▍Source: DianxuntongIn Traditional Chinese Medicine (TCM), “tongue diagnosis” is generally divided into three parts: tongue body, tongue coating, and tongue shape. Tongue coating diagnosis is one of them. The tongue coating is a thin, white, and moist layer on the dorsal surface of the tongue, composed of shed keratinized epithelium, saliva, bacteria, and food debris.
(Normal tongue coating)The observation of tongue coating includes examining the color and texture of the coating. A thin, white, and moist coating is considered normal. Additionally, there are four common types of tongue coatings:
- White Coatinggenerally indicates exterior syndrome or cold syndrome.
- The tongue coating is thin, white, and excessively slippery, commonly seen in exterior cold syndrome.
- The coating is thin, white, and dry, indicating exterior heat syndrome or invasion of dryness evil.
- The tongue coating is thick, white, and dry, representing dampness and turbidity transforming into heat, damaging body fluids. This can be further divided into thin white dry coating, thick white greasy coating, and cracked white coating.
Thin White Dry CoatingSymptoms: The thin white coating covers the tongue surface, with reduced body fluids leading to dryness, accompanied by symptoms such as cold, cough, and white foamy sputum.
Recommended Herbal MedicinesYin Qiao Jie Du Wan (Yin Qiao Detoxification Pill)Function: Disperses wind and clears heat, detoxifies. Used for wind-heat colds, with symptoms of fever, headache, cough, dry mouth, and sore throat.Dosage: Oral administration. 1 pill per dose, 2-3 times a day, taken with Lu Gen Tang (Reed Root Decoction) or warm water.Lan Ling Kou Fu Ye (Lan Ling Oral Liquid)Function: Clears heat and detoxifies, benefits the throat and reduces swelling. Used for acute pharyngitis and lung-stomach heat syndrome causing throat pain, dryness, and burning sensation in the throat.Dosage: Oral administration, 20 ml per dose, 3 times a day.Xiong Ju Shang Qing Wan (Chuan Xiong and Chrysanthemum Clear Pill)Function: Clears heat and disperses exterior, alleviates pain. Used for exterior wind invasion causing aversion to wind, fever, headache, runny nose, toothache, and throat pain.Dosage: Oral administration. 6 grams per dose, 2 times a day.Yang Yin Qing Fei Wan (Nourishing Yin and Clearing Lung Pill)Function: Nourishes yin, moistens dryness, clears lungs, and benefits the throat. Used for yin deficiency and lung dryness, with symptoms of dry and painful throat, dry cough with little sputum or blood-streaked sputum. Currently used for treating diphtheria, acute tonsillitis, and acute pharyngitis.Dosage: Oral administration, 6 grams for water honey pills, 1 pill for large honey pills, 2 times a day.Shuang Huang Lian Kou Fu Ye (Shuang Huang Lian Oral Liquid)Function: Disperses wind, clears heat, and detoxifies. Used for wind-heat colds, with symptoms of fever, cough, and throat pain.Dosage: Oral administration, 2 vials per dose, 3 times a day. Dosage for children should be adjusted or follow medical advice.Tong Xuan Li Fei Wan (Dispersing Cold and Clearing Lung Pill)Function: Disperses exterior, scatters cold, clears lungs, and stops cough. Used for cold cough, fever, aversion to cold, nasal congestion, runny nose, headache without sweating, and body aches.Dosage: Oral administration. 2 large honey pills per dose, 2-3 times a day.Ji Zhi Tang (Acute Cough Syrup)Function: Clears heat, transforms phlegm, clears lungs, and stops cough. Used for cough due to wind-heat invasion, with symptoms of fever, aversion to cold, chest fullness, cough, and throat pain; acute bronchitis, chronic bronchitis acute exacerbation with the above symptoms. Currently used for treating upper respiratory infections and lung heat obstructing cough.Dosage: Oral administration, 20-30 ml per dose, 3-4 times a day; for children under 1 year, 5 ml per dose; for ages 1-3, 7 ml; for ages 3-7, 10 ml; for ages 7 and above, 15 ml, 3-4 times a day.Zhi Ke Ju Hong Kou Fu Ye (Cough-Relieving Tangerine Peel Oral Liquid)Function: Clears lungs, stops cough, transforms phlegm. Used for cough with phlegm heat obstruction, with symptoms of excessive phlegm, chest fullness, shortness of breath, dry throat, and itchy throat.Dosage: Oral administration. 10 ml per dose, 2-3 times a day; dosage for children should follow medical advice.Thick White Greasy CoatingSymptoms: The coating is white and thick, with tight or loose granules, can cover the entire tongue, or be thinner at the edges and thicker in the middle and root, indicating dampness, phlegm, and cold.
