Today, let’s talk about tongue quality. The part of the tongue we observe, the tongue quality, is the area of the tongue body that is not covered by the tongue coating, and there are generally three areas we can observe.
First, when the tongue coating falls off or there are gaps in the coating, we can see the tongue quality on the front of the tongue;
Second, if the tongue coating normally covers the middle of the tongue body, we look at the edges of the tongue, which are generally not fully covered by the coating, revealing a ring of “tongue flesh”; this is the tongue quality;
Third, if we cannot observe the first two, we can look under the tongue, where there is no coating, allowing us to see the tongue quality, which is more authentic, but generally slightly reddish, which we need to correct in our minds.
So, what can we analyze through tongue quality?
We mainly look at the color of the tongue quality. The normal color of the tongue quality is light red, so we often say that a normal person has a light red tongue. Why? Because the structure of the tongue quality is such that: inside is the muscle of the tongue, and outside is a semi-transparent mucosa. Through the semi-transparent mucosa, we see the inside color, which is light red.
If the color of the tongue quality develops in an unfavorable direction, there are two directions: one is towards a pale white color, called pale white tongue, and more severely, withered white tongue, which is rarely seen; when we see a withered white tongue, it indicates that the body is in very poor condition. We often see pale white tongues, which means the color of the tongue quality is not so rosy, but pale white.
The other direction is from light red to red, first becoming a red tongue, then turning into a crimson tongue, which is deep red. Further development leads to a purple-red tongue, with a bluish-black tint, and finally a cyanotic tongue, indicating a deepening color.
What do these changes in tongue quality color represent?
Let’s discuss them separately. If the color of the tongue quality develops towards white, it indicates that there is cold in the body; the further it develops towards white, the cooler and colder the body becomes.
This cold should be understood dynamically. First, it may be due to external cold, which is called excess, meaning there is an excess of cold evil; second, it may be due to internal cold, indicating insufficient yang energy in the body. So, these are two indicators: one is excess, and the other is deficiency. For example, in the north during winter at minus 30 degrees, the external cold makes people susceptible to cold, and if they dress lightly, the color of the tongue will change towards white, indicating external excess.
The other is personal deficiency; for instance, in summer in Sanya, when it is very hot, while others wear short sleeves or swimsuits to go to the sea, you wear a shirt and still feel cool when the wind blows. This indicates that your kidney yang is insufficient, and this cold is internal.
However, whether it is external chill or internal yang deficiency, it indicates that your body is in a cold state. This body cold can be caused by multiple factors; sometimes, external cold and internal cold intertwine, with strong external cold and insufficient internal yang energy.
☜ Yang Deficiency Tongue Appearance
For example, some people drink ice beer, cold drinks, and eat ice cream, which suppresses yang energy. At this time, the internal dampness increases, and yang energy is insufficient. If they then blow cold air from an air conditioner, these individuals will develop towards cold. Therefore, the body’s chill is caused by multiple factors, both external and internal, which can lead to body cold.
◎ Eight-Year-Old Hand Drawing
Several years ago, a young man asked me to find a classmate from the TCM university for him. He had been married for many years, but his wife had not become pregnant. After examination, his wife was found to have no issues, but he sought medical help everywhere without success, and finally came to me. Upon examining his tongue quality, it was pale white with a thick white coating, indicating he had been affected by cold. When I asked, he indeed believed he had no issues and carelessly consumed cold foods, saying, “In winter, I even eat ice pops while lying in bed.” Therefore, despite being young and strong, the long-term consumption of cold foods led his body to develop towards cold, resulting in kidney yang not being able to warm, and of course, reproductive issues arose.
Thus, the old saying in China, “Silly boy, sleeping on a cold kang, relies entirely on strong firepower,” is not unfounded. If this continues for a long time, the body will likely have problems. Later, I helped him with appropriate warming and tonifying, and when his body improved, I asked my classmate to help him with conditioning. I later heard that his child is now several years old, which made me very happy.
The tongue developing towards heat is similar; the color of the tongue gradually turns red, then becomes crimson, and finally turns purple, indicating that internal heat is increasing. This increase in heat is also caused by two factors: one possibility is external environmental heat, such as hot weather; for example, in summer, people’s tongue quality is generally redder than in winter.
