The tongue: Assessment

A 55-year-old woman with flushes, night sweats, vaginal dryness and sleep broken from three o'clock. What do you expect to see?

1. A red body with no coating
2. A thick white coating
3. An abundant greasy coating
4. A thin white coating

What does a coating absent only in the centre, with the rest normal, mean?

1. Generalised yin deficiency
2. An artefact from scraping
3. Localised damage to Stomach yin

Place each finding in the area where it is read.

• Red spots appearing in sleepless spellsTongue tipTongue centreLateral bordersTongue root
• A peeled coating after gastritisTongue tipTongue centreLateral bordersTongue root
• A darker tone on one side onlyTongue tipTongue centreLateral bordersTongue root
• Persistent greasy coating in the deepest partTongue tipTongue centreLateral bordersTongue root
• Redness with irritability and dry eyesTongue tipTongue centreLateral bordersTongue root
• Redness with palpitations and light sleepTongue tipTongue centreLateral bordersTongue root

The first question before looking at a tongue, without exception:

1. Does anything hurt in your mouth?
2. What have you eaten or drunk in the last hour?
3. Have you ever looked at your own tongue?

Match each finding with its reading.

The tongue contradicts everything else in the interview. What do you do?

1. The tongue always rules: change the diagnosis
2. Ignore the tongue, it is a minor sign
3. Rule out an artefact first and, if the finding persists, suspect a mixed or false picture and look for the deciding datum