(2) Yellow coating: Yellow coating is the main internal heat syndrome. If the moss is thin, yellow, thick and dry, the heat inside will be abundant and the body fluid will be damaged. The yellow fur is dry and prickly, and the tongue is dry and cracked, which is characterized by extremely intense internal heat, severe bodily fluid injury, and hot viscera. Thick and greasy tongue coating is mostly caused by phlegm-heat, food retention or damp heat. The tongue coating is yellow and smooth, showing yang deficiency.
(3) Gray moss: the main internal syndrome. The fur is thin and slippery, mostly due to internal cold and dampness, or phlegm. The fur is gray and dry, which is a fever or a fire of yin deficiency.
(4) Black coating: Black coating is mostly transformed from yellow coating or gray coating, indicating that the condition is extremely serious. Black and dry fur is caused by insufficient heat and body fluid. The tip of the tongue is black and dry, full of heart fire. The coating is black and slippery, and it is extremely rich in yang deficiency and yin cold.
Finally, let me talk about the knowledge of moss. Quality of tongue coating refers to the shape and texture of tongue coating. Mainly observe the thickness, dryness, rot, peeling, rootlessness and deviation of moss.
(1) Thick moss and thin moss:
The thickness of moss depends on the bottom and the bottom. You can see the tongue coating through it, which is called thin coating, otherwise it is thick coating. The tongue coating is thin and the condition is generally mild; Thick tongue coating indicates serious illness. In the process of disease development, the tongue coating becomes thicker from thin, indicating that pathogenic factors enter the body and the condition changes from mild to severe; If the tongue coating turns from thick to thin, it means that the condition is exposed and the condition is getting better.
(2) Wet and dry moss:
Tongue coating lubricates a variety of body fluids and is not damaged by body fluids, which is called moistening coating. The tongue coating is dry and lacks body fluid, which is called dry coating. If the tongue coating is dry and yellow, the stomach is overheated and the body fluid is damaged. Dry and black tongue coating is a yin injury caused by extreme heat. If the tongue coating is dry, dull and prickly, it belongs to the exhaustion of body fluid.
(3) Rotten fur:
Moss particles are fine, thick in the middle, thin in the edge and easy to scrape off, which is called greasy moss. Moss particles are large, loose and thick, like bean curd residue piled up on the tongue surface. What is easy to scrape is called rotten moss. Greasy coating is common in damp turbidity, phlegm turbidity, food retention, damp temperature, etc. Rotten fur is the syndrome of indigestion in the stomach and phlegm turbidity causing sores. The tongue coating is white and greasy, mostly due to wet phlegm or stomach yang deficiency. The tongue coating is yellow and greasy, mostly phlegm-heat, and food stagnation turns to heat. Thick and rotten tongue coating, mostly due to food accumulation in the gastrointestinal tract. The tongue coating is covered with white clothes, called chyme, which means that the stomach qi drops.
(4) peeling off the moss:
The tongue used to be covered with moss. If it disappears partially or completely, it is called exfoliative moss. If all the moss falls off, it means that the stomach yin fails, which greatly hurts the stomach qi. If the tongue coating is not completely peeled off and the peeling place is smooth and without coating, it is called flower peeling, indicating that the stomach is injured by both qi and yin. If the tongue coating is not smooth, there are similar new particles, which are called shedding, indicating that the patient's blood gas is discontinuous. If most of the tongue coating falls off, only a small piece is left, which is called chicken heart tongue, which is a syndrome of deficiency of both stomach qi and yin. In addition, the tongue coating from there to there is due to the deficiency of both qi and yin in the stomach and the gradual decline of healthy qi; If the tongue coating becomes thinner and whiter from scratch, it means that the condition is improving.
(5) Rooted and rootless moss:
Tongue coating clings to the surface of the tongue and cannot be scraped off, which is called tongue root coating. If the tongue coating seems to cover the surface of the tongue, it will easily fall off, which is called rootless coating. Root coating shows that patients have stomach qi, which is common in excess syndrome and heat syndrome; Root-free coating indicates that stomach qi is decreased, which is seen in deficiency syndrome and cold syndrome. If there is a thin root moss, which belongs to normal moss, it means that healthy qi is not injured; If the rootless moss is thin or thick, it will be scraped off, and no new moss will be generated, indicating the decline of healthy qi.
