Archives for category: Diagnosis

tongue-syndromesA healthy tongue body is pink. In Traditional Chinese Medicine (TCM) the tongue body represents the yin organs, blood and nutritive qi (ying qi). Examples of a tongue that has lost it’s healthy qi (zheng qi) include a tongue that is: pale (qi or blood deficiency); pale sides (liver blood deficiency); red with purple spots (heat with blood stagnation); red center (stomach heat);  blue center, slippery and greasy (damp phlegm accumulation). These are just examples, there are many other patterns.

The tongue shape reflects the overall condition of the yin organs, blood and nutritive qi (ying qi). The shape of the tongue should be suitable to the mouth size (not too puffy or narrow). Examples of tongue shapes include: thin, red and peeled (yin deficiency); swollen (spleen yang deficiency); stiff (liver wind); flaccid (deficiency body fluids); short, pale and wet (interior cold); cracks (yin deficiency); teeth marks (spleen deficiency). These are just examples, there are many other patterns.

Tongue coating reflects the state of yang organs. The tongue coating is the layer over the tongue. A normal healthy coating should be white, thin, and allow the tongue body to be seen through the coating. The moisture of the tongue reflects the condition and transport of body fluids. Normal coating is slightly moist. If fluids become deficient the tongue will dry out. Tongue coating color shows the relative heat and cold of the condition and the severity of the pathogen. The thickness of the coating is relative to the amount of the pathogenic factor present. Increasing thickness means the pathogen is going deeper whereas the change from thick to thin reveals an improvement. Examples of different tongue coatings reflecting weak zheng qi include: yellow (heat); watery (yang deficiency); sticky and clear (phlegm damp retention); foul breath (heat); foamy (wind). These are just examples, there are many other patterns.

As for the tongue movement, when the zheng qi is healthy the tongue moves smoothly in and out. Examples of unhealthy movement include flicking the tongue out quickly (heat signs) and quivering (spleen qi deficiency). There are other movement patterns as well.

Different regions of the tongue are related to different parts of the body, internal organs and channels, for example: The tip of the tongue or “upper jiao” is related to the heart and lungs. The sides of the tongue are related to the liver and gallbladder. Middle of the tongue or “middle jiao” is related to the digestion system, stomach and spleen. The back of the tongue or “lower jiao” is related to the kidneys, urinary bladder and intestines.

When a practitioner of TCM looks at a patient’s tongue he/she is looking at many things such as the tongue body, shape, movement, coating as well as the yin and yang organs reflected on the tongue. Tongue diagnosis in TCM is comprehensive and much information can be gathered from it such as the degree of the pathogenic factor and the state of the organs as well as pregnancy issues.

TCM PulseTaking a patient’s pulse from the model of Traditional Chinese Medicine (TCM) is quite an art indeed. It’s an art because it requires “listening” to the pulse and in nine different ways. Briefly and simply, here is how pulse reading is done in TCM along the radial artery: the pads of the practitioner’s three fingers (index, middle and ring) are placed on the radial side of the patient’s wrist (palm side). The first position at the wrist crease is called “cun” and it’s where the index finger is placed. On the left hand this position assesses the primary “fire element” or the Heart (yin) and Small Intestine (yang) meridians. The middle finger which is at the position next to the index finger is called “guan” and it assesses the “wood element” or the Liver (yin) and Gallbladder (yang) meridians. The ring finger which is proximal to the wrist and beside the middle finger is positioned at “chi” and it assesses the “water element” or the Kidney (yin) and Urinary Bladder (yang). On the right hand the sequence is as follows: the index finger which is at the wrist crease assesses the “metal element” or the Lung (yin) and Large Intestine (yang) meridians. The middle finger assesses the “earth element” or the Spleen (yin) and Stomach (yang) meridians. The ring finger assesses the secondary “fire element” or the Pericardium (yin) and the San Jiao (yang).

Along with these six pulse assessments the practitioner feels the superficial level of the pulse where the state of yang organs and qi are, then the middle level where the Stomach and Spleen dominate and at the deep level to the bone where the state of yin organs dominate.

When listening to the pulse at these three levels and six positions the practitioner determines the quality of the pulse in terms of its speed (rapid, slow), strength (empty, full), depth (floating, deep), length (if long in elderly can indicate a long life), size (thin, big), rhythm (knotted, hurried, irregular, etc.) and shape (e.g., slippery, wiry, choppy). At least twenty-eight different combinations are noted that the practitioner must be sensitive to listening to and deciphering.

As the practitioner takes a breath in and exhales a patient’s normal pulse will have 4 to 5 beats, less than 3 beats indicates a slow pulse and anything greater than 5 beats per breath indicates a fast pulse.

Pulse taking is quite comprehensive in TCM. A lot of information can be obtained from the patient by his/her pulse such as: the health of the qi in general; the relationship between yin and yang organs; states of deficiency and excess and whether an exterior pathogen is present.