Observation of the tongue
Observation of the tongue is a unique diagnostic method in TCM which can judge the conditions of vital qi, and distinguish the depth of the location of the disease, differentiate the nature of the pathogenic factors and the deterioration or improvement of the disease. That is why the tongue diagnosis is very much emphasized in clinic. The normal infantile tongue is characterized by softness, flexibility, pale reddish tongue proper, thin and whitish fur as well as moderate humidity. The tongue of the new born babies is tender, reddish and furless.
Observation of the tongue proper
Pale tongue proper indicates asthenia of both qi and blood; reddish tip and margin of the tongue indicates exogenous wind and heat; prickly reddish tongue indicates abundance of interior heat; red or crimson tongue indicates invasion of heat into ying-blood; reddish tongue without fur indicates consumption of body fluid; purplish tongue indicates stagnation of qi and blood; tongue as red as bayberry indicates scarlet fever caused by toxin of heat; bulgy and tender tongue with tooth prints usually indicates asthenia of the spleen and kidney yang or retention of fluid or phlegm; swollen and purplish tongue indicates poisoning; stiffness of the tongue indicates consumption of body fluid by predominant heat; shrunk, crimson and dry tongue is usually caused by contraction of the meridians due to malnutrition resulting from consumption of body fluid in febrile diseases; ulceration of the tongue indicates aphtha due to hyperactivity of heart fire; wagging of the tongue usually indicates hypophrenia or omen of convulsion.
Observation of tongue fur
Whitish thin fur indicates exogenous wind-cold; whitish greasy fur indicates retention of cold dampness or internal accumulation of phlegm-dampness; thick and greasy fur or fur with thick hard greasiness indicates retention of food; yellowish greasy fur indicates internal accumulation of damp heat or stagnation of phlegmatic heat:blackish dry fur indicates fire transformed from stagnation of dampness and consumption of body fluid; exfoliative fur like map indicates disturbance of gastrosplenic functions and insufficiency of qi and yin mirror-like glossy tongue
indicates exhaustion of body fluid and severe consumption of stomach qi.
The tongue should be observed under natural light and attention should be paid to the protrusion of the tongue. If the tip of the tongue is raised, the tip and margin of the tongue will appear reddish. Repeated forceful protrusion of the tongue may make the tongue appear reddish. In the inspection of the tongue, attention should also be paid to the stained fur with certain food or drugs. Usually stained fur is bright and shallow in colour, different from the diseased fur. If the doctor feels doubtful, he or she should ask the child or his or her parents. For exam-
ple, hawthorn and olive fruit may make the tongue turn blackish yolk, tangerine and ovoflavin may make the tongue appear yellowish; bayberry, grape and vinegar
may make the tongue look blackish brown; red-colored sugar or fruit may make the tongue appear reddish; milk and soy-bean milk will make the tongue turn whitish.
These are all false manifestations of the tongue and should not be taken as morbid.