(6) Full and partial coating:
Tongue coating covers the whole tongue, which is called full coating. Tongue coating is only distributed in a certain part of the tongue, which is called partial coating. The whole fur represents the syndrome of damp phlegm blocking middle energizer. If there is only moss on the tip of the tongue, it is that the disease is not deep and the stomach gas is injured. If there is no coating on the tip of the tongue and the rest is coated, it means that there is stagnation or phlegm in the gastrointestinal tract. The tongue coating is on the left or right, indicating that the disease is half-exterior and half-interior, and the liver and gallbladder may also have damp heat; No coating in the center of tongue, thick coating on the edge of tongue and thin coating in the center are syndromes of yin deficiency, stomach gas injury or blood deficiency.
Identification method of black moss disease
The appearance of black moss often indicates a serious disease, or excessive use of antibiotics, or it may be caused by poor oral hygiene. The decoction of Coptidis Rhizoma 10g can be applied to black moss several times a day. If the black fur becomes shorter and softer, and the color becomes lighter or disappears, it means that the black fur is caused by poor oral hygiene. Otherwise, we should find out the reason.
Differential diagnosis of diseases by diamond-shaped shedding of tongue coating
There is a diamond-shaped peeling area in the center of the tongue surface, which is likely to be diabetes. At this moment, if symptoms such as overeating, hunger, thirst and weight loss occur at the same time, we should pay more attention.
Identification method of strawberry tongue's disease
The patient's tongue nipple is swollen, red and swollen, and looks like a red strawberry named strawberry tongue. At this time, if you have a high fever and there are tiny spots on your skin, you probably have scarlet fever. -It's painful to eat here.
Differentiation of diseases by stripping tongue coating with flowers
Flower peeling tongue coating is also called map tongue coating, which shows that a part of tongue coating is peeled off, revealing red tongue quality. The appearance of this kind of moss on children is often a sign of poor health. Such children often have allergic constitution and are prone to allergic diseases such as asthma and tinea lactis. Children who are partial to food and don't like fresh vegetables, or children who are malnourished, have parasites in the intestines and often catch a cold are also prone to peeling. The moss seen by adults is the expression of yin deficiency and blood deficiency; Seeing flowers peeling at the front end of tongue is deficiency of heart yin; Exfoliation of tongue root is yin deficiency of liver and kidney.
Syndrome differentiation of tongue pulse
When the tip of the tongue is rolled up, two veins can be seen at the base of the tongue, and normal people only faintly appear under the tongue. If its diameter is more than 2.7 mm and its length is more than three-fifths of the connecting line between the tip of the tongue and the terminal point of the lingual frenulum, it is considered pathological. Sometimes blue spots or countless small vascular plexus can be seen at the same time. It reflects the phenomenon of blood stasis in the whole body or an organ. Abnormal indexes such as hematocrit and blood viscosity often appear in blood tests.
[Edit this paragraph] Attachment: Advantages and disadvantages of tongue coating scraping
If you are often worried about thick and greasy tongue coating and being troubled by bad breath, you will definitely want to buy a gadget called "tongue coating scraper" on the market to try. Wait a minute! Let's listen to the experts' opinions on that gadget first.
Dr. Hua Hong from the Department of Mucosa, Peking University Stomatological Hospital made it clear that the tongue coating should not be scraped casually. Dr. Hua told reporters that tongue coating refers to a thin layer of dirt covering the surface of the tongue, which is an important content of tongue diagnosis in traditional Chinese medicine. By observing the texture and color of tongue coating, doctors can infer the deficiency and deficiency of patients' viscera function, distinguish the strength of digestive function and reflect the depth and nature of diseases. Normal people's tongue coating should be thin and white. If there is something wrong with the body, the thickness of the tongue coating will change. If the tongue coating turns from thin to thick, it means that the disease is from the outside to the inside, accompanied by symptoms such as indigestion, abdominal distension and nausea. The tongue coating is greasy and rotten, which may be due to phlegm dampness or food accumulation in the body. In addition, the tongue coating becomes thick and greasy, which may also be due to loss of appetite after illness, frequent eating of soft food and liquid, which reduces the mechanical friction effect of the tongue, or because of fever and dehydration, saliva secretion is reduced, and cleaning effect is reduced, which affects the self-cleaning effect of the tongue and accumulates exudates on the tongue surface. So once the tongue coating becomes thick and greasy, or the color is black and smelly, you should go to the hospital first. If you shave yourself first, it will affect the doctor's diagnosis.
