Introduction to Tongue Assessment f

Introduction to Tongue Assessment for the Western Herbalist
Many healing systems recognize the tongue as reflecting something about the health of a person, both patterns of overall health or imbalance and the state of particular organs and tissues.

This is one of the most valuable tools available to us herbalists. It’s an accessible, time honored and low-tech skill. Through the interview the herbalist generates a list of problems and symptoms with many possible interpretations and possible remedies. The tongue is a powerful tool for refining our understanding of the individual and moving us toward an effective remedy. I also appreciate that looking at the tongue lends itself easily to sharing observations and insights with whomever I am working, bringing them into the conversation more fully and helping them make sense of their own bodies.

Tongue signs can be used by those practicing from an Ayurvedic model, Traditional Western Herbalism or Traditional Chinese Medicine. I will speak mostly about tongue signs as they fit into the six tissue states model described by Matthew Wood. I find this model to be elegant, flexible and useful. It’s simple enough to learn as an herbal student who is just beginning to think about patterns of health and illness (energetics) yet sophisticated enough to offer a lifetime of deepening refinement for the practitioner. TCM describes many tongue signs that are beyond the scope of this article. These tongue signs play a part in specific TCM diagnoses and may be difficult for the non-TCM practitioner to translate into a Western practice. I encourage you to investigate the resources listed if you are interested in diving more deeply into this subject.

Let’s get started!

Try to look at the tongue in natural, bright light. Move to the window area if you need to. Blood pools in the tongue as it is extended for any length of time making the client’s tongue appear darker and more purple the longer the tongue remains out of the mouth therefore you don’t want the client to hold the tongue out for an extended period of time. If you are new to tongue assessment, don’t be afraid to ask the client to stick it out more than once.

I find that coat (color and quality/quantity), color of tongue body, level of wetness and the the absence or presence of shaking or trembling to be the indications that are the most important to observe. These four signs give us a lot of insight into the patterns of imbalance experienced by the client. They can help determine if the client is experiencing hot, cold, flowing damp, damp -stagnant, dry or tense and conditions. I also keep alert for a few helpful miscellaneous indications, particularly the shape of the tongue body and the presence of inflamed papillae.

When teaching students to assess the tongue I find it’s helpful for students to look at several tongues in succession focusing on one aspect at a time, such as coat, tongue body or wetness level. This is easier for beginners than trying to make sense of the whole tongue at one time. Memorize and internalize these four questions and ask them each time you look at a tongue: How wet is the tongue? What is the coat like? What is the color of the tongue body? Does the tongue tremble or shake? Make a small diagram of the tongue in your notes. This will help you remember what you saw when you review your notes and allow you make note of tongue changes over time from meeting to meeting.

Coat

Everyone has coating on their tongue. Normal coat is thin and white. It is often thicker in the posterior third of the tongue and is often more prominent in the center of the tongue as opposed to the edges or tip. The herbalist should assess the coat for color (usually white or yellow), quantity (thickness) and quality (dry or creamy and greasy).

Bear in mind that coating is the tongue sign that most reflects acute illness. Someone who sees you while they have an upper respiratory infection may have a tongue coating that is quite different than usual. A coat that is thicker, drier, whiter or more yellow are common changes when a person is ill. These signs can help you treat the infection more effectively with warming or cooling remedies for example. Tongue coating can be observed over the course of illness and can change quickly and dramatically.

Tongue coats indicate what I like to call “buildup.” Different healing traditions use a variety of words and concepts to discuss buildup. Toxins, ama,and phlegm are words or concepts you may be familiar with. Too much buildup indicates that a person is bogged down with waste products, function is impeded by stagnation. As mentioned above, a thin white coating is completely normal. Thicker coats indicate greater buildup and the need to disperse the stagnation or cleanse the tissues, allowing the body to throw off the extra burden. Whether the coat is dry or creamy reveals to us the extent to which the person is also dealing a dry or damp imbalance respectively. And the color of the coat white or yellow reveals whether the imbalance is cold or hot, with white generally indicating cold and yellow generally indicating heat.

Tongue Coat: Note the thick, creamy, white coat with peeling patches in the center.
Tongue Coat: Note the thick, creamy, white coat with peeling patches in the center.

Put it all together. It’s easy. A yellow dry coat is dry heat. A yellow, thick, creamy or greasy coat is damp heat. An extremely yellow tongue coat can begin to look somewhat brown. Likewise, thick, creamy or greasy white coat is damp cold and a white dry coat is dry cold. Western herbalism offers such a full, rich materia medica of alteratives that can cleanse every type of constitution from the damp and hot or damp and cold to the cold and dry or cold damp.

Tongue Coat: The coat is primarily thin but is somewhat yellow towards the center/back.
Tongue Coat: The coat is primarily thin but is somewhat yellow towards the center/back.

