wk5 - tongue shape

Question 1

T or F: fluid pathologies are reflected in the tongue after a long time, as they develop.

Answer 1

true

Question 2

what pathologies are generally associated with a thin tongue?

Answer 2

deficiencies:

• fluid, blood & yin deficiency
• qi deficiency

Question 3

what does a thin tongue with blood deficiency look like?

Answer 3

• thin
• pale or orange body (orange = long term)
• dry

Question 4

what does a thin tongue with yin deficiency look like?

Answer 4

• thin
• red body
• dry

Question 5

what does a thin tongue with early stage qi deficiency look like? (color & moisture)

Answer 5

• thin
• pale
• normal moisture (bc early stage)

Question 6

what pathologies are generally associated with a thick tongue?

Answer 6

• excess damp or phlegm
• could also be long term vacuity:
  > late stage SP qi vacuity
  > late stage KD or SP yang vacuity

Question 7

what does a late stage SP qi deficiency tongue look like? (thickness & moisture)

Answer 7

thick & wet

Question 8

what does a late stage SP or KD yang deficiency tongue look like? (thickness & moisture)

Answer 8

thick & wet

Question 9

T or F: swelling alone does not indicate whether it’s an excess or vacuity condition

Answer 9

true

Question 10

what does swelling in the upper jiao area indicate?

Answer 10

• exterior invasion that has moved internally after a couple days (e.g. cold)
• will most likely see it in the LU position; not the HT position

Question 11

what does swelling in the middle jiao area indicate?

Answer 11

• longer term ST/SP vacuity with beginning of damp accumulation (very organ-specific)
• sides of tongue may seem very thin

Question 12

what does swelling in the lower jiao area indicate?

Answer 12

• damp heat in the lower jiao (e.g. damp heat in the LI or UB)
• happens to women more frequently (e.g. UTI’s)

Question 13

what does swelling along the sides (or one side) indicate?

Answer 13

• if both sides swollen = damp accumulation

- if left side swollen = damp heat, intense LV fire

Question 14

what does “false swelling” look like?

Answer 14

• looks double-mounded
• either center crack is so deep it that it looks like both sides are swollen (but it ‘s really just one swelling with a crack in the middle)
• or, it’s not swollen at all but the center crack is so deep that it appears swollen

Question 15

what does swelling of both sides indicate?

Answer 15

• first, assess origin by looking at color & moisture
• if red & damp = damp heat
• if scarlet & dry = fire

Question 16

what does overall swelling with scallops indicate?

Answer 16

• late stage qi vacuity
• scallops bc tongue is too big, and is pressing up against teeth
• scallops help us assess how long term the situation is

Question 17

T or F: hammerhead shape of tongue is NOT considered swelling.

Answer 17

true

Question 18

what pathology is associated with a hammerhead shaped tongue?

Answer 18

• psychiatric disorder (bc HT is being distorted)

- usually a significant disorder

Question 19

what pathology is generally associated with a long tongue?

Answer 19

• excess conditions, which could over time lengthen tongue

- generally excess heat

Question 20

what pathologies are generally associated with a short tongue?

Answer 20

• usu. nutrient deficiency (mostly qi or blood xu) bc reflects lack of nourishment
• cold (bc tongue is a myo & contracts when cold), in which case it would be short and pale or blue in color

Question 21

what does a flaccid tongue look like?

Answer 21

• lacks tone
• just sort of hangs
• is spiritless

Question 22

what pathology is generally associated with a flaccid tongue?

Answer 22

always associated with a vacuity bc reflects lack of nourishment:

• qi or yang vacuity
• blood or yin vacuity

Question 23

what does a stiff tongue look like?

Answer 23

• lacks flexibility, not pliable
• looks like a board
• speech is likely to be impaired

Question 24

what pathology is generally associated with a stiff tongue?

Answer 24

• long term lack of nourishment

- if more on dry side, indicates blood & yin vacuity (due to failure of nourishment drying out tongue over time)

Question 25

what pathology is generally associated with tongue that’s curled?

Answer 25

heat (usually Heart heat)

Question 26

what pathology is generally associated with tongue that’s curled DOWN?

Answer 26

vacuity heat

Question 27

what pathology is generally associated with tongue that’s curled UP?

Answer 27

excess heat

Question 28

what is a geographic tongue?

Answer 28

has cracks or tire treads in specific areas of the tongue map

Question 29

what pathology is associated with horizontal cracks?

Answer 29

always yin vacuity (may be location-specific or not)

Question 30

what do horizontal cracks throughout tongue indicate?

Answer 30

KD yin vacuity (KD is the root of all yin)

Question 31

what do horizontal cracks at the center of tongue indicate?

Answer 31

ST yin vacuity

Question 32

what do horizontal cracks at the sides of tongue indicate?

Answer 32

SP qi vacuity (throws the map aside)

Question 33

what pathology is associated with tire treads (deep cracks / gouges)?

Answer 33

long term severe yin deficiency (may be constitutional or congenital)

Question 34

what pathology is associated with cross-shaped (x) cracks?

Answer 34

yin vacuity (location is biggest factor in diagnosis)

Question 35

what pathologies are associated with a longitudinal center crack?

Answer 35

• ST yin vacuity
• ST heat
• SP / ST heat
  (look at tongue coat to distinguish between conditions)

Question 36

what pathology is associated with a center crack that extends to tip?

Answer 36

• HT problem (usu. a weakness)
• if redness at tip, may be HT fire
• there may be psycho emotional stress (Shen is disturbed)

Question 37

what pathology is associate with a longitudinal center crack with horizontal cracks coming off of it?

Answer 37

• really long term KD yin vacuity

- chronic; seen in elderly

Question 38

what pathologies are associated with a deviated tongue?

Answer 38

• excess / wind (e.g. LV yang rising, or hyperactivity of Lv yang)
• blood vacuity (bc vessels are not full, and wind fills the space)
• yin vacuity (bc not enough yin to anchor yang, which becomes hyperactive)
• may indicate stroke

Question 39

what pathologies are associated with numbness of the tongue?

Answer 39

• deficiency (e.g. qi, blood, or yang deficiency bc failure to nourish)
• excess bc vacuity often gives rise to excess (e.g. qi or blood stagnation, phlegm, or damp bc it blocks circulation of nourishment)
• note: lack of nourishment leads to deficiency and block of nourishment leads to excess

Question 40

what pathology is associated with a moving tongue (that makes large, slow, undulating, involuntary movements)?

Answer 40

internal wind

Question 41

what pathologies are associated with a quivering tongue (that makes rapid small movements)?

Answer 41

either excess or vacuity:

• extreme qi & blood vacuity (possibly yin vacuity)
• excess heat

Question 42

what pathology is associated with ulcerations on the tongue tip?

Answer 42

HT fire (can be excess or vacuity)

Question 43

what pathology is associated with open sores on the tongue tip?

Answer 43

HT toxin (e.g. poison or Ebola – always an excess heat)

Question 44

T or F: fire can be excess or vacuity.

Answer 44

true

e.g. yin vacuity heat/fire, or excess fire