Tongue Diagnosis in TCM

Stick Out Your Tongue - comparative analysis and diagnostic significance of the tongue in Western and Oriental (TCM) medicine. Clinical application demonstrated through case studies.

TCM Tongue Topology The significance of tongue diagnosis in both western and oriental medicine has been analyzed in this document. Examination of the methodologies of tongue diagnosis in both medical disciplines and their applicability in diagnostics is demonstrated through comparative review of sample case studies. The findings suggest that western clinical application of tongue diagnostics focuses primarily on superficial evaluation of the organ and in some cases obtaining supportive findings in diagnostic confirmation. Oriental medicine extends beyond superficial evaluations and has methodologies and techniques for obtaining diagnostic data of greater depth and significance within the confines of its medical theory. Findings also support the observation that both western and oriental diagnosis can arrive at same-or-similar conclusions when using the tongue, but that the classification and hence treatment principles for the condition will vary greatly between the western and oriental disciplines.

Case 1 Male 73 years old

Reddish glossy tongue, small dry cracks in the anterior third (lung area) tofu like, thin coating on the left posterior of the tongue

Other findings: Shortness of breath, Dry cough, Intense thirst, night sweats, 40 Year smoker

OM Diagnosis and findings

Diagnosis – Chronic Lung Yin vacuity Kidney vacuity, Dangerous exhaustion of Yin

Western Clinical Diagnosis and findings

Diagnosis – Bronchial Fibrosis

Case 2 Male 44 Years old

Red, slightly purple dusky thick tongue body, edges pale. Vertical crack with small horizontal cracks branching off without coating, slightly reddish center and tip areas with raised papilla (Stomach and Heart). Thick dry white coating at root of tongue

Other findings: Heartburn, Stomach pain, fatigue, insomnia, and irritability. Strong appetite with irregular eating habits, strong demands at work.

OM Diagnosis and findings

Diagnosis – Damp accumulating in Lower burner with ST yin vacuity. Ht fire.

Western Clinical Diagnosis and findings

Diagnosis – Reflux Esophagitis

Case 3 Female 62 Years old

Pale swollen body. Bluish Purple tip and sides, Deep vertical crack, rootless peeled coating at middle of tongue.

Other findings: severe attacks of anxiety and panic, feeling of pressure in the head, cold hands and feet and inner restlessness. Wasting and thirsting

OM Diagnosis and findings

Diagnosis – Spleen QI vacuity with dampness accumulation, Blood stasis, Stomach and KI yin vacuity.

Western Clinical Diagnosis and findings

Diagnosis – Diabetes

Case 4 Male 65 Years old

Long stiff body with Red swollen tongue tip, Dry tip with thick yellow coat in root slightly swelled left side.

Other findings: SOB, fatigue, Angina pectoris, insomnia, anxiety, low back and knee pain

OM Diagnosis and findings

Diagnosis – KI Yin vacuity with HT fire blazing upwards. Water and fire disharmony.

Western Clinical Diagnosis and findings

Diagnosis – Myocardial infarction, Coronary disease

Clinical Conclusions

Historically the tongue assessment and examination played a great role in the western medical discipline, But with the advent of advanced automation in various diagnostic and laboratory instruments and procedures the art and science of tongue diagnosis in the western clinical practice has been reduced to a superficial analysis for quick check of inflammatory conditions or for obvious surface indications. The oriental medicine having had considerable time and reliance of the methodologies of tongue diagnosis in conjunction with the other diagnostic procedures has developed a comprehensive method of effective diagnosis. As evidenced in the sample cases studies, the oriental practitioner has been able to isolate and pin point, a disease mechanism, within the context of the oriental discipline, which closely correlates to western diagnostic conclusions.

The classic Nei Jing text of the Oriental medicine states:

The tongue represents the inside of the body and that a learned practitioner can gaze into the body by observing the tongue.

Which Tongue Are you? Find out Here.