Recommended Herbal MedicinesEr Chen Wan (Two Aged Pill)Function: Dries dampness, transforms phlegm, regulates qi, and harmonizes the stomach. Used for cough with excessive phlegm due to phlegm-damp stagnation, chest and abdomen fullness, nausea, and vomiting.Dosage: Oral administration, 9-15 grams per dose, 2 times a day.White Coating CrackedSymptoms: The coating is white, either thin or thick, with rough and loose granules, dry and hard texture, resembling sand or stones. If the granules are finer and hard, with crosswise cracks, it is called cracked white coating. Commonly seen in acute warm diseases, with dryness and heat damaging body fluids.
Recommended Herbal MedicinesZi Xue San (Purple Snow Powder)Function: Clears heat, detoxifies, stops spasms, and opens orifices. Used for heat diseases, high fever, irritability, delirium, convulsions, rashes, and bleeding.Dosage: Oral administration, 1.5-3 grams per dose, 2 times a day; for children under 1 year, 0.3 grams per dose, increasing by 0.3 grams for each additional year up to 5 years, once a day; for children over 5 years, adjust as needed.Ling Qiao Jie Du Wan (Ling Qiao Detoxification Pill)Function: Disperses wind, clears heat, and detoxifies. Used for wind-heat colds, with symptoms of aversion to cold, fever, dizziness, cough, and throat pain.Dosage: Oral administration, 1 pill per dose, 2-3 times a day.Bai Yun Shan Ban Lan Gen Ke Li (Bai Yun Shan Ban Lan Gen Granules)Function: Clears heat, detoxifies, cools blood, and benefits the throat. Used for throat swelling and pain due to excessive lung and stomach heat; acute tonsillitis and mumps with the above symptoms.Dosage: Dissolve in hot water. Half a bag to 1 bag (containing sugar) per dose, 3-4 times a day.Yellow CoatingIndicates interior heat syndrome. A thin yellow and dry coating indicates severe interior heat and damage to body fluids. A yellow, dry, and prickly coating with cracks indicates extreme interior heat and significant damage to body fluids, with great heat in the organs. A thick and greasy yellow coating often indicates phlegm-heat, food stagnation, or damp-heat accumulation. A yellow, slippery, and moist coating indicates yang deficiency. Common types include greasy yellow coating and dry yellow coating.Greasy Yellow CoatingSymptoms: The tongue shows a yellow and greasy coating, with tightly packed granules, resembling yellow powder spread over the tongue. Formed by the combination of heat evil and phlegm dampness. Yellow indicates heat, and greasy indicates dampness. Indicates damp-heat stagnation, phlegm-heat transformation, or food stagnation transformation into heat; also indicates exterior heat and dampness.Recommended Herbal MedicinesShen Ling Bai Zhu San (Ginseng, Atractylodes, and Bai Zhu Powder)Function: Tonifies the spleen and stomach, benefits lung qi. Used for spleen and stomach deficiency, poor appetite, loose stools, shortness of breath, cough, and fatigue.Dosage: Oral administration, 6-9 grams per dose, 2-3 times a day.Xiao Qing Long He Ji (Xiao Qing Long Mixture)Function: Disperses exterior, transforms fluids, stops cough, and relieves asthma. Used for wind-cold and water retention, with symptoms of aversion to cold, fever, no sweating, and cough with thin phlegm.Dosage: Oral administration, 10-20 ml per dose, 3 times a day. Shake well before use.Warm Reminder: The above medications should be used based on syndrome differentiation.Dry Yellow CoatingSymptoms: The tongue shows a yellow, dry coating with little body fluid, indicating heat evil damaging body fluids.
Recommended Herbal MedicinesXin Qing Ning Pian (New Qing Ning Tablets)Function: Clears heat, detoxifies, purges fire, and promotes bowel movements. Used for internal accumulation of heat causing throat swelling, toothache, red eyes, constipation, diarrhea, and fever; for infectious inflammation with the above symptoms.Dosage: Oral administration, 3-5 tablets per dose, 3 times a day; dosage can be increased as necessary; for preschool children, adjust or follow medical advice; for constipation, take 5 tablets before bedtime.Niu Huang Jie Du Pian (Niu Huang Detoxification Tablets)Function: Clears heat and detoxifies. Used for excessive internal heat, throat swelling and pain, gum swelling, mouth ulcers, and red, swollen eyes.Dosage: Oral administration, 3 tablets per dose, 2-3 times a day.Warm Reminder: As dry yellow coating often accompanies complex primary diseases, medication should also be determined based on the condition.In TCM, the tongue is considered a mirror of the internal organs, reflecting many internal changes. However, pharmacy staff can assist in diagnosis and should recommend medications based on TCM scientific guidance for appropriate treatment.
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