Tongue Diagnosis – Lingual Coating Inspection

Flashcards covering key diagnostic features of lingual coating (color, thickness, humidity, quality, distribution, peeling, rootedness) and sublingual vessels.

What are the seven main aspects inspected in the lingual coating during tongue diagnosis?

Color, thickness, humidity (moisture), quality (texture), distribution, presence of peeling, and whether the coating is rooted or superficial/growing or declining.

What does a white thin tongue coating usually indicate?

Exterior or cold syndrome.

Which condition is suggested by a white thin and slippery tongue coating?

External pathogen invasion caused by Wind-Cold.

A white slippery and sticky coating signals what internal condition?

Existence of internal dampness or phlegm.

What does a white tender and slippery coating that can be scraped off completely suggest?

Interior deficiency cold syndrome.

What does a white coating on a crimson (deep-red) tongue indicate?

Containment of dampness by hidden Heat.

A white coating that looks like a layer of accumulated white powder is characteristic of what disorder?

Serious filthy Turbidity in epidemic febrile diseases.

What does a white thick, dry, cracked coating with sand-like granules imply?

Sudden and violent internal Heat accompanied by extreme exhaustion of body fluids.

What syndrome does a yellow thin coating generally represent?

Interior or Heat syndrome; the deeper the yellow, the higher the Heat.

A light-yellow, still-moist coating means what about the pathogen?

The external pathogen has begun to invade the interior.

What does a yellow thick, dry coating point to?

Exuberance of internal heat with consumption of body fluids.

A scorching yellow, dry, cracked coating indicates what?

Extreme exuberance of internal heat and depletion of body fluids.

Which conditions are associated with a yellow, slippery, greasy coating?

Accumulation of Damp-Heat in the Spleen & Stomach or internal Heat complicated by Phlegm Turbidity.

Grey-colored coating (light black) generally signifies what type of syndrome?

Interior syndrome.

What does a grey, dry coating reflect?

Exuberance of Heat with depletion of body fluids.

A grey, moist coating usually indicates what?

Internal obstruction due to Cold-Dampness.

What can a black tongue coating signify?

Extreme internal Heat or extreme internal Cold, often at a critical stage.

Black, dry, cracked or prickled coating is evidence of what?

Extreme Heat with Genuine Yin about to be exhausted.

What does a black, moist, slippery coating indicate?

Presence of obstinate Cold-Dampness.

From the perspective of thickness, what does a thin tongue coating tell about the disease?

Mild disorder or exterior syndrome; righteous Qi intact and condition not serious.

What does a thick tongue coating reveal?

Serious disorder, exuberant pathogenic evils, interior syndrome, or accumulation/retention of Phlegm, Dampness, Turbidity, body fluids or food.

If a coating changes from thin to thick, what does that signify?

The disease is advancing or getting deeper.

What does a change from thick coating to thin coating suggest?

The disease is retreating or improving.

What does a moist tongue coating say about body fluids?

Body fluids have not been damaged.

A slippery tongue coating is associated with which pathogenic factors?

Dampness, Cold, or upward outflow of Phlegm/Fluid due to decline of Yang or Vital Energy.

What underlying issues are indicated by a dry tongue coating?

Exuberance of Heat, exhaustion of Yin or body fluids, or failure of upward transportation of fluids due to Yang/Qi deficiency.

A shift in coating humidity from moist to dry (or vice-versa) signals what?

A corresponding change in the pathological state.

What is a corroded tongue coating and what does it suggest?

Thick, loose, bean-dreg-like coating that is easily wiped off; indicates food retention or accumulation of Phlegm/Turbidity.

Describe a greasy tongue coating and its clinical significance.

Slimy, oily layer that cannot be wiped off; denotes Dampness/Turbidity, Phlegm, or food retention.

What can the distribution of the tongue coating (complete vs partial) tell the practitioner?

Complete coating covers the entire tongue; partial coatings at anterior, posterior, medial, or lateral areas may indicate localized organ pathology.

What is the fundamental cause of peeling off of the lingual coating?

Depletion of both Stomach Qi and Stomach Yin.

What does it mean when a thick piece of coating peels off leaving a red, dry surface?

An ominous sign indicating severe depletion of Stomach Qi and Yin.

Multiple peeling sites with clear margins on the tongue produce what appearance and signify what?

Geographic tongue; reflects instability or deficiency of Stomach Qi and Yin.

Complete loss of coating producing a mirror-like tongue indicates what?

Severe exhaustion of Stomach Qi and Yin.

What is meant by a "rooted" versus "rootless" tongue coating?

Rooted coating is firmly attached to papillae (strong Stomach Qi); rootless coating is loose or easily wiped away (weak Stomach Qi).

Which observable changes in sublingual vessel collaterals assist diagnosis?

Tortuosity or varicosity, distended/engorged vessels, or thin/slender collaterals.