“The method of diagnosing the sublingual collaterals” is a component of tongue diagnosis.
Over the years, through careful clinical observation of various diseases, it has been recognized that the method of diagnosing the sublingual collaterals can supplement and expand the application of tongue diagnosis, especially in the differentiation of blood stasis syndromes, providing significant diagnostic value and a strong objective basis for the application of blood-activating and stasis-resolving methods.
1. Clinical Application of the Method of Diagnosing the Sublingual Collaterals
Collaterals Connect to the Organs
In many years of clinical practice, I have focused on observing the color and morphological changes of the sublingual collaterals. As early as the 1970s, I proposed the method of diagnosing the sublingual collaterals (abbreviated as sublingual pulse diagnosis, hereafter referred to as such).
This method is believed to supplement and expand the application of tongue diagnosis, particularly valuable for blood stasis syndromes, especially in assessing the severity and prognosis of cardiovascular diseases, pulmonary heart disease, liver diseases, and spleen-stomach diseases.
This article will only discuss aspects related to blood stasis syndromes.
I believe that the collaterals of the whole body can be directly observed, and the most superficial and exposed, most reflective of the five organs and six bowels, is none other than the sublingual collaterals. Therefore, when there is a disease in the organs, especially in blood-related conditions, it can be immediately apparent.
The reason is that the sublingual collaterals are distributed beneath the tongue, originating from the Jin Jin (金津) and Yu Ye (玉液) points, directly connecting with the qi and blood of the organs through the meridians, serving as the upper orifices of the human body.
“The tongue is the sprout of the heart,” “the hand Shaoyin heart channel connects to the root of the tongue,” “the foot Jueyin liver channel connects to the root of the tongue,” “the foot Taiyin spleen channel connects to the root of the tongue,” “the foot Shaoyin kidney channel connects to the root of the tongue.” Although the hand Taiyin lung channel does not have a meridian connection, the lung system communicates with the throat and connects to the root of the tongue. Due to the interconnection of the organs and the circulation of qi and blood, it ascends through the meridians to the tongue.
Therefore, whenever there are cold, heat, deficiency, or excess changes in the organs’ qi and blood, it will inevitably reflect on the upper orifices of the body.
The sublingual pulse diagnosis is a direct representation of the qi and blood of the organs on the tongue body. The cold and heat of the organs, the deficiency and excess of qi and blood, are first manifested in the color and morphology changes of the sublingual collaterals, especially evident in blood stasis syndromes.
2. Clinical Application of the Method of Diagnosing the Sublingual Collaterals
Understanding the Norm to Recognize Changes
To understand the specific application of sublingual pulse diagnosis, one must first understand the normal color and morphology of the sublingual collaterals.
In years of practice, I have observed that the main branches of the sublingual collaterals in normal individuals exhibit three forms: single branch, double branch, or three branches.
The branched collaterals have several small branches.
The length is divided into two segments along the entire tongue body; those exceeding 1/2 are considered long, while those less than 1/2 are considered short.
The main collateral is approximately 2 millimeters in diameter; those exceeding this are considered thick, while those less than this are considered thin. Normal pulse shapes do not exhibit excessive length or tightness.
The main collateral is dark red in color, while colors such as cyan-purple, light purple, purple-red, and light red are considered abnormal. The branched collaterals are often a light red, densely networked appearance, and are not visible externally in normal conditions.
When blood stasis syndromes occur, the color and morphology of the sublingual collaterals will become abnormal.
Common manifestations include cyan-purple, light purple, thick and long or tight and short, or even excessively distended and curved with numerous small granules.
3. Clinical Application of the Method of Diagnosing the Sublingual Collaterals
Identifying Deficiency and Excess through Color and Shape
“What is within must manifest without.” Through years of practical experience, I propose that the changes in color and morphology of the sublingual collaterals can indicate the cold and heat of the organs, the deficiency and excess of qi and blood, especially with distinct characteristics in blood stasis syndromes.
The changes in the color and shape of the sublingual collaterals can be summarized as follows: deficiency presents as light red, small, and short; stasis presents as cyan-purple, distended, and long; cold presents as light purple and tight; heat presents as purple-red and thick and long, particularly with close relationships to the heart, liver, and spleen.
In summary, the color changes of the sublingual collaterals indicate that stasis is deep in color, while deficiency is light in color.
The morphological changes, with thick and long distension, are often due to qi stagnation and blood stasis or qi deficiency and blood stasis, indicating poor blood circulation; while thin, short, and tight shapes are often caused by cold congealing or yang deficiency leading to poor blood flow.
Specific observation methods can be approached from the following four aspects:
1. Sublingual collaterals that are cyan-purple, with a rough long distension or tight short shape, and small collaterals that are cyan-purple or dark red and curved, or have small granules, indicate qi stagnation and blood stasis, or phlegm-stasis obstruction.
This is commonly seen in conditions such as accumulation of symptoms, abdominal distension, true heart pain, cough with phlegm obstruction and blood stasis, hemoptysis, hematemesis, blood in stool, abdominal pain due to spleen-stomach stasis, gynecological blood stasis dysmenorrhea, amenorrhea, and phlegm nodules.
2. Sublingual collaterals that are light purple, with a rough long distension or tight short shape, and small collaterals that are light purple or dark red and curved or have small granules, indicate cold congealing or yang deficiency leading to poor blood flow, qi deficiency and blood stasis.
This is commonly seen in conditions such as chest obstruction and heart pain, stroke with hemiplegia, numbness and tingling of limbs, edema, abdominal distension due to spleen-stomach deficiency and cold pain, gynecological cold congealing blood stasis dysmenorrhea, infertility due to cold in the uterus, and amenorrhea.
3. Sublingual collaterals that are purple-red, with a rough long distension or tight long curved shape, and small collaterals that are dark red or deep blue and curved or have small granules, indicate heat obstructing blood stasis or dampness obstructing blood stasis.
This is commonly seen in conditions such as damp-heat diseases with heat entering the blood, surgical abscesses with stasis and corruption, damp-heat jaundice, water retention and abdominal distension due to mutual obstruction of dampness and stasis, abdominal pain due to spleen-stomach heat stasis, heat-stasis headaches, damp-heat bi syndrome, gynecological heat-stasis dysmenorrhea, irregular menstruation, menorrhagia, and leukorrhea.
4. Sublingual collaterals that are light red or light blue, with a small and short shape, and small collaterals showing little change, indicate qi deficiency and blood weakness, a condition of both yin and yang deficiency, often accompanied by stasis.
This is commonly seen in chronic consumptive diseases, qi deficiency and blood loss, deficiency due to overwork, diabetes, prolonged diarrhea, chronic dysentery, abdominal pain due to spleen-stomach deficiency, gynecological deficiency of Chong and Ren leading to infertility, miscarriage, abdominal pain after menstruation, blood deficiency amenorrhea, and qi deficiency menorrhagia.
Note: This article is excerpted from “Li Shoushan’s Medical Essentials”