Tong diagnose
Hierboven een overzicht welke delen van de tong corresponderen met het orgaan. Alle verkleuringen of veranderingen in dat gebied kan duiden op een probleem met het orgaan.
Er zijn allerlei tekenen op de tong die een aanwijzing voor de acupuncturist zijn. Een dikke tong of dunne tong. Plekjes op de tong en het tongbeslag, de kleur van tong en tong beslag zijn allemaal dingen waar een acupuncturist op let. Soms zijn er tandafdrukken als kleine deukjes aan de rand van de tong, alles heeft een betekenis.
Tongengallerij
Hieronder een overzicht van verschillende tongen en wat het betekend in de Chinese geneeskunde. Helaas nog in het Engels.
Example 1
Body colour: Reddish-Purple.
Body shape: Swollen and cracked.
Coating: peeled.
A Reddish-Purple tongue body colour usually indicates Blood stasis
deriving from or associated with Heat (whereas a Bluish-Purple colour
generally indicates Blood stasis deriving from Cold). In this case, the
tongue colour is consistent over the whole tongue so we cannot
determine from the tongue alone where the Blood stasis is located. The
pulse and the symptoms can tell us this. However, the most likely
pattern is that of Liver-Blood stasis.
The tongue body is also Swollen which indicates the presence of Phlegm.
The Lung and Heart areas of the tongue are especially swollen which
points towards the fact that the Phlegm is predominantly in the Upper
Burner. Phlegm and Blood stasis are often seen existing side by side,
especially in older patients, as they interact with and "promote" each
other. Blood stasis stops fluids from being transported around the body
smoothly therefore encouraging the production of Phlegm, while Phlegm
blocks the smooth flow of Qi and Blood leading to stasis.
The tongue is totally peeled (without coating) and with many cracks,
both signs of chronic Yin deficiency. It is likely that the Yin
deficiency preceded the Blood stasis. Chronic Yin deficiency leads to
Empty-Heat and we know in this case that the Blood stasis derives from
Heat as the tongue is a Reddish-Purple colour. Although we cannot tell
conclusively from the tongue only, the Yin deficiency is most likely of
the Stomach and Kidneys
Therefore, in conclusion, we can say that this many suffers from Yin
deficiency with Empty-Heat, Blood stasis and Phlegm in the Upper Burner.
Example 2
Body colour: Reddish-Purple,
Bluish-Purple in the chest area on the right.
Body shape: Stiff, slightly Swollen.
Coating: sticky coating without root.
The overall body colour of this tongue is Purple, indicating Blood
stasis. It is predominantly Reddish-Purple, which indicates Blood
stasis deriving from or associated with Heat but the chest area on the
right of the tongue is Bluish-Purple which indicates that there is also
some Cold which has lead to Blood stasis in the chest.
The tongue is also Stiff. A Stiff tongue indicates either severe Blood
stasis or internal Wind. As the tongue is also Purple, in this case it
is most likely that it indicates Blood stasis.
The sticky consistency of the coating simply indicates that there is
Dampness (or together with the Swollen tongue body Damp-Phlegm), but
the fact that it is rootless reflects a deficiency of Stomach-Yin. A
rootless coating reflects the beginning stages of Stomach-Yin
deficiency.
Example 3
Body colour: Slightly Red but
Pale on the sides.
Body shape: Swelling in the Spleen area on
the sides, Stomach cracks.
Coating: Peeled.
This tongue shows clearly a relatively common condition of Stomach-Yin
deficiency (leading to some Heat) and Spleen-Yang deficiency. The
cracks in the Stomach area indicate Stomach-Yin deficiency and the
overall colour of the tongue is slightly Red showing that this Yin
deficiency has lead to some Heat, but the sides of the tongue in the
Spleen area are Swollen and Pale. This relects Spleen-Qi and Yang
deficiency leading to Dampness.
It is important to distinguish between the Liver and the Spleen areas
on the sides of the tongue. The Liver area is a longer and thinner
strip, covering nearly the whole side of the tongue, whereas the Spleen
area is shorter and fatter and in the middle of the side of the tongue.
