1. Pale Purple Tongue
Tongue Quality
Color: Pale purple, pale white;
Shape: Slightly tender, few petechiae, mild tooth marks.
Tongue Coating
Coating Quality: Thin, moist;
Coating Color: White.
Clinical Significance
Stagnation of Qi and blood due to Yang deficiency, Qi deficiency, and Qi stagnation.
2. Flaccid Tongue
Tongue Quality
Color: Pale white;
Shape: Tender, tooth marks;
State: Flaccid.
Tongue Coating
Coating Quality: Thin, moist;
Coating Color: White.
Clinical Significance
Qi deficiency, Spleen deficiency, Yang deficiency.
3. Mirror Red Tongue
Tongue Quality
Color: Bright red;
Shape: Old, cracked.
Tongue Coating
Coating Quality: Glossy, bare, dry.
Clinical Significance
Yin deficiency with excess heat, or heat injuring Yin fluids, severe damage to Yin fluids.
4. Withered White Tongue
Tongue Quality
Color: Pale white, almost bloodless;
Shape: Fat, tender, mild tooth marks, few cracks.
Tongue Coating
Coating Quality: Thin, moist;
Coating Color: White.
Clinical Significance
Yang deficiency, Qi and blood deficiency, Spleen deficiency; Yang deficiency with water retention, internal dampness.
5. Central Coated Tongue Analysis
Tongue Quality
Color: Slightly red;
Shape: Slightly old, few red spots, cracks.
Tongue Coating
Coating Quality: Slightly thick at the edges, central coating;
Coating Color: Light yellow.
Clinical Significance
Deficiency with excess: Yin deficiency, phlegm-heat; or phlegm-damp transforming into heat, injuring stomach Yin.
6. Bright Red Tongue
Tongue Quality
Color: Bright red;
Shape: Tender, bright red.
Tongue Coating
Coating Quality: Glossy, central coating severe, dry;
Coating Color: Slightly thin white coating at the edges.
Clinical Significance
Liver and gallbladder or Spleen and stomach damp-heat (Yang jaundice); excessive heat injuring Yin, heat entering Ying and blood, injuring Yin fluids.
7. Stagnation Spot Tongue
Tongue Quality
Color: Bright red, local dark red, purple spots;
Shape: Slightly thin, red spots, stagnation spots.
Tongue Coating
Coating Quality: Thick at the root, slightly dry;
Coating Color: White coating.
Clinical Significance
Blood heat, blood stasis; heat entering Ying and blood, combined with phlegm-damp.
8. Pale Purple Fat Tongue
Tongue Quality
Color: Pale purple;
Shape: Fat, severe tooth marks, stagnation spots.
Tongue Coating
Coating Quality: Thin;
Coating Color: White.
Clinical Significance
Spleen deficiency with phlegm obstruction, Yang deficiency with blood stasis; Qi deficiency with blood stasis, Qi stagnation with blood stasis.
9. Pale Purple Tongue with Thick White Coating
Tongue Quality
Color: Pale purple, pale white;
Shape: Tender, stagnation spots, stagnation patches, slight cracks.
Tongue Coating
Coating Quality: Wet and slippery, moderately thick;
Coating Color: White.
Clinical Significance
Qi stagnation, Yang deficiency or cold syndrome, phlegm-damp, blood stasis.
10. Red Tip Tongue with Thick Coating
Tongue Quality
Color: Pale white, red tip;
Shape: Tender, red spots at the tip, slight cracks.
Tongue Coating
Coating Quality: Thick, greasy, dry;
Coating Color: White.
Clinical Significance
Qi and blood deficiency, Yang deficiency, cold-damp transforming into dryness and heat; Yang deficiency with damp obstruction, combined with heat evil.
11. Pale White Tongue with Slippery Coating
Tongue Quality
Color: Pale white;
Shape: Slightly tender, cracks.
Tongue Coating
Coating Quality: Thin, few (peeled), slippery;
Coating Color: Thin white (slight yellow).
Clinical Significance
Spleen and stomach Qi deficiency, Yang deficiency with water flooding.
12. Red Tongue with Thick Coating
Tongue Quality
Color: Pale white, interspersed with pale purple, red tip;
Shape: Slightly tender, red spots at the tip, slight cracks.
Tongue Coating
Coating Quality: Thick, greasy, dry;
Coating Color: White, moderately yellow.
Clinical Significance
Spleen Qi deficiency, phlegm-damp accumulation, Qi stagnation with blood stasis; heat in the heart and lungs, phlegm-damp transforming into dryness.
13. Accumulated Powder Coating
Tongue Quality
Color: Covered with tongue coating, red spots at the tip;
Shape: Red spots at the tip, cracks.
Tongue Coating
Coating Quality: Full tongue with accumulated powder coating, dry and rough without fluids;
Coating Color: White.