I have always emphasized that tongue diagnosis is a dynamic process. I am not saying that the standard tongue appearance remains the same throughout the year or that it is the same in the morning and at night; it is not like that. You need to observe dynamically. Usually, the tongue quality may be slightly white in winter, and then you will notice that in June, when the weather suddenly becomes hot and people start changing clothes, the tongue appearance will change, and the tongue will start to become rosy, indicating that the internal qi and blood are abundant. Therefore, we should observe the tongue appearance in relation to the weather; when the external weather is hot, it will lead the tongue appearance to develop towards red. However, this is within the normal range of heat, so the tongue appearance only slightly turns red.
However, if the increase in external temperature becomes abnormal, such as extremely hot weather, or if you suddenly move from a normal environment to a very hot one, then this change exceeds the normal range, and this external heat is no longer normal; we call it evil qi. This evil qi (warm-heat evil) will cause the tongue to turn red. At the same time, external evil qi can lead to warm diseases; for example, if a person contracts a severe infectious disease, experiences dry stools, sore throat, and fever, this is caused by external evil, which is heat-related, and at this time, the person’s tongue appearance will develop towards red due to external causes.
Yin Deficiency Tongue Appearance ☞
On the other hand, the increase in internal heat can also cause the tongue appearance to turn red. How does internal heat increase? For example, if the body is yin deficient, it will generate heat. What is yin? It refers to the moistening and static fluids in the body, which are called yin, including body fluids and blood. Yin is responsible for moistening and nourishing the static aspects of our body.
It is like the lubricating oil in a car engine; when the engine has lubricating oil, it generates very little heat during operation, which is normal. If you remove the lubricating oil, the machine will generate heat when it runs dry. The human body is similar; when the fluids responsible for moistening are sufficient, the body will not produce much false heat. When these fluids are insufficient, false heat will arise. Therefore, TCM says: “Yin deficiency generates internal heat.”
◎ Image authorized by Baotu Network
Thus, insufficient fluids that are responsible for static and moistening are called yin deficiency, which leads to the generation of internal heat. The greater the internal heat, the redder the tongue quality. Therefore, each color coordinate has two aspects: one is the insufficiency of the body’s righteous qi, and the other is the influence of external factors. These two will have subtle distinctions in tongue appearance.
Regardless, the color of the tongue quality changing from pale white to light red, then to red, crimson, and purple signifies what? It indicates that this process reflects the increase of internal heat, transitioning from cold to heat, whether due to internal or external reasons, will certainly be reflected in the tongue appearance.
Thus, by observing the changes in tongue color, we can determine the internal state of the body. If external heat is excessive, we will clear heat; if internal yin is insufficient, we will nourish yin. After supplementing the moistening substances, the false heat will decrease, and the tongue color will return to normal. Therefore, the heat generated by internal yin deficiency is called false heat; the heat caused by external evil invasion or internal blood stasis is called real heat.
False heat and real heat require different methods of adjustment. For false heat, we supplement it; for insufficiency, we nourish it, and gradually it will return to normal. If there is excessive external evil, we can clear it away easily. However, this area is very easy to confuse, including many TCM practitioners when adjusting the body, whether it is real heat or false heat requires careful consideration. Why? Because real heat and false heat can sometimes combine, and we need to consider the proportion.
Therefore, sometimes, if a person’s tongue is red, giving them Huanglian (Coptis) or Lianqiao (Forsythia) to clear heat may not work; giving them Shengdi (Rehmannia), Shashen (Glehnia), or Maidong (Ophiopogon) to nourish yin will normalize the tongue color, indicating that there is false heat in the body. We should supplement it. Thus, some people with yin deficiency have red tongues, and they mistakenly believe they have heat and try to clear heat by taking detoxifying pills, which is incorrect. At this time, taking such heat-clearing medications may provide temporary relief, but it will soon relapse and worsen. However, if nourishing yin medications are used, the body will improve.
Sometimes, it can be the opposite; no matter how much you nourish yin, it doesn’t work, but clearing heat resolves the issue, indicating real heat. Sometimes, false heat and real heat combine; when external heat is excessive, it will consume internal fluids, so you need to clear heat while adding some yin nourishment. After the heat evil decreases, you can increase the yin nourishment. This process is a lever, a two-way adjustment process. This is a consideration needed when adjusting the body.
— THE END —
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