The Tongue

As a Diagnostic Microsystem

Einstein

The study of the tongue as a microsystem at the physical exam is very important, and is one of the easier learnable microsystems, that is not to say, that it is easy, at all. Nevertheless, recognizing whether or not the tongue is coated, pale or angry red, what region is affected, is usually pretty straightforward and objective.

Obviously, it is to be interpreted in context with other presentations, signs and symptoms. Nevertheless, paying particular attention to the tongue at the physical exam can be very informative for any medical provider.

Tonge surface presentations

The representation of the internal organs on the tongue surface is also easy to visualize and imagine.

As you can see on this schematic drawing on the right, the midline represents the gastro-intestinal system with the stomach surrounded by the spleen in the middle, at the base of the tongue are the two kidneys, the liver and gallbladder on the two sides, lungs at the front, and the heart is on the tip.

Understanding and visualizing these representations, one can easily recognize pathology at the relevant organ zone on the tongue surface.

My analogy is that imagine the tongue as a blanket laying over and above, covering the organs.

angry tongue The ascending heat (Yang condition) of an organ burns its corresponding zone on the surface making it angry red (demonstrated on the left), whereas a deficiency (Yin condition) makes the malfunctioning organ`s corresponding microsystem on the tongue surface pale and listless (right).

Tongue deficiency

Obviously I`m over simplifying it, the possible scenarios and signs can be very complex even contradictory, so the examiner needs to put the entire clinical presentation into context.

There are full text books written on tongue diagnosis alone, so I can`t even remotely attempt to show you everything on one single webpage, nonetheless this can give you a general idea how the coating, shape, color, and texture of the tongue provide useful information for an acupuncturist, modern or ancient, to prompt to a diagnosis or even guide the therapy monitoring the response.


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