Clinical Significance
Warm disease (epidemic), sudden evil heat, severe damage to Yin fluids; Yang Qi stagnation.
14. Red Tongue with Yellow Thick Coating
Tongue Quality
Color: Red;
Shape: Slightly old, cracked;
State: Slightly tilted.
Tongue Coating
Coating Quality: Thick, greasy, lubricated;
Coating Color: Yellow, white at the edges.
Clinical Significance
Phlegm-damp, transforming into heat, transforming into turbidity.
15. Burnt Yellow Coating
Tongue Quality
Color: Red;
Shape: Old, cracked at the tip.
Tongue Coating
Coating Quality: Thick, burnt yellow, dry, rough;
Coating Color: Yellow.
Clinical Significance
Evil Qi injuring fluids, dryness causing obstruction in the bowels.
16. Gray Greasy Coating
Tongue Quality
Color: Pale white;
Shape: Slightly tender, few stagnation spots, tooth marks.
Tongue Coating
Coating Quality: Moderately thin, thick at the edges, moist, slightly greasy;
Coating Color: Gray at the edges, moderately thin white.
Clinical Significance
Spleen Qi deficiency, Qi and blood stagnation; long-term phlegm-damp, transforming into turbidity and heat.
17. Peeled Coating
Tongue Quality
Color: Pale white, red at the tip and middle peeling area;
Shape: Tender, tooth marks, red spots at the tip.
Tongue Coating
Coating Quality: Moderately thick at the root, peeling at the edges, greasy, moist;
Coating Color: White, slightly yellow at the root.
Clinical Significance
Deficiency of both Qi and Yin, Spleen deficiency with damp obstruction; internal disturbance of empty fire, or phlegm-damp gradually transforming into heat.
18. Red Crimson Tongue
Tongue Quality
Color: Red with a crimson hue;
Shape: Thin, with red spots at the tip.
Tongue Coating
Coating Quality: Thin, slightly dry;
Coating Color: Slightly yellow.
Clinical Significance
Internal heat blazing, heart and liver fire excess.
19. Pale White Tongue
Tongue Quality
Color: Pale white;
Shape: Tender.
Tongue Coating
Coating Quality: Thin, moist, root greasy;
Coating Color: White.
Clinical Significance
Qi deficiency, Spleen deficiency, Yang deficiency, phlegm-damp.
20. Red Spot Tongue with Thick Coating
Tongue Quality
Color: Light red;
Shape: Slightly tender, slightly thin, red spots at the tip, stagnation spots.
Tongue Coating
Coating Quality: Thick, greasy, moist;
Coating Color: White.
Clinical Significance
Heart fire excess, Spleen Qi deficiency, blood stasis, phlegm-damp.
21. Withered White Tongue
Tongue Quality
Color: Pale white, almost bloodless;
Shape: Tender, thin, mild tooth marks;
State: Slightly tilted to the right.
Tongue Coating
Coating Quality: Thin;
Coating Color: White.
Clinical Significance
Qi and blood deficiency, Spleen Qi deficiency, Spleen Yang deficiency.
22. Cyanotic Purple Tongue with Yellow Greasy Coating
Tongue Quality
Color: Cyanotic purple;
Shape: Slightly tender, slightly thin.
Tongue Coating
Coating Quality: Thick, turbid, moist;
Coating Color: Gray, yellow (slightly gray at the tip).
Clinical Significance
Qi stagnation with blood stasis, phlegm-turbidity with heat, turbid Qi rising.
23. Tongue Bleeding
Tongue Quality
Color: Dark red;
Shape: Slightly old, tongue bleeding (bleeding spots), slight purple spots at the tip and middle with slight cracks.
Tongue Coating
Coating Quality: Moderately thick at the root, greasy, moist;
Coating Color: White.
Clinical Significance
Qi stagnation with blood stasis, phlegm-damp.
24. Slippery Coating
Tongue Quality
Color: Pale white (withered white);
Shape: Tender, slightly thin.
Tongue Coating
Coating Quality: Thick, greasy, slippery (water-covered);
Coating Color: White.
Clinical Significance
Yuan Yang deficiency, water damp obstruction.
25. Pale Purple Tongue
Tongue Quality
Color: Pale white, pale purple;
Shape: Fat, tooth marks, tender.
Tongue Coating
Coating Quality: Thick at the root, moist;
Coating Color: White.
Clinical Significance
Yang deficiency, water damp not transforming.
26. Yellow Dry Greasy Peeled Coating
Tongue Quality
Color: Dark red, slightly pale purple;
Shape: Cracked.
Tongue Coating
Coating Quality: Thick, greasy, middle root peeling, slightly dry;
Coating Color: Yellow.
Clinical Significance
Allergic constitution, Yin deficiency, phlegm-heat obstruction; or phlegm-heat damaging Yin over time.
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