not dark, tortuous, and
distended. Such a tongue indicates
that qi and blood are sufficient and
flowing freely, that yin and yang are
in relative balance, and that, in
particular, the stomach is
functioning harmoniously.
In terms of deviations from this
norm, a tongue which is thicker
than normal indicates a yin
repletion due to nonmovement and
nontransportation of water fluids,

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Tongue Analysis
18
By Dr Rama Prasad

while a tongue which is thinner than

normal indicates an insufficiency of
righteous yin, including qi and
blood. A tongue which is paler than
normal indicates a blood vacuity. A
tongue which is redder than normal
indicates heat. A tongue which is
blue indicates cold, while a tongue
which is purple and dark indicates
blood stasis. Static speckles or
spots, brownish papillae, also
indicate blood stasis in the organ
corresponding to their location on
the tongue as do static macules,
black and blue spots on the tongue.
Another indication of blood stasis,
this time primarily in the chest, are
distended, dark, tortuous sublingual
veins. If the tip of the tongue is red,
this means heat specifically in the
heart, but, if it is the sides of the
tongue that are red, this indicates
heat in the liver-gallbladder. Cracks
and crevasses on the surface of the
tongue can mean either of two
things. If the tongue is not red,
crevasses and cracks in the tongue
mean longstanding spleen vacuity.
If the tongue is red, then they mean
chronic and enduring yin vacuity.
And finally, if the tongue quivers
excessively when presented, this
indicates stirring of internal wind.
The tongue fur is believed to be a
reflection of the stomach qi or
stomach function. If the tongue fur

is thin and white, this means that
the stomach is functioning normally.
It is dispersing and downbearing
food properly and it is not too hot. If
the fur becomes thicker than
normal, this means that the
stomach is not dispersing the food
properly but that the food is backing
up in the stomach and intestines. If
the fur is thicker than normal and
dry, it shows that there is also
damage to the stomach and
intestinal fluids. If the fur turns
yellow, it indicates pathological
heat. If it further turns brown or
black, then this pathological heat is
even worse. If the tongue fur is
glossy and slimy, it indicates an
turbidity, but if it is patchy and
geographic, this means that,
although there is damp heat, the
heat is damaging yin fluids. So this
is a more complicated pattern of
disharmony. While the color and
shape of the tongue only change
slowly over the course of hours or
even days, the tongue fur can
change within a single hour.
Inspecting the tongue
In China, when the practitioner
wants to see the patient's tongue,
they say, "Kan kan she tai," "Let me

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Tongue Analysis
19
By Dr Rama Prasad

see your tongue and fur." Typically,

the patient is sitting upright in a
room well lit with natural light. The
patient should then stick out his or
her tongue moderately far. Like so
much else in Chinese medicine, the
patient should neither stick their
tongue out too far, which distorts
both its shape and color, or too
little, which makes the tongue
impossible to assess. The
practitioner should look at the
tongue in short, repeated bouts so
that the tongue does not change
color or shape due to the strain of
holding it in an unusual place.
Instead the practitioner asks the
patient to stick out their tongue,
writes down an impression, and
then tells the patient to relax and
close their mouth again. This
procedure is repeated several times
until the practitioner feels confident
he or she has a good picture of the
patient's tongue body shape and
color and its fur's thickness, color,
and moisture. This procedure can
be done relatively quickly and
easily, does not require any special
equipment, and is painless and
nonthreatening to most patients. If
there is no natural light, then the
practitioner must make allowance
for the color of the light. For
instance, incandescent light makes
the fur look yellowish when it's not,
and fluorescent light makes the

tongue look bluish or purple when
it's not.

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Tongue Analysis
20
By Dr Rama Prasad

Hot New Articles by Topic

Chinese tongue examination is
much, much easier to master than
Chinese pulse examination. The
basics of this art can be learned in
a single day or less. Therefore,
many students of Chinese medicine
place more emphasis on the tongue
than the pulse during the early
years of their practice, effectively
using the tongue to teach
themselves the pulse over time.
Because the tongue is inspected
visually, interrater reliability is quite
good. It is relatively easy to agree
whether there are teeth-marks on
the edges of the tongue or cracks
down its middle. Likewise, it is
relatively easy to agree on color,
thickness and color of tongue fur,
and the moistness of the tongue.
An example of the use of tongue
examination in clinical practice
The patient was a 36 year-old
female who was seen for the
common cold. She had had a sore
throat, fever, chills, nasal
congestion, profuse phlegm, and
cough for four days. In addition, she
was fatigued and had lost her
appetite. When the woman had first
come down with the cold, she had
gone to her local health food store
where she had purchased Yin Qiao

Wan (Lonicera & Forsythia Pills), a
common Chinese ready-made
medicine for a wind heat external
contraction pattern of the common
cold. However, she had taken only
the dosage of these pills
recommended on the package
(which is typically too little) and,
even then, had missed a number of
doses. Because she had not gotten
better as expected, she came in for
a professional examination. Beside
the forgoing signs and symptoms,
the patient's pulse was fine,
bowstring, and slightly rapid and
her tongue was enlarged with teethmarks on its edges, normal in color,
but was covered with thicker than
normal fur. This fur was white on
one side of the body and yellow on
the other. In this case, the pulse is
really not very revelatory on its own.
It could indicate a number of
different patterns. However, the
tongue was very accurate in its
indications.
Based on the enlargement of the
tongue with teeth-marks on its
edges, I knew that there was a
chronic spleen qi vacuity. This had
led to a righteous qi vacuity and,
thus, the body's susceptibility to
external invasion and its inability to
throw off the evil qi. Because the

