The tongue: Recognising

Insomnia with agitation, mouth ulcers and hot urine. What finding do you expect?

1. A thin white coating
2. Red spots, mostly toward the tip
3. Tooth marks on the borders
4. A greyish coating

Years of fatigue, weak digestion and heavy legs. Which finding confirms the diagnosis?

1. Tooth marks on the borders
2. Deep cracks in the centre
3. A thin yellow coating
4. A bright red body

Match each tongue with the picture that produces it.

• Pale, swollen, with tooth marksSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis
• Red, peeled and crackedSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis
• Red with a thick, greasy yellow coatingSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis
• Purple, with dark sublingual veinsSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis
• Red and narrow, very dry, no coatingSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis
• With localised dark patchesSpleen qi deficiencyYin deficiencyDamp-heatBlood stasis

After three weeks of treatment the coating has gone from thick and yellow to thin and whitish, but the body is just as pale. What does that mean?

1. The treatment is not working
2. The patient has worsened: cold has appeared
3. The acute layer has resolved and the background remains, which will need much longer

Order the observation of a tongue.

1. Ask what they ate or drank in the last hour↑↓
2. Ask them to put it out without straining, in daylight↑↓
3. Look at the body: colour, size and shape↑↓
4. Look at the layer: presence, colour, thickness, distribution↑↓
5. Place the findings by area and compare with last time↑↓

Match each area with the organs it represents.