Frequent scraping of tongue coating will stimulate taste buds, damage tongue nipples, cause numbness of tongue roots, reduce taste and appetite, and then affect health.
Dr. Hua said that in order to maintain oral hygiene, some simple methods can be used to clean the tongue surface. Including gently brushing the tongue surface with a special soft brush. If you can't buy a special soft brush, you can use a toothbrush, but you must not use too much force. You can also rinse your mouth with salt water and mouthwash, or rinse the root of your tongue with a tooth washer. Remember not to scrape the tongue coating with hard plates and sharp things.
Observing the changes of tongue coating can check stomach diseases.
Chinese medicine pays attention to seeing, listening and asking questions, and attaches importance to the change of tongue coating. By observing the tongue picture, we can understand and understand the essence and development of the disease. The same is true for the treatment of stomach diseases. The change of tongue coating can really reflect some laws of spleen and stomach diseases.
If patients with stomach diseases carefully observe their tongue coating, they will often find some abnormalities: some are particularly thick and greasy, some are black, some are yellow, and some fall off. If a person's tongue coating is abnormal for a long time, others will kindly remind him: go and see if there is stomach trouble! In fact, the change of tongue coating can really reflect the law of diseases, especially some spleen and stomach diseases.
How to observe and analyze tongue images
Stick out your tongue is also learned. Stick out your tongue naturally, relax your tongue, spread it flat, slightly lower the tip of your tongue, open your mouth as wide as possible (but don't use too much force) and fully expose your tongue. If the tongue is stretched too hard, or the tongue is tense and curled, it will affect the blood circulation of the tongue, causing the change of tongue color or the change of tongue dryness and wetness.
Look at the tongue in order. Generally, look at the tip of the tongue first, then at the middle and side of the tongue, and finally at the root of the tongue. At the same time, look at the color of the tongue body (tongue substance), the thickness and color of the tongue coating.
Observe two key points of tongue diagnosis, mainly observing the changes of tongue body and tongue coating. What color is the tongue? Is the shape fat or thin? Is the texture shiny or dry? Is the activity flexible? Tongue coating-Is the tongue coating thick or thin, wet or dry? Is the moss white, yellow or brown?
The characteristics of normal tongue picture Normal tongue picture can be summarized as "red tongue with thin white fur". Specifically, the tongue color is reddish and bright, the tongue quality is moist, the tongue body is moderate in size, soft and elastic, and the tongue coating is even, thin and white.
Generally speaking, the tongue coating changes from thin to thick for disease progression, and from thick to thin for disease regression.
Common tongue images of patients with gastric diseases are:
Thin white fur-the disease begins at the beginning, and the disease is mild, and the stomach gas is not hurt;
The tongue coating turns from thin to thick, the color turns from white to a little yellow, the tip of the tongue turns from pale red to red, and there are teeth marks on the tongue-the condition is aggravated, suggesting indigestion, gastrointestinal stagnation, and so on;
The tongue coating turns from white to yellow, and the edge of the tongue is red-there is a heat image;
The tongue coating turns from yellow to brown, or from brown to black, and it is dry and less fluid, and the tip of the tongue turns dark red-hot, often accompanied by dry stool;
The tongue coating is thick and greasy, and there is a layer of white mucus on the tongue surface-phlegm dampness;
The tongue coating is thick and greasy, and the tip of the tongue is red and hot;
The tip of the tongue is crimson, even purple-blood in the sputum;
Red tongue without coating, smooth as a mirror-stomach yin deficiency; Tongue coating peeling, pale tongue-deficiency of both qi and yin.
According to the above different tongue images, combined with other diagnostic methods such as smell, questioning and pulse-taking, TCM can make comprehensive analysis and treat according to syndrome differentiation.
