Throughout the day, I have seen several patients with a dark purple and stagnant tongue coating, often accompanied by palpitations, shortness of breath, and pain in the precordial area. These symptoms indicate insufficient blood and oxygen supply to the heart, as well as deficiencies in heart qi and heart blood, and poor blood circulation, yet they remain unaware of this.It is crucial to remind them to take this seriously.
The heart opens to the tongue, making it an important external observation point for internal changes in the heart. Compared to the face and lips, which can be easily influenced by makeup and other factors, the tongue body and coating often provide a more reliable reflection. Whether in TCM internal medicine, gynecology, pediatrics, oncology, or even warm disease diagnostics, the tongue plays an indispensable role. It is a vital method in TCM, known as ‘shen’ (spirit) through observation. This has been emphasized by physicians throughout history and has been continuously refined, especially after the Ming and Qing dynasties, where tongue inspection and pulse diagnosis, along with the four examinations, greatly advanced TCM diagnosis and treatment.
Observing the tongue involves examining both the tongue body and the tongue coating. The tongue coating can be directly affected by brushing teeth or eating (for example, eating green vegetables can turn it green, eating oranges can turn it yellow, eating mulberries can turn it black, and drinking milk can turn it white). Additionally, the tongue coating can vary significantly throughout the day, but the tongue body is less influenced by these factors, thus providing a more direct and accurate reflection of the changes in the yin and yang of the five organs, especially the heart.
A dark purple tongue body is an important external manifestation of heart qi deficiency, heart blood deficiency, blood stasis, and poor blood circulation. It is often seen in various heart diseases, including coronary heart disease, rheumatic heart disease, myocarditis, and myocardial infarction. This observation tends to have high accuracy. When combined with pulse patterns, electrocardiograms, and the patient’s self-reported symptoms, it can lead to a higher probability of diagnosis.
These patients often experience chest tightness, palpitations, shortness of breath, and pain in the precordial area, which may radiate to the left shoulder and back, along the left elbow to the left little finger and ring finger, or to the back of the heart. In rare cases, it may radiate to the right shoulder and back. These are all manifestations of cardiac ischemia and hypoxia. Some cases are caused by coronary artery spasm leading to angina, while others may involve thrombosis in the heart leading to myocardial infarction. Since the heart is the body’s blood pump, maintaining normal blood circulation is essential. Therefore, TCM regards the heart as the ‘monarch organ,’ governing the spirit, consciousness, and blood circulation.
Once these symptoms appear, there may be changes in the heart’s governing functions of spirit and consciousness: dullness of thought, slow reactions, a sense of confusion, anxiety, weak willpower, and an inability to let go of worries, leading to a lack of control over thoughts and actions. Patients may avoid conflicts, not want to meet people, fear crowded places, and dislike noise. They may lack the willpower to overcome difficulties, and even minor external stimuli can trigger intense internal emotional fluctuations. Their emotions may be extremely unstable.
How can we prevent these situations?
These issues are often seen in elite individuals, entrepreneurs, corporate executives, researchers, professors, and especially high school students preparing for graduation. They frequently stay up late, overthink, and exhaust their mental energy, damaging heart qi and heart blood. The harder they work, the more severe the damage and symptoms become. Many young students experience precordial pain, chest tightness, and shortness of breath at an early age. Some students from prestigious schools often stay up until 2-3 AM and wake up at 5-6 AM, relying on coffee and tea to stay alert. Over time, various symptoms gradually manifest. However, some do not take it seriously because the heart pain is often transient, lasting only a few seconds, seemingly disappearing without a trace, leading to a false sense of security.
In reality, due to the unique nature of heart cells, myocardial cells do not regenerate; damage is often irreversible and lifelong. Early detection, early treatment, and early control of the condition at its nascent stage are crucial for prognosis.
Additionally, excessive indulgence and frequent masturbation can damage liver and kidney essence and blood, harming heart and kidney yang, which are also significant causes of heart damage. Women who experience miscarriage or heavy menstrual flow are also prone to damaging liver and kidney essence and blood, affecting heart and kidney yang, following the same mechanism.
Excessive alcohol consumption and a diet high in cold foods, taking cold showers, and exposing oneself to air conditioning after sweating profusely in hot weather, or sleeping on the ground in summer can easily lead to cold pathogens, harming yang qi and damaging heart yang.
Moreover, catching a cold when having a weak constitution can lead to cold pathogens directly entering the heart meridian, causing acute myocarditis. Many children are prone to this condition after catching a cold.
Overexertion, excessive work, and overtraining are also significant causes of cardiac emergencies. For instance, long-distance running or continuous high-intensity work without rest is often a primary cause of sudden death.
Early detection and treatment, along with proactive prevention, are of utmost importance in preventing heart damage.
Many people may lack sufficient awareness of these risks, leading to worsening conditions and untreated issues, which is truly unfortunate. Therefore, it is essential to inform relevant individuals early and encourage preventive measures.