I’ve never seen a black coat in practice but authors on the subject agree that a black tongue coating is seen in cases of serious illness. In Leslie Tierra’s book, “HealingWith the Herbs of Life” she writes that a grey/black coat when” wet indicates extreme Cold; and dry designates extreme Excess Heat”.

The lack of coat is well described in TCM which views a lack of tongue coat as a sign of Yin Deficiency. In our terms we might understand this as an extremely dry and deficient imbalance and weakened condition likely with secondary heat from a lack of fluidsUsually the tongue body is also quite red and often the withered in appearance. You see this tongue more frequently in thin people with some nervous system/emotional issues, issues of dryness and weakness. Treat with moistening remedies for the atrophic tissue state.

Body Color

Normal color is pale red. Tongue body color is one of the more challenging tongue signs to read. The experience of color is somewhat subjective. In addition, a thick tongue coat may obscure the color in the center (learn to try to look beneath it and around it). Tongue color is rarely uniform throughout the individual tongue. While experts maintain that redness at the tip is a sign of imbalance, in practice this is a very, very common tongue sign and a person may not have any complaints that seem related to this heat.

A deep or bright red tongue body calls for cooling remedies. Many herbs may have a cooling effect. (See Illustration tongues 1, 3, and 4). When assessing for heat is important to also assess for dryness. Some people have heat that may be secondary to a dry condition.

A pale tongue body is a sign of cold and calls for warming remedies. I have noticed that very pale tongues are also often wet, damp tongues that may be fat or flabby. These bodies are calling out for the warming astringents.

A purple cast is sometimes seen in the center of the tongue (See illustration tongues 5 and 6). This spot may be quite small or take up a large proportion of the central tongue body. This as a sign of stagnant blood that calls for dispersing via circulatory stimulants. Purple in the lung area of the tongue may indicate poor circulation and stagnation in the respiratory tract. Many women show purple in the center to back half of the tongue that seems to correlate with stagnant conditions in the pelvic and reproductive organs.

Blue coloration in the tongue is uncommon. This is a tongue sign I find a bit worrisome when I see it. Blue is a more extreme form of blood stagnation than the purple sign. This tongue state calls for warming remedies and powerful blood movers. Every herbalist will have personal favorites. I find Yarrow tests well for these folks and can provide nice results.

Wetness

Wetness is a relatively easy sign to read. Occasionally, you will notice a client attempt scrape all the saliva off their tongue and swallow it before sticking out his or her tongue. Explain that you want to observe the normal wetness of the tongue. Ask her to put the tongue back in the mouth for a few moments and try again this time allowing the saliva to remain on the tongue. A normal level of wetness is moist, but the tongue is not dripping with saliva. There’s no frothy saliva and no streamers of saliva.

Wet tongues with lots of saliva or streamers of saliva indicate a damp condition. Seeing a wet and damp tongue should lead you to consider your favorite astringents, tightening and toning remedies. A dry tongue is easy to spot and should lead you to consider your favorite moistening remedies. These might be mucilage rich emollients/demulcent remedies, but they may also be nutritive, tonic, building or lubricating herbs that increase the flow, retention or absorption of fats, oils and fluids.

Trembling or deviated

The nervous system can be reflected in the tongue as well. When the person sticks out his tongue does it tremble? You might see a delicate little tremble or big jerky moveme

Hasil (Melayu) 1:

