Weekend 3 Tongue (and Pulse reading )

Many thousands of years ago, it is said that a Chinese Emperor sought the help of a doctor for his favourite concubine. Given that it was inconceivable that another man should touch or even see her, a silk sheet was used to provide a barrier. Her tongue (observed through a small slit) and her wrist pulses (felt through the silk), were the only two regions the doctor was allowed access. From this, he had to make an accurate diagnosis and commence treatment. (Bear in mind, his life will have depended on it back then!) These assessment tools however, do remain invaluable in the world of Traditional Chinese Medicine (TCM) to this day.

The tongue and the pulses are apparently connected with the whole body through reflex chains and energy channels, and therefore is a great visual/palpable guide to organ harmony/disharmony present in the body.

There is a recognised mapping system of the tongue which clearly denotes what organs are represented in that area which then gives the practitioner a clue as to the presenting organ disorder. Smoking, drinking and other lifestyle choices may affect the tongue. Variations from the normal may be indicators of disharmony. Changes, therefore, in its presentation during the course of treatment will enable a skilled practitioner to follow the evolution of the patient’s condition.

As a young trainee physiotherapist, I experienced many seemingly embarrassing moments during anatomy training, (when WE were the models assessed in front of 30 peers with only well-chosen underwear to hide our modesty!) Who would have thought that being asked to stick your tongue out in front of your new class mates, 30 years on, would evoke some of the same emotions! But if we were to learn about the tongue this was obviously a necessary process. (I will certainly be mindful of my reticence when I ask patients to do the same for me)

Anyway, moving on, as you would imagine a healthy tongue is a nice pink colour, well-shaped, free of cracks and neither too thick or thin, short or long. Colour changes can be significant findings. A pale tongue is suggestive of digestive problems, dark red -exhausted organic fluids (caused by excessive heat) and purple – problems with the liver and pericardium. (This list is obviously more extensive)

Next, consider the coating on the tongue. It is normal to have a thin coating, as this is a by-product of digestion and as such reflects stomach quality. But changes in its colour, coverage, thickness and even dryness. can all indicate body changes that may need attention.

Seemingly as we age, organs often weaken and increase in size. The same happens with the tongue so that the form of the tongue changes. For example, as vitality in the person decreases, so the tongue reflects that general deficiency at the blood, hormonal and lymphatic levels by appearing thin and shrunken. Swelling of the tongue on the other hand, with teeth marks around the edge, occur with problems of absorption and distribution of important nutrients –it would appear Spleen and Pancreas energy would be prime culprits in this instance.

Cracks, spots and even quivering of the tongue all have their place in diagnosis. Things that I have never really paid much attention to, are now becoming very important, as I embark on my daily tongue diary (strange new year’s resolution I know!)

Pulse Diagnosis to come…Thanks for reading Michelle Kinney Leyland Physiotherapy