The tongue is the sprout of the heart, an external manifestation of the spleen, and the coating is produced by Stomach Qi . Tongue diagnosis primarily examines the quality and coating of the tongue, including its shape, color, moisture, and dryness, to determine the nature of diseases, the severity of the condition, the abundance or deficiency of Qi and blood, the balance of body fluids , and the deficiency or excess of the organs.
Thickness of Tongue Coating
01
Thin Coating – Mild Condition
A thin white coating and a light red tongue are normal tongue appearances; a thin yellow coating primarily reflects the pathological characteristics of an initial heat syndrome.
This indicates a normal tongue coating or the onset of a disease, or shows a mild condition.
02
Thick Coating – Gastrointestinal Stagnation
If the tongue is red, with a yellow, thick, and dry coating, it indicates excessive heat in the Qi level damaging Yin; if it is a light red tongue with a thick, white, greasy coating, it indicates phlegm-dampness, turbid fluids, or food stagnation.
This indicates a progression from mild to severe condition, or the presence of gastrointestinal stagnation.
03
Dry Coating – Fluid Damage from Vomiting and Diarrhea
If the coating is merely dry and white, it indicates poor circulation of body fluids; if the coating is dry and yellow, it indicates excessive stomach heat damaging body fluids; if the coating is dry and black, it indicates extreme heat damaging Yin.
This generally indicates high fever and fluid damage from vomiting and diarrhea. It is also important to check the color of the tongue itself.
04
Rough Coating – Fluid Deficiency
If the dryness in the body becomes severe, it raises concerns about chronic conditions such as hyperlipidemia or diabetes, and individuals with asthma may experience difficulty breathing.
Rough coating indicates severe fluid deficiency.
05
Slippery Coating – Mental Fatigue
If the body is easily fatigued, with mental fatigue and lack of energy, it indicates a state of reduced bodily functions and lowered immunity.
This indicates deficiency syndromes and cold syndromes. It is also important to note the size of the tongue and the tooth marks on the edges of the tongue.
06
Greasy Coating – Dampness and Turbidity Accumulation
A white coating that adheres to the surface of the tongue indicates internal cold and excessive dampness; if the coating is yellow, it indicates dampness-heat or phlegm-turbidity accumulation transforming into heat.
This indicates dampness and turbidity accumulation, with Yang Qi being restrained, primarily indicating phlegm-dampness and food accumulation.
07
Putrid Coating – Excessive Internal Heat
Be cautious of discomfort and infections caused by overeating.
Putrid coating is often associated with heat syndromes, primarily indicating food accumulation and phlegm-dampness.
Color of Tongue Coating1
White Coating – Dampness and Turbidity
A thin white coating is a normal tongue coating or indicates the onset of an exterior syndrome. A thin white and moist coating indicates internal cold or cold-dampness; a thin white and greasy coating indicates dampness and turbidity.
Based on the moisture level and thickness of the coating, it can be categorized into thin white coating, white slippery coating, white dry coating, and white powdery coating.
2Yellow Coating – Transformation from Cold to Heat
A thin yellow coating indicates mild heat; a yellow coating indicates severe heat; a scorched yellow coating indicates extreme heat; a yellow greasy coating indicates damp-heat syndrome.
A yellow coating indicates diseases of the spleen and stomach, internal syndromes, and heat syndromes.
3Gray Coating – Dampness and Turbidity Obstruction
Once the tongue coating turns gray, it indicates that the disease has taken root in the body, and the condition has become serious.
A gray-white coating indicates cold-dampness or dampness and turbidity obstruction; a gray-yellow and dry coating indicates internal heat, damaging body fluids.
4Black Coating – Intensified Pathogenic Heat
A black dry coating indicates the influence of chronic diseases or inflammation; a black greasy coating indicates excessive accumulation of pathogenic heat and dampness in the body.
A black coating indicates a more severe condition or a trend towards chronicity.
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