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Tongue Analysis
21
By Dr Rama Prasad

spleen qi moves and transforms

water fluids in the body, the swollen
tongue indicated that water fluids
had accumulated, thus making a lot
of dampness and phlegm. Although
"the spleen is the root of phlegm
engenderment, the lungs are the
place where phlegm is stored."
Such spleen vacuity was confirmed
by the fatigue and lack of appetite.
The tongue fur which was white on
one side and yellow on the other
showed that the evil qi was half
inside and half outside. This is
called a shao yang aspect disease.
It means that there was still evil qi
lodged in the exterior of the body
but that some of this evil qi had
made it to the interior. This then
explained why the Yin Qiao Wan
had not adequately dealt with the
condition and was certainly
inappropriate now. Yin Qiao Wan,
as an exterior-resolving formula,
only clears wind heat evils from the
exterior of the body. Now this
patient needed a shao yang aspect
harmonizing formula (shao yang
fen he fang). This is an entirely
different category of Chinese herbal
formula.
formula, the woman's appetite

immediately returned, her fever
went down, her chills abated, and
her energy began to return. In
terms of tongue examination, the
yellow fur on one half of her tongue
disappeared and the entire coating
turned white. By the second day,
her cough had stopped and she
was only producing a slightly
abnormal amount of mucus. By the
third day, she was back to work,
feeling relatively normal, and her
tongue fur was thin and white. This
shows both how tongue
examination is used in Chinese
medicine and how clinically
important its findings can be. In this
particular case, the half white and
half yellow tongue fur is a clear and
definite indication of the stage and
pattern of this disease. It showed
that the Chinese herbs the woman
was currently taking on her own
were not the right ones and pointed
unequivocally to the right formula
which, when prescribed, did the job
expected of it.
When administered a modification

of Xiao Chai Hu Tang (Minor
Bupleurum Decoction), the classic
shao yang aspect harmonizing
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Tongue Analysis
22
By Dr Rama Prasad

BENEFITS OF TONGUE
DIAGNOSIS
* Tongue diagnosis is a vital
diagnostic Ayurvedic tool for
assessing the current health of a
patient and providing a basis for
prognosis
* It also informs about the
underlying challenges of the
patient?s constitution.
* The tongue gives very accurate
information about the state of Prana
and blood, progression and
regression of disease, degree of
heat and cold and the depth or
penetration of a pathogenic
imbalance.
* 80 percent accuracy before any
blood tests, hair analyses, or
urinalysis results come back form
labs.
In the ancient texts it says "the
tongue is the sprout of the heart"
and that "the tongue is external
indication for the spleen and
stomach".
Tongue diagnosis is a vital
instrument used in Ayurvedic
Medicine both for assessing the
current health of a patient and
providing a basis for prognosis. It
also informs the practitioner about
the underlying challenges of the
patient's constitution. The tongue

gives very accurate information
about the state of Prana and blood,
progression and regression of
disease, degree of heat and cold
and the depth or penetration of a
pathogenic imbalance. This course
is taught by Walter 'Shantree'
Kacera bringing to the practitioner a
very important and flexible resource
for those wishing to integrate
tongue diagnosis into their private
practice.
For the student, it is a very valuable
and important aid. The work is
designed for both the beginner and
practitioner in mind, and comes
with fundamentals supported by
slide presentations of sample
clinical indicators.
By using tongue diagnostic, you will
be able to discern your own health
and those of your patient's
problems with 80 percent accuracy
before any blood tests, hair
analyses, or urinalysis results come
back form labs. The most valuable
benefits of tongue diagnosis is to
work on a preventative level, which
can be achieved with the
knowledge of one's constitution.
The results from tongue diagnosis
can direct the natural health
practitioner's attention to the major

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Tongue Analysis
23
By Dr Rama Prasad

body systems to accurately pinpoint

the health imbalances.
Tongue Diagnosis 2
Tongue diagnosis is a method of
observing the changes of the
tongue body and the tongue coating
to analyze and diagnose disease. It
is one of the main methods of
diagnostic observation in T.C.M.
According to T.C.M. theory, the
tongue is nourished by Qi and
blood. The heart opens on the
tongue. Tongue is the sprout of the
heart and the heart is the supreme
monarch of all organs. All
disharmony of Zang and Fu organs
influences not only the heart, but
also the tongue by pushing the flow
of the qi and blood into the bodys
blood circulation. The tongue is also
closely related to the function of the
spleen and the stomach and is
considered the outside
representation of the stomach and
spleen. The Tongue coating has a
special relation to the stomach qi.
The spleen and stomach affects the
acquired source of the body which
in turn affects the qi or blood
functions of the other organs. The
tongue links the Zang and Fu
directly and indirectly through
meridians and collaterals. The body
meridians flow upward into the
tongue. Examples are the
meridians of three yin of the foot,