Abnormal tongue picture that can be nursed back to health by itself
Thick tongue coating and heavy breath If a person has thick tongue coating and heavy breath all the year round, it generally means that there is something wrong with the stomach. If there are no other uncomfortable feelings at present, you can start with diet and daily life. Keep a regular life, feel comfortable and happy, eat digestible food, eat more vegetables and fruits, eat less greasy and fried food, and it is best not to drink or smoke. After a period of nursed back to health, abnormal tongue coating and breath are expected to heal themselves.
The tongue coating is black and sticky. If you only see this abnormal tongue coating, the tip of the tongue is normal and reddish, and there is no other obvious discomfort, sometimes it belongs to the phenomenon of "staining". The patient may have eaten some colored food or taken some drugs. For example, taking "Julie Dole" will lead to black fur and black stool; When taking antibiotics, sometimes there will be black moss. The above situation is not morbid, so don't be nervous. However, patients with severe stomach diseases should also be vigilant when observing black moss. If the tip of the tongue is crimson or even blue, it means that the condition is getting worse and you should go to the hospital in time.
Some people have irregular "map-like" changes in tongue coating, some places are thin and some places are smooth without coating. This is called "map tongue". If people with this tongue picture don't feel any discomfort, it's mostly physiological changes and don't need treatment. If you have stomach trouble or other chronic diseases for a long time, you must have never seen such a tongue picture before. If you have a "map tongue", it is mostly a manifestation of yin deficiency. While treating the primary disease, you can drink American ginseng tea (9 grams per day, brewed with boiling water and frequently drunk) to promote self-healing.
People with cracks also have many "cracks" on their tongues, and most of them have no tongue coating, which is called "cracked tongue". If there is no discomfort, it is also physiological and does not need treatment. For example, after a serious illness, there is a cleft tongue, red tongue without coating, and discomfort, which also belongs to yin deficiency and needs medical treatment.
Some people with teeth marks on the tongue are fat, and the tongue body is also fat. There are teeth marks on the tongue and the tongue coating is thin and white. If there is no obvious discomfort, it is too fat. According to the theory of traditional Chinese medicine, "Fat people are full of phlegm and dampness", and the spleen and stomach transport function of fat people is relatively insufficient, so the digestion and absorption of food are prone to obstacles. These people should eat less greasy and indigestible food, eat more vegetables and fruits and light food, and exercise properly. If the tongue coating is thick and greasy, there are teeth marks on the edge of the tongue, you don't want to eat, abdominal distension is full, and loose stool is thin, which belongs to excessive phlegm and dampness. You should cooperate with drug treatment and eat light and digestible food at the same time.
Some people with red tongue, thick coating and constipation don't understand the stool for a few days. Bad breath, thick coating, red tongue edge and yellow urine belong to stomach fire. The stomach is full of fiery heat, and the turbid gas rushes up and fumigates the mouth and tongue, so bad breath, yellow tongue coating, heat injury to body fluid and intestinal disharmony lead to dry stool. At this time, you can take rhubarb, coptis root, scutellaria root, gardenia and other traditional Chinese medicines for clearing away heat and purging fire. In diet, avoid alcohol and spicy food, such as pepper and mutton, eat more vegetables, fruits and light food, and drink more water.
Tongue image of patients with atrophic gastritis
The following three patients diagnosed as "atrophic gastritis of gastric antrum" by gastroscope have completely different tongue pictures, symptoms and TCM diagnosis. Of course, the treatment principles and medication are also different, which is the characteristic of TCM treatment based on syndrome differentiation.
Tongue picture: the tongue coating is thin and white, the tongue is purple, and there are petechiae on the tip of the tongue.
Symptoms: repeated dull pain in the upper abdomen, aversion to heat and cold, and spitting water.
Diagnosis: spleen and stomach deficiency and cold
Tongue picture: the tongue coating is yellow and thick, the base of the tongue is gray and black, and the tip of the tongue is dark red.
Symptoms: upper abdominal pain, local pain, and the pain is aggravated after eating.
Diagnosis: phlegm-heat with blood stasis in stomach.
Tongue picture: the tongue coating is thin, white and yellowish, with peeling coating in the middle and front of the tongue, red tongue and little body fluid.
Symptoms: dull pain in the upper abdomen, loss of appetite and dry mouth. Diagnosis: insufficient stomach yin.