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Written by | Guo Shala
A few days ago, a case was presented where the tongue coating was quite yellow, thick, and greasy. However, during the treatment of this condition, no medications for resolving food accumulation were used, leading friends to ask: “This child has such a thick tongue coating, could there be no food accumulation?” “Why not use Baohe Wan (Preserve Harmony Pill)?” “Does a thick tongue coating not indicate food accumulation?”This question involves two aspects: first, what exactly is the ‘garbage’ that we refer to as food accumulation? Second, when observing the tongue coating, are we considering other indicators as well?When we talk about food accumulation, we generally understand it as overeating. But where exactly is this ‘garbage’ blocked? Is it in the stomach, the large intestine, or has it spread throughout the body’s blood and skin? Additionally, in what form is this garbage blocking the body? Is it fermented food? Is it feces that cannot be expelled? Is it retained stool? Is it phlegm? Or something else?Food accumulation is termed as such, but each case is different.In the stomach, the garbage is primarily food, possibly accompanied by phlegm-dampness. The simplest case is overeating yesterday, leading to stomach distension, nausea, and loss of appetite.In the intestines, the garbage consists mainly of food residues, possibly also accompanied by phlegm-dampness. This will definitely cause abdominal distension, discomfort, and difficulty in defecation, or incomplete bowel movements, with a hot abdomen and warm palms. At night, the child may have trouble falling asleep and may toss and turn due to abdominal discomfort.In the spleen, the garbage is not food; it is something that has accumulated over time, possibly phlegm or dampness, and it is no longer in the form of food waste. This may manifest as chronic constipation, poor sleep, or stunted growth, among other issues.
This is the tongue coating of a child with spleen stagnation ▲When the substances we consume are not digested and absorbed, leading to the accumulation of phlegm-dampness, they do not just remain in our gastrointestinal tract. Sometimes they can linger in the lungs, causing coughs and nasal congestion; in the spleen, leading to malnutrition; and in the skin, resulting in issues like eczema and urticaria.From the perspective of tongue coating, if there is garbage in the gastrointestinal tract, the middle part of the tongue coating will definitely be thick and greasy. If the accumulation of garbage has lasted a long time, and there is garbage in the lower jiao (lower burner) of the body, then both the middle and root of the tongue may be thick and greasy. A white coating indicates a predominance of cold; if there is a thin layer of yellow on top of the white coating, it indicates the presence of both cold and some stagnant heat.
Below is a white coating with a faint yellow layer, indicating both cold-dampness and stagnant heat ▲Another type of tongue coating is a geographic tongue or a smooth tongue with no coating.A thin tongue coating indicates that our body has sufficient body fluids and righteous qi to digest and metabolize food and waste; however, if the tongue coating is missing or completely absent, it may be due to past incorrect treatments or congenital issues that have damaged the stomach qi. These two types of tongue coatings often indicate a deviation in constitution and partial deficiency of body fluids, and in such cases, even if there is food accumulation, it may not be discernible from the tongue coating.
Children with peeled tongue coating will not exhibit a thick tongue coating even with food accumulation ▲For simple gastrointestinal food accumulation, using Baohe Wan, Jiao San Xian (焦三仙), abdominal massage, performing the Eight Trigrams exercise, clearing the large intestine, and adjusting the diet are all effective. However, if the garbage is no longer in the gastrointestinal tract but has accumulated in the spleen, blood, or skin, Baohe Wan will not resolve the issue; more long-term regulation is needed. The approach remains to regulate the spleen and stomach and enhance their metabolic capacity. (For specific methods, refer to: Deficiency Cold Regulation Routine).Moreover, our observation of the tongue coating needs to be combined with other evidence for reference.It is incorrect to simply look at a thick tongue coating and decide to give the child Baohe Wan. Some mothers have reported that after taking Baohe Wan too much, even eating congee leads to food accumulation, which indicates improper use and damage to qi. Although Baohe Wan is gentle, it should not be used indiscriminately or in large quantities.When examining the tongue coating, it is equally important to consider the condition of bowel movements, sleep, emotions, appetite, and sweating together. If the tongue coating is thick but bowel movements are fine and the abdomen is not distended, then we need to consider the situation before and after the illness. Once, a baby had diarrhea multiple times, and by the end, there was not much left to expel, but the tongue coating was still somewhat thick and yellow; in this case, we cannot assume there is still food accumulation in the gastrointestinal tract, but rather consider it may be a manifestation of phlegm-dampness.More importantly: the manifestation of tongue coating is often delayed!!!It is crucial to understand that the formation of tongue coating is a result of changes in the body’s microbiome, but this formation takes time. This means that when a child has food accumulation, at the very first moment, their tongue coating may appear normal, but in reality, the gastrointestinal tract may already be blocked, leading to discomfort, and they may not be able to pass gas. At this time, we should prioritize the child’s feelings. Conversely, if a child takes medications for food accumulation and their bowel movements become cleaner, appetite improves, and sleep gets better, but the tongue coating has not yet improved, then we should not be overly concerned about the tongue coating issue.
Children with garbage in their bodies but who can still metabolize normally are like cars carrying a lot of mud ▲Another situation is when a child has good bowel movements, sleep, spirit, growth, and constitution in all aspects, but the tongue coating is consistently a bit thick.This can actually be left untreated, with further careful observation. We can understand this as the child’s body being like a garbage truck that moves slowly; they have the ability to metabolize, just at a slower rate, but this garbage has not yet reached a level that interferes with their daily life. Such children may need to pay more attention to preventing illness, which means keeping warm, avoiding wind, not overexerting themselves, and focusing more on preventing external pathogenic factors.In fact, in modern urban life, it is rare to find children with a clean, thin white coating every day; what is more important is that we closely observe the child. This means conducting a comprehensive observation to promptly detect any issues with the child and make timely adjustments to their diet, rest, and exercise, which may effectively prevent problems.
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Related ReadingHow to judge and handle food accumulation?It’s time to distinguish the uses of Jiao San Xian, Baohe Wan, and Dou Chi Chen Pi Shui.Is Jiao San Xian effective for persistent food accumulation?Persistent food accumulation is primarily due to stagnation in the spleen.A comparison of tongue coatings before and after handling food accumulation.
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