Quality of the tongue coating : Thin or thick, can be considered and understand the severity of the pathogenic factors. Thin tongue coating is present if superficial portion of the body is affected in a disease, or if the disease is due to deficiency of the anti pathogenic qi. It may be retention of food or phlegm in the interior, or inward transmission of pathogenic factor from the exterior, and is a sign of aggravation of the disease.
Moist coating and dry coating : It indicates body’s fluid by distinguishing the moisture and dryness of the tongue coating. A normal tongue is moist and lustrous whereas dry looks coarse and feels lacking moisture indicates consumption of body fluid due to excessive heat or consumption of fluid. If there is an excess moisture, the saliva dribbles whereas in sever case, it is a slippery and the condition is caused by upward flooding of harmful water and damp.
Sticky coating and granular coating : It reduce the turbid damp in the intestines and stomach. A sticky tongue coating is often seen in syndromes resulting from retention of turbid damp and phlegm or retention of food. In granule tongue surface are coarse, loose and thick like residue of making soy bean curds, and easily scrubbed. A pastry tongue coating often results from excessive heat bringing the turbid qi in stomach upwards.
Peeled coating : The tongue with a part of its coating peeling off is know as geographic tongue. It is a sign of consumption of qi and yin of stomach. If the entire coating peels off leaving the surface mirror smooth, the condition is known as glossy tongue. It is a sign of exhaustion and sever damage of stomach.
Color of the tongue coating ;
White Coating : A thin and white coating is normal. Yet a white coating may appear in an illness. If so, it indicates exterior syndromes and cold syndromes. A thin and white coating is present in exterior cold syndromes, whilst a thick white coating is seen in interior cold syndromes.
Yellow Coating : It indicates interior and heat syndromes. The deeper yellow the coating is the more severe pathogenic heat it indicates. A light yellow coating point to mild heat; a deep yellow coating to severe heat; a burnt yellow coating is accumulation of heat.
Grey Coating : It indicates interior heat syndromes or resulting from cold and damp. If grey coating is yellowish and dry, it signifies consumption of body fluid due to excessive heat. If it shows whitish and moist, it implies retention of cold damp in interior or retention of phlegm and fluid.
Black Coating :It is interior syndromes due to extreme heat or excessive cold which appears in case of sever illness.
As conditions of the tongue and its coating are manifestations of interior complicated pathological changes. The conditions mainly reflext deficiency or excess of organs and strength of the essential qi.
It is desirable to observe the tongue in direct natural light. The patient is required to protrude the tongue naturally.
Some food and drugs may color the tongue coating and the thickness and moisture of the tongue coating may change after eating or scraping the tongue. Attention should be paid to the exclusion of false phenomena induced by such factors in the clinical situation.
In normal course if a person’s tongue move freely inside the mouth without opening the mouth means heart is healthy!
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