Advanced Naturopathic Case Taking: Naturopathic Evaluation Tools: Tongue Flashcards
Tongue Diagnosis
- Tongue diagnosis in traditional Chinese medicine (TCM) dates to the Shang Dynasty which began circa 1600 B.C. Since that time, it has evolved into a very important assessment tool.
- Tongue diagnosis is also an important ayurvedic assessment tool.
Tongue examination
Examination takes into consideration:
* Condition —may indicate nutrient deficiencies.
* Shape.
* Colour.
* Patterns.
* Coating.
TCM Tongue Map:
Use the TCM tongue map to help you identify dysfunctional areas:
* Root / back: Lower abdomen - kidneys, bladder, intestines and reproductive organs.
* Centre: Central abdomen - Stomach and spleen.
* Sides: Liver and gall bladder.
* Tip and front: Chest - heart and lungs.
Colour: Pale
- Excess cold, Qi or Yang deficiency, blood deficiency
- Medically a pale tongue can indicate iron deficiency anaemia.
Colour: Red:
- Excess heat, inflammation, infection.
- Use the tongue map i.e. a red tip of the tongue (heart area) indicates disturbance of the ‘shen’ (spirit) and often indicates underlying anxiety.
- Medically, a red and painful tongue / glossitis can indicate deficiency of folate, B12, B2, B3, B6.
Colour: Purple
- Blood stagnation, reduced Qi, poor circulation
- Medically a purple tongue can indicate cyanosis (low oxygen).
Condition and Taste: Prominent red papillae (spots)
Excess heat.
Condition and Taste:
Excess papillae
- ‘Hairy tongue’ with a thick coating may follow antibiotic treatment.
- Probiotics and prebiotics required.
Condition and Taste:
Dry and cracked
Yin deficiency (not enough fluids, not ‘holding’ fluids, or dried out due to excess heat).
Condition and Taste: Wet
Excess moisture and fluids.
Condition and Taste: Impaired Taste
Zinc deficiency.
Tongue shape: Thin
Blood deficiency.
Tongue shape: Swollen
Qi or Yang deficiency causing fluid retention; dampness.
Tongue shape: Scalloped (teeth marks on sides)
Weak digestion (spleen Qi deficiency), pancreatic insufficiency.
In Ayurveda this will lead to build up of ‘ama’ (undigested food toxins).
Tongue shape: Raised / upturned edges
A sign of high stress.
Mobility of the tongue: Tremor / quiver:
Spleen Qi deficiency.
In Ayurveda it indicates excess ‘vata’ —nervous energy and anxiety.
Nutritionally it can indicate magnesium deficiency.
Ayurvedic Tongue Analysis / Map
- In ayurvedic tongue analysis, the midline of the tongue, also known as the ‘sulcus’, represents the spine.
- The tip of the tongue is the top (cervical region) and the back the bottom (lumbar region).
- Cracks or fissures can correspond to painful areas of the spine.
Cracks / Fissures
Cracks in the tongue (called ‘fissures’) are signs of potential health issues and may indicate imbalances in the area where located.
Medial fissure:
A shallow vertical crack through middle of tongue (not to the tip) —can be a sign of deficiency of digestion. This indicates an under-secretion of digestive juices.
Midline fissure at the tip:
- Tendency to constitutional heart problems.
- May also indicate thyroid issues.
Geographical (or mapped) tongue:
- Yin deficiency
- Nutritionally it can indicate a B vitamin deficiency.
- Often seen in psoriasis sufferers.
Tongue Coating
- Tongue coating reflects the state of the digestive system & potential toxicity
- When looking at the coating of the tongue, use the tongue map to identify the affected organs.
Coating: Thin white:
- Normal.
Coating: Brown:
- Chronic excess heat (leading to degenerative changes).
Coating: Greasy yellow
- Damp heat (inflammation and infection).
Coating: Greasy white:
- Damp cold (excess mucus / phlegm).
Tongue Coating: No coat:
- Yin deficiency.
