Diagnostics of

Traditional Chinese Medicine

Yuan WeiLing

2018.11
Inspection
 Inspection
• Observing the patient’s external conditions to know
the patient’s health condition and infer the state of
the illness
• Inspection of the whole body
• Inspection of the local regions
• Inspection of the tongue
 Inspection of the whole body

• Spirit
• Complexion
• Body
• Postures
 Inspection of the spirit
• 1.Existence of spirit

• 2.Lack of spirit (insufficiency of spirit)

• 3.Loss of spirit (depletion of spirit)

• 4.False spirit

• 5.Mental derangement
 Inspection of the spirit
• Existence of spirit
Project Manifestation
Mental consciousness Normal vitality
Facial expressions Natural
Complexion Ruddy
Eyes Flexible and brightness
Verbal expression and reply Accurate
Voice and breath Normal
Limbs Normal and natural movement

These manifestations suggest non-impairment of healthy qi,

normal visceral functions,mild pathological conditions,
or favourable prognosis,even for serious diseases.
 Inspection of the spirit
• Lack of spirit (insufficiency of spirit)

Project Manifestation
Mental consciousness Dispiritedness
Complexion Pale
Eyes Dull
Breath Short
No desire to speak and low voice

These manifestations suggest mild consumption of healthy qi, weak visceral

functions, more serious disease and better prognosis. These manifestations
are usually seen in patients at the rehabilitating stage or with weak
constitution.
 Inspection of the spirit
• Loss of spirit (depletion of spirit)
Project Manifestation
Mental consciousness Dispiritedness
Complexion Pale
Eyes Dull
Breath Weak or dyspnea
Body Emaciation,Difficulty in movement,
Retard response
Consciousness Anesthesia or coma with delirium and
floccitation
These manifestations suggest great impairment of the primordial and decline
of the visceral functions, usually seen in chronic disease and serious disease
with unfavourable prognosis or suggest exuberance of pathogenic factors
and serious disturbance of the viscera, often seen in critical pathological
conditions with unfavourable prognosis.
 Inspection of the spirit
• False spirit
Project Manifestation
Complexion Dull or pale complexion suddenly
changes into reddish cheeks
Consciousness extreme dispiritedness, mental
derangement and retard response
suddenly change into excitation but with
restlessness
Voice No desire to speak, low and weak voice
and incoherent speech suddenly change
into incessant, but simply repeated talking

These phenomena indicate declination sof essence and floating of yang due to
failure of yin to control yang. This condition is clinically known as"the last
radiance of the setting sun“---- the premonitory signs of death
 Inspection of the spirit
• Mental derangement
 Inspection of the spirit
• Mental derangement
Project Manifestation
Stagnation of phlegm which confuses the Indifferent expression；taciturn and
mind depression, followed by being in a trance,
now laughing and then crying
Disturbance of the heart by phlegmatic Dysphoria, running wildly, shouting,
fire fighting against people or even family
members
Endogenous liver wind and phlegm Sudden coma, drooling, staring upwards,
confusing the mind convulsion of limbs and groaning like pig
and goat usually indicate epilepsy
 Inspection of the complexion
• 1.Normal complexion
• 1.1 Dominant complexion
• 1.2 Varied complexion
• 2.Morbid complexion
• （Diseases indicated by the five kinds of colour：
• Red，White，Yellow，Bluish，Blackish）
 Inspection of the complexion
• Normal complexion： ruddy and lustrous

Indicating exuberance of visceral essence and normal functions of the visceral,

and it can be divided into dominant complexion and varied complexion.

Dominant complexion: the colour of the skin and face that never changes due to
racial and constitutional factors.
Varied complexion: the changes of the facial and skin color in correspondence
to the variations of the seasons and climates.
 Inspection of the complexion
• Morbid complexion:
Facial colour during the course of disease is called morbid complexion marked by dry
and dull colour, or obvious bright colour, or a single colour alone.
Diseases indicated by the five kinds of colour:
Colour Five zang organs
Bluish Liver
Red Heart
White Lung
Yellow Spleen
Blackish Kidney
 Inspection of the complexion
• Diagnostic significance of the
five colors
• Bluish color
• Cold syndrome

• Pain

• Qi stagnancy

• Blood stasis
 Inspection of the complexion
• Diagnostic significance of the five colors

• Red color
• Heat syndrome

• False heat syndrome

 Inspection of the complexion
• Diagnostic significance of
the five colors
• Yellow color
• Spleen deficiency