In the case of this patient, it would therefore be necessary to treat
both Yin deficiency (of the Stomach) and Yang deficiency (of the
Spleen). Even though the Yin deficiency (and Empty-Heat) seem
predominant because the main area of the tongue body is Red and it is
peeled, it is likely that the Spleen deficiency came first. As the
Spleen and Stomach are so closely connected, a long-standing case of
Spleen-Qi and/or Yang deficiency may lead to a deficiency of the
Stomach (which has a tendency to become Yin deficient). A suitable
remedy for this condition might be Shen Ling Bai Zhu San (Central
Mansion in the Three Treasures remedies).
Example 4
Body colour: slightly Red.
Body shape: Swollen, especially in the
chest area with a Heart crack.
Coating: sticky coating.
This tongue is slightly unusual in that it clearly shows us the exact
location of a pathogenic factor. The chest area is clearly more Swollen
than the rest of the tongue indicating the presence of Phlegm in the
Upper Burner.
As a general rule, the tongue body shows more the presence of Phlegm
and the coating reflects the presence of Dampness. When the tongue body
is Swollen and the coating is sticky, as in this case, it normally
indicates the presence of Damp-Phlegm, in this case clearly in the
Lungs.
Example 5
Body colour: slightly Red.
Body shape: Swollen, especially in the
chest area with a Heart crack.
Coating: sticky coating.
The Reddish-Purple coating is more distinct on the sides in the Liver
area which points specifically towards Liver-Blood stasis. The Liver
area on the sides is also Swollen which usually indicates severe or
chronic Liver-Heat. The Liver area being Red and Swollen simply
indicates a more severe degree of Liver-Heat than if the Liver area is
just Red.
The strips of a slightly thicker, white coating on either side of the
tongue indicate a Gall-Bladder pathology, most usually Dampness in the
Gall-Bladder.
Although the tongue points towards the Blood stasis being especially in
the Liver, treatment of this patient should focus equally on moving
Blood in the Heart. The presence of a Heart crack indicates a
constitutional tendency to Heart patterns.
Example 6
Body colour: pale.
Body shape: swollen, central Heart crack, transverse Spleen cracks on the sides.
Coating: thin-white (normal), slightly yellow in the centre.
The pale tongue-bocolour indicates Yang deficiency (it may also indicate Blood deficiency, but in a man, it is more likely to be Yang deficiency). It is not possible from the tongue only to establish which organ is mostly affected in this case by the Yang deficiency: however, since the tongue body is also swody llen, which usually indicates Phlegm, it is more likely to be Spleen-Yang deficiency. The central crack in this case correlates with the Heart.
A "Heart crack" is rather thin and long, extending from near the root of the tongue to near the tip; a "Stomach crack" is rather wide and is situated only in the middle section of the tongue, in the Stomach area. What does a Heart crack indicate? It depends on its depth and on the colour of the tongue tip. Generally speaking, a Heart crack indicates a constitutional propensity to Heart patterns and to emotional problems: the deeper the crack, the stronger this propensity. If, in the presence of a Heart crack, the tongue tip is red, it indicates that there already is a Heart pattern usually from emotional problems. In other words, a change in colour of the tongue body indicates that that particular constitutional tendency to Heart patterns has manifested itself and generated an actual Heart pattern. If we compare two people both with a red tip of the tongue, one with a Heart crack and the other without, the presence of a Heart crack indicates that that person has a constitutional tendency to Heart patterns and that his or her condition is deeper and more difficult to treat than that of the person without a Heart crack.
The small, transverse cracks on the sides usually indicate
severe, chronic Spleen deficiency. Thus, we can conclude that this man
suffers from a chronic Spleen-Yang deficiency and Phlegm.
Example 7
Body colour: dark red, redder on the sides.
Body shape: swollen on the sides, Stomach crack.
Coating: white, rootless.
The dark red body colour clearly indicates intense Heat and
the redder colour and swelling on the sides shows that the Heat is in
the Liver. Thus, this patient has suffered from Liver-Fire for a long
time (we can deduce it is a long time from the dark-red colour) and the
intense Fire has begun to injure Yin. We know this from the fact that
the coating is rootless: this indicates the beginning of Yin deficiency
and, since the tongue is dark-red and there is a coating, we can deduce
that it is the Fire that is injuring Yin rather than deficient Yin
giving rise to Empty Heat.
Example 8
Body colour: red slightly tending to purple, redder tip.
Body shape: swollen tip, tip curling up, Heart crack.
Coating: normal but there is a slightly peeled patch without coating on the left side towards the root.
