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Symptoms 3, tongue
症状3,舌 〔症狀3,舌〕zhèng zhuàng 3, shé
Below is a brief description of the major tongue body and tongue fur symptoms, with links to entries that provide more detail.
See tongue examination.
Tongue Body
Pale-white tongue (舌质淡白 shé zhì dàn bái): A tongue paler than normal. It indicates dual vacuity of qì and blood or yáng vacuity.
Pale-red tongue (舌质淡红 shé zhì dàn hóng): A healthy tongue with a moist sheen. It indicates that qì and blood are in harmony. It is seen in healthy individuals or people suffering from mild disease.
Red tongue (舌红 shé hóng): A tongue redder than normal. It indicates repletion heat or yīn vacuity. A red-tipped tongue (舌尖红 shé jiān hóng) is a tongue that is redder at the tip than in other parts. It is most commonly associated with hyperactive heart fire.
Crimson tongue (舌绛 shé jiàng): A tongue that is deep red in color. It indicates exuberant internal heat or yīn vacuity with effulgent fire.
Green-blue or purple tongue (舌青紫 shé qīng zǐ): A tongue with generalized green-blue or purple coloration. It indicates blood stasis or blood stagnation attributable to (a) intense heat toxin scorching provisioning-yīn and affecting blood flow, (b) to exuberant internal yīn cold inhibiting blood flow, or (c) injuries from knocks and falls. A deep purple (crimson turning purple) reflects heat. A pale green-blue tongue that is glossy reflects cold. See also the next item.
Stasis speckles on the tongue (舌有瘀点 shé yǒu yū diǎn): Purple speckles on the tongue indicate blood stasis or stagnation. Speckles on the tip indicate heart blood stasis obstruction (heart vessel obstruction in which blood stasis is the prominent factor). Speckles on the margins indicate liver depression and blood stasis (blood stasis resulting from depressed liver qì).
Tender-soft tongue (舌嫩 shé nèn, 舌娇嫩 shé jiāo nèn): A tongue that is soft and spongy, like a child’s flesh, with fine markings and granularity. It mostly indicates vacuity.
Somber-tough tongue (舌老 shé lǎo, 舌苍老 shé cāng lǎo): A tongue that is hard, dull, with coarse markings and granularity. It usually indicates repletion.
Tongue with dental impressions at the margins (舌边有齿痕 shé biān yǒu chǐ hén): A tongue with teeth marks at the edges. Dental impressions develop when the tongue becomes enlarged. They are a sign of insufficiency of the spleen’s yáng qì with exuberant dampness. Since the tongue body is usually pale, the term pale enlarged tongue with dental impressions
(舌质淡胖有齿痕 shé zhí dàn pàng yǒu chǐ hén) is often encountered in the literature.
Fissured tongue (舌裂 shé liè): A tongue with one or more grooves or furrows. It is usually a sign of depletion of essence-blood. If the tongue is pale, it reflects blood vacuity. If red or crimson, it is caused by damage to yīn fluids resulting from exuberant heat. If it is pale-white enlarged and tender-soft with dental impressions, this is spleen vacuity with dampness.
Tongue Fur
White tongue fur (舌苔白 shé tāi bá): A white tongue fur forms as a result of upward steaming of stomach qì in healthy individuals or as a result of obstruction of yáng qì by external cold, other external evils, internal cold, or cold-damp. It is seen in exterior patterns, cold patterns, and dampness patternsand may also appear in mild heat patterns.
- Thin white tongue fur (舌苔薄白 shé tāi bó bái): The tongue fur is said to be thin if the tongue body can be seen through it. This is a normal tongue fur, or it indicates exterior evils. When moist, it is normal or indicates initial-stage exterior patterns. When glossy, it indicates external contraction of cold-damp, spleen-kidney yáng vacuity, collecting water-damp, or food accumulation. If dry, it reflects externally contracted wind-heat.
- Thick slimy white tongue fur (舌苔厚白而腻 shé tāi hòu bái ér nì): This is seen in spleen yáng vacuity, collecting water-rheum, or phlegm-damp arising internally. A white chalky tongue fur is often seen in warm epidemics or internal welling-abscesses (e.g., intestinal welling-abscess).
Yellow tongue fur (舌苔黄 shé tāi huáng): The tongue fur most commonly turns yellow with the scorching action of heat. It occurs in heat patterns and interior patterns.
