Tongue Diagnosis in Traditional Chinese Medicine
Traditional Chinese Medicine (TCM) believes that the state of one’s health condition will be revealed on the tongue with strong visual indicators. Therefore, tongue inspection is one of the most important diagnostic methods in Traditional Chinese Medicine by observing and examining the shape, size, color, and texture of the tongue body and its coating that has been manifested. Herewith attached pictures of a member’s tongue taken from a closed group with his permission allowing me to share it here. Analysis will be based on his body constitution (classification of different body types) according to TCM principles and theories.
Following are the given narrated complains: - He often has dizziness with heart palpitations, motion sickness (dizziness) while riding in car, will trigger while in roller coaster. - Vertigo without nausea nor vomiting, feeling the surroundings are turning and moving - Soreness felt on neck and shoulder, often carrying heavy object at the back - Weak and easy to get tired (fatigue), occasionally with chest tightness and discomfort - Had mouth ulcer previously, face often has acne (more on the forehead) - Often sleep late at night, yet frequently feel the need to sleep - Bowel movement - loose watery stool (mild condition), bowel pattern is once every 3 days - With sticky mouth and sometimes has poor appetite - Protein (+) in urinalysis, urine color is yellowish.
The main objective of this case is merely for analysis purposes in which the syndromes should be differentiated accordingly. The effectiveness of a treatment depends largely on how detail and accurate the practitioner analyzes the conditions in order to prescribe the correct medication needed.
The tongue body is pale in color. It is enlarged in size and looks tender leading to slightly indented marks (teeth marks) seen on its edges. The tongue is moist with thin white coating, yet plenty of small stagnated red dotted marks could be seen more on the upper jiao area and also the lower jiao area of the tongue. Typically classified as having a spleen-qi deficiency syndrome as precursor and maybe due to inadequate or late intervention to provide the correct treatment, problems are apparently increasingly as secondary symptoms already manifested that could be seen here in addition to the spleen-qi deficiency indications. If not correctly attended with the right treatment, it will then further become worsen leading to a point of having more serious problems.
In traditional Chinese medicine (TCM), the spleen plays a vital role in the health and vitality of the body. It is the organ that is in charge of the transformation and distribution of the converted food into essence and fluids to different parts of the body which are essential for our growth and development. It also takes charge in the dispersing of pathological dampness out from the body. If there is a problem with the spleen, its transformation and distribution functions will be affected in providing enough nutrients, then one will feel weakness and easy to get tired, likewise the metabolism of fluids function will also be affected causing excessive pathogenic fluid or dampness to build up as phlegm that will block the free flow or passage of qi and blood. That is why this patient has a sticky mouth and sometimes has poor appetite. In TCM, qi flows with blood, qi moves blood follows, (qi pushes the blood). Therefore, weakness and slowness in qi and blood flow will cause congestion that will lead to blood stasis. If the qi (clear yang) unable to ascend properly bringing inadequate qi and blood supply to the brain, it will cause dizziness. It is also the reason why this patient frequently feels the need to sleep due to low oxygen supply to the brain. If the ascending lifting, and holding ability of the spleen functions become weak, metabolism of fluids becomes poor will cause too much excessive fluid to sink and drain down to the lower jiao or intestine that will cause loose watery stool. Same as to provide proper nutrition such as protein, the protein supposedly for absorption as nutrient fails and sinks with the turbid as waste. Therefore, we could see protein (+) in the urinalysis, yellowish of the urine color may indicate there is heat. If there is excessive heat or fire, it will cause mouth ulcer.
In this case, spleen-qi deficiency is the precursor, overtime; it affects the heart which can be explained by the generation cycle of the five elements theory as secondary manifestations. The relationship between the heart as the mother and spleen acted as the son could be use as an explanation to this phenomenon. When the child is deficient, the mother has to nurture and will subsequently in turn become drained and also weaken. That is why this patient will experience dizziness with heart palpitations. Same with the relationship between spleen and the lungs, the spleen now portrays as the mother and lungs as the son respectively. That is why lungs also become weak with poor wei-qi or defensive-qi against external factors. That is why the patient here is also experiencing soreness felt on his neck and shoulder which indicates muscle tightness or might be invaded by external pathogens. If there is prolong accumulation of dampness in the body, it will later transform into damp-heat that is being manifested with acne on his face and more on the forehead which means damp-heat is more prevalent on the upper jiao area as indicated with .red dotted marks on the tongue. It will also cause stagnation difficult for the qi and blood to flow smoothly, leading to chest tightness and discomfort. This patient is also complaining of having vertigo, yet without nausea or vomiting, but he is feeling the surroundings are turning and moving. So in this regard, we have to rule out other possibilities if he has cervical spondylosis or musculoskeletal problem which will also cause vertigo. We can use hand palpation diagnostic method to check to confirm. To treat the root cause for this case, there is the need to restore the qi or energy level with improving ascending function of the spleen and its related organs, at the same time have to dispel the external pathogens as well as the need to clear away the internal damp-heat and the stagnated phlegm with blood stasis on the affected areas.