The red body colour indicates Heat and the slight purple
colour indicates that there is some Blood stasis. The red tip indicates
Heart-Fire and the swelling of the tip and its curling up confirm and
reinforce this diagnosis. The presence of the Heart crack indicates
that this patient had a constitutional tendency to Heart patterns and
to emotional problems. The small patch without coating indicates the
beginning of Stomach-Yin deficiency.
Example 9
Body colour: red, tending to purple
Body shape: very swollen, Stomach crack.
Coating: yellow, rootless, dry.
The red body colour indicates Heat while its slightly purple hue indicates that there is some Blood stasis. The very swollen body shape indicates the presence of Phlegm. The red colour, together with the Stomach crack and the yellow coating, indicates that the Heat is located in the Stomach. This is confirmed by the rootless coating which indicates the beginning of Stomach-Yin deficiency, presumably from the Heat injuring Yin. The dryness of the coating confirms both the Heat and the Yin deficiency (it could be due to either).
This tongue has a rootless but relatively thick coating: this
is doubly bad. Why? The rootlessness of the coating indicates that
there is the beginning of Yin deficiency but the relative thickness of
it indicates that there is a pathogenic factor, in this case,
Stomach-Heat: thus, this patient suffers from a Full condition
occurring against a background of Stomach deficiency. In other words,
it would have been better if the coating had been either rootless but
thin (indicating Yin deficiency but no pathogenic factor) or thick with
root (indicating the presence of a pathogenic factor but also a good
state of the Stomach).
Example 10
Body colour: reddish-purple, red sides
Body shape: very swollen, swollen sides, Stomach crack
Tongue coating: sticky-yellow, sticky-dry-rough-yellow inside the Stomach crack.
The reddish-purple colour of the tongue body indicates Blood stasis deriving from or associated with Heat. The redness on the sides indicates Heat in the Spleen and/or Stomach; in this case, the redness on the sides is not related to the Liver because it occupies a wider area than the Liver are and also because it is associated with a Spleen-type of swelling on the sides. The general swelling of the tongue body indicates the presence of Phlegm, while the swelling on the sides is related to the Spleen and it indicates Dampness occurring against a background of chronic Spleen deficiency.
The sticky-yellow coating confirms the presence of Dampness while the Stomach crack, together with the sticky-dry-rough-yellow coating insides it indicates Phlegm-Heat in the Stomach.
In conclusion, the main location of the disharmony in this case is in the Middle Burner with Stomach and Spleen Heat, Damp-Heat and Phlegm-Heat in the Stomach. The Blood stasis probably derives partly from the Heat and partly from the chronic retention of Phlegm.
Example 11
Body colour: slightly pale, almost normal
Body shape: very swollen, more so on the (patient's) left side
Tongue coating: thick-white-rootless coating.
The swelling of the tongue body indicates Phlegm while the partial swelling on the left side often indicates a weakness of the channels on that side. Such weakness may derive either from a febrile disease with high temperature or from an accident to that side of the body.
The rootless coating indicates Stomach-Qi or Stomach-Yin
deficiency, but its thickness indicates the presence of a pathogenic
factor, probably Dampness. A thick-rootless coating is doubly bad
because, on the one hand Stomach-Yin is deficient, but, on the other,
there is a pathogenic factor. It is better for a rootless coating to be
thin (indicating Stomach-Qi deficiency but no pathogenic factor) or for
a thick coating to have a root (indicating the presence of a pathogenic
factor but also intact Stomach-Qi).
Example 12
Body colour: reddish-purple
Body shape: swollen sides
Tongue coating: thin-white-rootless coating, peeled in patches.
The reddish-purple colour indicates Blood stasis with Heat. The swelling on the sides indicates chronic Spleen deficiency and the rootless coating missing in patches indicates Stomach-Yin deficiency.
This patient too suffers primarily from a disharmony in the Middle Burner with chronic Spleen-Qi deficiency and Stomach-Yin deficiency. Both the swelling on the sides (related to the Spleen) and the rootless coating missing in patches (related to Stomach-Yin) indicate a chronic condition because this type of swelling and the lack of coating develop over a long period of time.
It is not possible to tell from the tongue only which other
organ (apart from the Stomach), if any, is affected by the Blood stasis
and the Heat.
Example 13
Body colour: red, red tip
Body shape: short.
Tongue coating: thin-white.
This slide is presented here mainly as an example of a short tongue body. The patient could not stick the tongue out more than that. The red tip indicates Heart Heat.
Bron: Giovanni Maciocia