When yellow at the tip, it indicates heat in the upper burner. When yellow in the middle, it indicates heat in the stomach or intestines. When yellow at the root of the tongue, it indicates heat in the lower burner. When yellow at the margins, it indicates liver-gallbladder heat.
- A glossy yellow tongue fur (舌苔黄滑 shé tāi huáng huá) on a pale enlarged tender-soft tongue indicates debilitation of yáng qì and water-damp failing to transform. It is important to take note of this because a yellow tongue fur does not necessarily reflect heat.
A pale-yellow tongue fur indicates that the heat is mild; a deep yellow tongue fur indicates that the heat is severe.
A thin dry yellow fur indicates damage to liquid by heat evil, which calls for attention to the need to safeguard liquid.
A slimy yellow fur usually indicates damp-heat.
A mixed white and yellow tongue fur
(舌苔黄白相兼 shé tāi huáng bái xiāng jiān) is one in which there are patches of white and yellow. This indicates the initial-stage transformation of cold into heat, which is associated with evils passing into the interior. A tongue fur turning from white to yellow (舌苔由白转黄 shé tāi yóu bái zhuǎn huáng) has the same significance.
An old-yellow fur
(老黃苔 lǎo huáng tāi) is dark yellow. A burnt-yellow tongue fur
(舌苔 焦黃 shé tāi jiāo huáng) is a blackish yellow. Both indicate the gathering of repletion heat and heat bind
(heat binding in the intestines and causing constipation).
Tongue and Fur Combinations
Pale-red tongue
- with a thin white fur: Healthy individuals; wind-cold exterior patterns; mild disease or shallow penetration.
- with a white fur: If only the tip of the tongue is red, this means a wind-heat exterior pattern pr hyperactive heart fire.
- with a mealy white fur: External contraction of epidemic qì with exuberant heat toxin in the inner body.
- with a white and tofu fur: Phlegm-food collecting internally; debilitation of stomach qì with phlegm turbidity welling upward.
- with a yellow and white mixed fur: Exterior patterns transforming into heat and passing into the interior.
- with a slimy thick white fur: Damp turbidity or phlegm-rheum collecting internally; food accumulating in the stomach and intestines; cold-damp impediment (bì) patterns.
- with a thin yellow fur: Mild interior heat patterns.
- with a dry yellow fur and little liquid: Interior heat damaging liquid and transforming into dryness; desiccated liquid and blood dryness; dryness of the stomach and intestines.
- with a slimy yellow fur: Damp-heat; phlegm-heat; food accumulation transforming into heat.
Bright-red tongue
- with a dry white fur: Evil heat entering the interior and damaging liquid.
- with a floating grimy tongue fur: Depletion of right qì with residual damp-heat.
- with a thick slimy white tongue fur on a red or crimson tongue body indicates
dampness trapping hidden heat
(湿遏热伏 shī è rè fú). - with a thin yellow fur with little liquid: Interior heat that has already damaged the fluids.
- with a thick yellow fur with little liquid: Damage to yīn humor by exuberant qì-aspect.
- with a slimy yellow fur: Damp-heat brewing internally; phlegm and heat biding together.
- with a dry black fur: Desiccated fluid and dry blood.
Crimson tongue
- with a dry burnt-yellow tongue fur: Severe internal heat; heat binding in the stomach and intestines.
- with a dry black fur: Extreme heat damaging yīn.
- with no fur: Heat entering the blood aspect; yīn vacuity with effulgent fire.
Green-blue or purple tongue
- with a dry yellow fur: Extreme heat and desiccated liquid.
- with a dry burnt-black fur: Severe heat toxin with major damage to fluids.
- with a white glossy fur: Yáng vacuity with exuberant cold; congealing and stagnating qì and blood.
Pale-white tongue
- with no fur: Yáng debilitation in enduring illness; dual vacuity of qì and blood.
- with a transparent fur: Spleen-stomach vacuity cold.
- with a thin white fur at the margins and none in the middle: Dual vacuity of qì and blood; stomach yīn vacuity.
- with a white fur: Insufficiency of yáng qì; dual vacuity of qì and blood.
- with a slimy white fur: Spleen-stomach vacuity with phlegm-damp gathering.
- with a glossy gray-black fur: Yáng vacuity with internal cold; phlegm-damp collecting internally.