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Tongue Analysis
24
By Dr Rama Prasad

three yang of the foot, Tai yang

meridians of the hand and Shao
yang meridians of the hand. All
meridian qi and blood flows up to
the tongue. So the tongue is a
natural mirror of the human body
reflecting the bodys internal status.
The tongue basically reflects the
condition and disease of Zang and
Fu organs, qi, blood and the
constitution of a person.
Zang and Fu organs have their
representative areas on the tongue
surface. Generally speaking the tip
of the tongue belongs to the heart
and lung. The middle belongs to the
spleen and stomach. The root
belongs to the kidneys and the
sides belong to the liver and
gallbladder. It also can be
explained as the tip associated with
the upper Jiao, the middle part
associated with the middle Jiao and
the root associated with the lower
Jiao.
The normal tongue is soft and
reddish, neither dry nor too wet and
fits perfectly within the mouth while
moving freely. Its coating is a thin
white moist distributed evenly over
the tongue.
Usually observing the tongue body
includes observing the vitality of the
tongue body; the tongue colors

could be pale, red, crimson, purple
or blue. Other observation factors
are the tongue shape and size that
would include puffiness, swollen,
thin and skinny, spots, cracks, teeth
marks, bleeding, carbuncle, ulcers
and blisters. The tongue movement
such as stiffness, atrphy, trembling,
deviation, wagging and numbness
and the veins under the tongue are
also factors used in the observation
procedures of tongue diagnosis
Observing the tongue coating
includes the reading of the tongue
coating color. The color can be
represented in the colors of white,
yellow, gray, blue and either dark or
pale. Other factors to observe in
regards to the tongue coating is the
thickness, moisture, does it seem
rotten, greasy, patchy, peeling or no
coating at all. Another ongoing
factor is to notice change in the
coating either a increase or
decrease of the tongue coating over
time
In a clinic setting the tongue body
and tongue coating have their own
diagnosis patterns yet they are
commonly combined when used for
diagnosis. Observation of the
tongue body is for the determination
of condition of the Zang and Fu

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Tongue Analysis
25
By Dr Rama Prasad

organ conditions. Observation of

the tongue coating helps determine
the disease nature, location, and
conditions of the stomach Qi.
The clinical significances of
tongue diagnosis
Judge the overall human body of
constitutions exuberance and
decline of genuine Qi
Tongue body bright reddish with
normal tongue appearance show Qi
and blood exuberance. The light
pale tongue body (tongue not
nourished) is signs of deficiency of
Qi and blood. A tongue with thick or
thin moist coating indicate stomach
exuberance. A tongue with no
coating shows stomach function not
good.
Yellow tongue coating is due to

heat. White coating with moist is
due to cold. Thick greasy coating is
due to phlegm or food accumulation
and thick yellow coating due to heat
and damp. Tongue deviated to one
side suggests wind. Spots on the
tongue show blood stasis.
Predict progress of disease
When tongue coating turns from
white to yellow, then yellow to dark,
or moist turning to dryness it shows
the pathogen going inside from
superficial to interior, from cold to
heat condition, and disease from
mild to severe. If the change from
thick to thin or dryness to moist it is
a sign the pathogen is regressing,
body fluids regenerating and
disease improving.
Determine depth and severity of

pathogen and disease
Thin tongue coating suggests
disease is in the initial stage while
thick coating suggests disease is
much more advanced. The deep
red crimson tongue shows major
deficiency of Ying or blood levels. A
tongue body with deep red means a
severe condition.
Distinguish nature of disease
and pathogen.

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Tongue Analysis

Collected from various sources

The tongue with the purple body

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Blood deficiency may or may not

hot flashes, night sweats, irritability,

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A dirty white coating is the same as

Internal heat damaging Yin is what

Yellow Tongue Coating

A thick coating indicates an

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what's a Jiao and where's the

pathologies. It can be aggravated or

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acupuncture meridians giving rise

Means that you have a normal

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own shape and begin to take on the

your tongue extend past the 50%

Teethmarks can indicate that your

This indicates Heat or blood

No spots? That's good news. There

The "lower Jiao" suggest that the

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This indicates either heat or blood

get longer and extend further up to

Certain problems with blood

As a whole the tongue reflects the

a wide tongue reflects an

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animal fats, especially in the

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a shrivelled or witheredlooking tongue: indicates a

Qualities are again divided into

Pimples or projections of the

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coated, it will indicate that toxins

Different areas of the tongue

Can Tongue Diagnosis Predict

Yang Cai, PhD, a native of Suzhou,

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gastrointestinal cancer prevention

takes two photographs of each

To date, Cai has personally

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"From a clinical standpoint, it's not

"There may be valuable insights to

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The practitioner examines the

moist with a thin clear or white coat.

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symptoms, tongue signs, and pulse

patterns of disharmony and their

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Sites on these maps reflect

Tongue body and fur

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while a tongue which is thinner than

stomach function. If the tongue fur

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see your tongue and fur." Typically,