Pengenalan kepada penilaian lidah herba Barat yangBanyak sistem penyembuhan mengiktiraf lidah sebagai mencerminkan sesuatu tentang kesihatan seseorang, kedua-dua corak kesihatan secara keseluruhan dan tidak seimbang dan keadaan tisu-tisu dan organ-organ tertentu.Ini adalah salah satu alat terpenting kita herba. Inilah yang boleh diakses, masa berbesar hati dan berteknologi rendah kemahiran. Melalui temu bual dengan pakar herba menjana senarai masalah dan gejala-gejala dengan pelbagai tafsiran yang mungkin dan remedi yang mungkin. Lidah adalah alat yang ampuh untuk Betulkan pemahaman kita mengenai individu dan menggerakkan kita ke arah pemulihan yang berkesan. Saya juga menghargai bahawa melihat lidah meminjamkan sendiri dengan mudah untuk berkongsi pemerhatian dan pandangan dengan sesiapa sahaja yang saya sudah bekerja, membawa mereka menjadi perbualan yang lebih terperinci dan membantu mereka membuat rasa tubuh badan mereka.Tanda-tanda lidah boleh digunakan oleh orang-orang yang mengamalkan dari model Ayurveda, ubatan herba Barat tradisional atau perubatan tradisional Cina. Saya akan bercakap terutamanya mengenai tanda-tanda lidah kerana mereka dimuatkan ke dalam model Syarikat enam tisu yang digambarkan oleh Matthew Wood. Saya dapati model ini supaya elegan, fleksibel dan berguna. Ianya cukup mudah untuk belajar sebagai seorang pelajar herba yang hanya mula berfikir tentang corak kesihatan dan penyakit (energetics) lagi canggih cukup untuk menawarkan seumur hidup mendalamkan penghalusan bagi pengamal. TCM menerangkan tanda-tanda lidah ramai yang di luar skop artikel ini. Tanda-tanda lidah ini memainkan peranan dalam diagnosis TCM yang tertentu dan mungkin sukar untuk pengamal TCM untuk diterjemahkan kepada suatu amalan Barat. Saya menggalakkan anda untuk menyiasat sumber yang disenaraikan jika anda berminat untuk menganalisa lebih mendalam perkara ini. Ayuh kita bermula!Cuba lihat lidah dalam cahaya semulajadi, cerah. Berpindah ke kawasan tingkap tersebut jika anda perlu. Kolam darah di lidah kerana ia dilanjutkan untuk mana-mana tempoh masa membuat lidah klien kelihatan gelap dan lebih ungu lagi lidah masih keluar daripada mulut oleh itu anda tidak mahu pelanggan untuk memegang lidah bagi suatu tempoh masa. Jika anda masih baru lidah penilaian, Jangan takut untuk meminta pelanggan untuk melekat lebih dari sekali.Saya mendapati bahawa kot warna (warna dan kualiti/kuantiti), badan lidah, tahap basah dan ketiadaan atau kehadiran gegaran atau gementar sebagai tanda-tanda yang paling penting untuk memerhati. Tanda-tanda yang empat ini memberi kita banyak wawasan ke dalam corak tidak seimbang yang dialami oleh klien. Mereka boleh membantu menentukan jika pelanggan mengalami Panas, sejuk, mengalir lembap, lembap - bertakung, kering atau tegang dan syarat-syarat. Saya juga perlu berjaga-jaga untuk beberapa pelbagai petunjuk berguna, terutamanya bentuk badan lidah dan kehadiran papillae radang.Apabila mengajar pelajar-pelajar untuk menilai lidah saya mendapati ia adalah berguna untuk pelajar-pelajar untuk melihat beberapa lidah berturut-turut yang menumpukan kepada satu aspek pada satu-satu masa, seperti kot, badan lidah atau basah peringkat. Ini adalah lebih mudah untuk pemula daripada cuba untuk membuat rasa lidah keseluruhan pada satu-satu masa. Menghafal dan internalize persoalan tersebut dan tanya mereka setiap kali anda melihat lidah: Bagaimana basah adalah lidah? Apakah kot seperti? Apakah warna badan lidah? Adakah lidah suara atau goncang? Membuat gambarajah kecil lidahnya dalam Nota anda. Ini akan membantu anda mengingati apa yang anda nampak Bilakah anda menyemak semula Nota anda dan membolehkan anda membuat nota lidah perubahan dari masa ke masa untuk mesyuarat.KotSemua orang mempunyai salutan pada lidah mereka. Normal kot adalah kurus dan putih. Ia sering tebal di ketiga memberi lidah dan adalah lebih menonjol di lidahnya bertentangan dengan tepi atau Petua. Herba yang perlu menilai kot warna (biasanya putih atau kuning), kuantiti (tebal) dan kualiti (kering atau berkrim dan berminyak).Harus diingat bahawa lapisan adalah lidah mendaftar Tempahan menggambarkan penyakit akut. Seseorang yang melihat kamu ketika menghidap jangkitan pernafasan atas mungkin mempunyai salutan lidah yang agak berbeza daripada biasa. Satu lapisan yang tebal, Kering, whiter atau lebih kuning adalah perubahan biasa apabila orang yang sakit. Tanda-tanda ini boleh membantu anda merawat jangkitan dengan lebih berkesan dengan pemanasan atau penyejukan remedi sebagai contoh. Salutan lidah dapat diperhatikan sepanjang penyakit dan boleh berubah dengan cepat dan mendadak.Lidah kot menunjukkan apa yang aku ingin menelefon "pembentukan." Tradisi penyembuhan berbeza menggunakan pelbagai perkataan dan konsep untuk membincangkan pembentukan. Toksin, ama dan kahak adalah perkataan atau konsep yang anda mungkin biasa dengan. Pembentukan terlalu banyak menunjukkan bahawa seseorang adalah bogged dengan produk-produk buangan, fungsi dihalang oleh stagnasi. Seperti yang dinyatakan di atas, lapisan putih nipis adalah benar-benar biasa. Tebal kot menunjukkan tokokan yang lebih tinggi dan perlu Bersurai dalam stagnasi atau membersihkan tisu badan, yang membolehkan