Inspection of Tongue在线视频

Hello everyone

We have talked several topics about TCM so far

For today’s class we will go through a new chapter

chapter 6 diagnostic methods

Let’s think about a question

how to diagnose a disease

As we have mentioned previous

blood pressure body temperature heart rate

lab examination

image examination etc

are all needed to be considered for the western medical diagnosis

While for TCM it focuses on

pulse

tongue

complexion

feeling of patients and so on

Four basic procedures are usually used in diagnosing a disease by TCM

which are called four diagnostic methods

According to TCM theories

when a disease occurs

there must be some abnormal manifestations

reflected on the outside of the body

Therefore the external manifestations should be observed

if we want to know the internal pathological changes of the body

The four diagnostic methods refer to inspection

listening and smelling inquiry as well as palpation

They are the basic methods in Chinese medicine to examine

and learn about the pathological conditions

from different aspects

and find out the etiology and pathogenesis

thereby providing the basis for treatment

by differentiation of syndromes

Among the four diagnostic methods

the tongue observing in the inspection method

and the pulse taking

in the palpation method

are the two most important and necessary steps

We are going to mainly talk about the two diagnostic methods

TCM holds that the human body is an organic whole

The exterior of the body is closely related to the internal organs

The Chinese doctors try to know the conditions of qi and blood

yin and yang or the zang-fu organs

by observing general external manifestations

of life activity of the human body

As a unique procedure in TCM diagnosis

tongue observing is used to observe the changes of the tongue body

and the tongue coating

so as to determine the condition of healthy qi

tell the location of a disease

distinguish the nature of pathogenic factors

and infer the degree of seriousness of a disease

Anyway

tongue observing is one of the most important diagnostic methods of inspection

It has very important diagnostic significance

You may just wonder why do we need to observe the tongue

before making a diagnosis

The reason is that TCM always looks the human body

as an organic whole

One side

the exterior of the body is closely related to the internal organs

The other side as one part of the exterior

the tongue is connected with organs by meridians

That’s why we can obtain information of the internal organs

by observing the condition of the tongue

Now let’s see how it works

The patient is asked to sit down or lie in supine position

The tongue is stuck out naturally

and the tip of the tongue is kept slightly downwards

Here are two pictures to show how to put a tongue out of the mouth

Which one do you think it is good enough

for the doctor having a tongue observing

Absolutely B is better than A

Because the patient from picture B shows his tongue completely

In order to check a tongue completely and effectively

a TCM doctor usually check

both the tongue body and tongue coating

which is a layer of fur-like substance

The order for checking the tongue usually starts from tip of tongue

then middle area

then the two margins

finally root of the tongue

We need to check the tongue completely before we make a diagnosis

Each part of the tongue is correspondent

with different organs inside the body

Generally speaking

tip part is corresponding with heart and lung

middle part is corresponding with spleen and stomach

two margin areas are corresponding with liver and gallbladder

and root part is corresponding with kidneys

During checking a tongue we should

always keep in mind

that the four diagnostic methods are needed

before we make a diagnosis

Because all the four diagnostic methods

cannot be separated from one another

each having its specific function that cannot be

substituted for the others

In clinical practice

only when the four techniques

are organically

combined can a disease

be understood comprehensively

Thus a correct diagnosis can be made

Now let me show you three pictures of tongue

Could you please tell me which one is the normal one

If your answer is B

that’s correct

We should know what is a normal tongue before we judge

the condition of a tongue for patients

Typically speaking

a light reddish tongue with thin and whitish coating

is considered as a normal tongue

A normal tongue represents the normal visceral functions

since tongue reflects the functions of internal organs

Now let’s take a look at what are abnormal tongues

Like this one

the color of tongue is light-whitish

which suggests

the patient may have a deficiency syndrome or cold syndrome

What kind of syndrome it exactly is

depends on a comprehensive analysis

combining with other diagnostic methods

Here is reddish tongue which suggests excessive heat inside the body

For example a patient

with too much lung heat

usually has such kind of tongue

The patient may have the symptoms

such as high fever

cough

thirst etc

This is a very special kind of tongue with

tooth-marked along the two sides

This type of tongue usually suggests

deficiency of spleen which may induce

low digestive function

This is a unique tongue with prickles on the surface

We usually call this tongue “strawberry tongue”

because it looks like a strawberry right

This kind of tongue suggests excessive heat or static blood

From this picture

we can see a tongue with fissures on the surface

which suggest deficiency of yin

especially refers to the spleen yin

We just talked about the color of tongue

Now let’s take a look at the color of the tongue coating

Clinically we can see three kind of tongue coating

White yellow and grayish black

White tongue coating usually suggests exogenous disease

caused by external wind-cold pathogenic factors

Such patient may have the symptoms

like cough

aversion to cold headache fever etc

The yellow tongue coating represents damp- heat or phlegm-heat

which may cause symptoms like cough

excessive phlegm high fever thirst constipation etc

Greyish black tongue coating suggests

severe disease condition

If the tongue coating is greyish but moistening

it suggests cold-dampness syndrome

If the tongue coating is greyish but dryness

it suggests fire or heat syndrome

The two conditions are all needed to be treated immediately

Let’s have a quick review for today’s contents

A normal tongue always is light-reddish tongue with

thin and whitish coating

For checking the abnormal tongue

we need to observe both the tongue body and tongue coating

The clinical significance is to know the conditions of internal organs

by tongue observing

since the interior-exterior relationship

between the tongue and the body

OK that’s all for today

I’ll see you in next class