badan membuang beban tambahan. Sama ada kot adalah kering atau berkrim mendedahkan kepada kita sejauh mana orang juga berurusan ketidakseimbangan yang kering atau lembap masing-masing. Dan warna kot putih atau kuning mendedahkan sama ada ketidakseimbangan adalah sejuk atau Panas, dengan putih secara amnya menunjukkan sejuk dan kuning secara amnya menunjukkan haba.Lidah kot: Ambil perhatian kot tebal, berkrim, putih dengan tompok-tompok di Pusat mengelupas. Lidah kot: Ambil perhatian kot tebal, berkrim, putih dengan tompok-tompok di Pusat mengelupas.Meletakkan semua bersama-sama. Sangat mudah. Kot kuning kering ialah haba kering. Kot kuning, tebal, krim atau berminyak ialah haba lembap. Satu lidah amat kuning kot boleh mula kelihatan agak coklat. Begitu juga, kot putih yang tebal, krim atau berminyak lembap sejuk dan kering kot putih sejuk kering. Ubatan herba Barat menawarkan tersebut yang penuh, kaya materia medica alteratives yang boleh membersihkan setiap jenis Perlembagaan daripada yang lembap dan panas atau lembap dan sejuk untuk lembap yang sejuk dan kering atau sejuk.Tongue Coat: The coat is primarily thin but is somewhat yellow towards the center/back. Tongue Coat: The coat is primarily thin but is somewhat yellow towards the center/back.I’ve never seen a black coat in practice but authors on the subject agree that a black tongue coating is seen in cases of serious illness. In Leslie Tierra’s book, “HealingWith the Herbs of Life” she writes that a grey/black coat when” wet indicates extreme Cold; and dry designates extreme Excess Heat”.The lack of coat is well described in TCM which views a lack of tongue coat as a sign of Yin Deficiency. In our terms we might understand this as an extremely dry and deficient imbalance and weakened condition likely with secondary heat from a lack of fluidsUsually the tongue body is also quite red and often the withered in appearance. You see this tongue more frequently in thin people with some nervous system/emotional issues, issues of dryness and weakness. Treat with moistening remedies for the atrophic tissue state.Body ColorNormal color is pale red. Tongue body color is one of the more challenging tongue signs to read. The experience of color is somewhat subjective. In addition, a thick tongue coat may obscure the color in the center (learn to try to look beneath it and around it). Tongue color is rarely uniform throughout the individual tongue. While experts maintain that redness at the tip is a sign of imbalance, in practice this is a very, very common tongue sign and a person may not have any complaints that seem related to this heat.A deep or bright red tongue body calls for cooling remedies. Many herbs may have a cooling effect. (See Illustration tongues 1, 3, and 4). When assessing for heat is important to also assess for dryness. Some people have heat that may be secondary to a dry condition.A pale tongue body is a sign of cold and calls for warming remedies. I have noticed that very pale tongues are also often wet, damp tongues that may be fat or flabby. These bodies are calling out for the warming astringents.A purple cast is sometimes seen in the center of the tongue (See illustration tongues 5 and 6). This spot may be quite small or take up a large proportion of the central tongue body. This as a sign of stagnant blood that calls for dispersing via circulatory stimulants. Purple in the lung area of the tongue may indicate poor circulation and stagnation in the respiratory tract. Many women show purple in the center to back half of the tongue that seems to correlate with stagnant conditions in the pelvic and reproductive organs.Blue coloration in the tongue is uncommon. This is a tongue sign I find a bit worrisome when I see it. Blue is a more extreme form of blood stagnation than the purple sign. This tongue state calls for warming remedies and powerful blood movers. Every herbalist will have personal favorites. I find Yarrow tests well for these folks and can provide nice results.WetnessWetness is a relatively easy sign to read. Occasionally, you will notice a client attempt scrape all the saliva off their tongue and swallow it before sticking out his or her tongue. Explain that you want to observe the normal wetness of the tongue. Ask her to put the tongue back in the mouth for a few moments and try again this time allowing the saliva to remain on the tongue. A normal level of wetness is moist, but the tongue is not dripping with saliva. There’s no frothy saliva and no streamers of saliva.Wet tongues with lots of saliva or streamers of saliva indicate a damp condition. Seeing a wet and damp tongue should lead you to consider your favorite astringents, tightening and toning remedies. A dry tongue is easy to spot and should lead you to consider your favorite moistening remedies. These might be mucilage rich emollients/demulcent remedies, but they may also be nutritive, tonic, building or lubricating herbs that increase the flow, retention or absorption of fats, oils and fluids.Trembling or deviatedThe nervous system can be reflected in the tongue as well. When the person sticks out his tongue does it tremble? You might see a delicate little tremble or big jerky moveme