• Dampness

• Jaundice
 Inspection of the complexion
• Diagnostic significance of
the five colors
• White color
• Asthenia syndrome

• Cold syndrome
 Inspection of the complexion
• Diagnostic significance of the five colors

• Blackish color
• Kidney asthenia syndrome

• Cold syndrome

• Blood stasis syndrome

• Fluid retention syndrome

 Inspection of the body
• Physical strength and weakness

• Physical obesity and emaciation

• Deformity
 Inspection of the body
• Physical strength and weakness
Strength Weakness
lustrous skin dry skin
strong muscles lean muscles
wide chest thin chest
thick bones thin bones
indicate sufficiency of qi;powerful functions indicate insufficiency of qi;weak functions
of the viscera of the viscera
 Inspection of the body
• Physical obesity and emaciation
Obesity Emaciation
round head long head
short and thick neck thin and long neck
wide and flat shoulders narrow shoulders
wide short round chest narrow and flat chest
big belly small belly
smaller body higher body
flabby muscles thin muscles
dispirtedness and lassitude dryness of skin
The sign of predomination of the body and The sign of asthenia of blood and internal
asthenia of qi pulmonary tuberculosis and internal
exuberance of asthenic fire
 Inspection of the body
• Deformity:includes chicken chest and tortoise back
Chicken chest: It refers to the evident protrusion of the lower part of
sternum marked by longer posterior and anterior
diameter and shorter left and right diameter of the
thoracic cavity, usually seen in children.
Tortoise back: It refers to protrusion of the spinal column.
Both cases are caused by congenital defects or postnatal malnutrition which
lead to insufficiency of kidney essence and maldevelopment of
the bones.
 Inspection of the postures
•Inspection of postures in tranquility and action
Movement, supination and extension indicate that the disease of
Sitting yang nature usually manifesting as external syndrome, heat
syndrome and sthenia syndrome;
Lying
Quietness, pronation and bending indicate the disease of yin nature,
Walking usually manifesting as internal syndrome, cold syndrome and
asthenia syndrome.

•Inspection of abnormal movements

 Inspection of the postures
Sitting

Performance Diagnosis

head bending down, shortness of breath asthenia of pulmonary qi or failure of the kidney to
and no desire to speak receive qi

head rising up cand asthmatic breath pulmonary sthenia

signifies adverse flow of qi

asthma with inability to lie down pulmonary distension and retention of fluid in the
chest and abdomen.
 Inspection of the postures
Lying
Performance Diagnosis
lying on bed facing the outward with the ability to turn the yang syndrome, heat syndrome and sthenia syndrome
body freely
lying on bed facing the inward with inability to turn the yin syndrome, cold syndrome and asthenia
body freely sydrome
lying on a supine position with the extension of the limbs syndrome of predominant yang and sthenic heat
and refusal to cover quilt and put on clothes
huddling up when lying on bed with preference to put on yin sthenia and yang asthenia or abdominal pain
more clothes
inability to lie down due to cough usually occurs in autumn internal retention of fluid
and winter
lying on bed with inability to sit up(sitting up causes asthenia of both qi and blood
dizziness)
 Inspection of the postures
Walking

Unstable walking with tremor of the limbs usually occurs

together with dizziness, usually caused by internal
disturbance of liver wind or impairment of tendons and
bones.
 Inspection of the postures
Abnormal movements
Diagnosis
spasm of the limbs, stiff necks and opisthotonus internal disturbance of liver wind due to extreme heat
generating wind, usually seen in exogenous febrile disease
at the stage of exuberant heat

tremor or peristalsis of fingers and toes internal disturbance of asthenic wind

pain of the limbs and joints, inflexibility of the joints obstructive syndrome
or spasm of the hands and feet as well as swelling,
stiffness and deformity of the joints

flabbiness of the limbs and difficulty in moving or flaccidity syndrome

atrophy of muscles

difficulty in moving or numbness of unilateral limbs hemiplegia due to stroke

Inspection of the local regions
• inspection of head and hair
• inspection of five sense organs
• inspection of neck
• inspection of skin
• inspection of excreta
 Inspection of head and hair
Inspection of head
Performance Diagnosis
shape
Bigger head with smaller face, insufficiency of kidney essence and
downward looking of the eyes and retention of fluid
of
low intelligence

Smaller head with round top, earlier insufficiency of kidney essence and
closure of fontanel and low maldevelopment of the brain
head
intelligence

Protrusion of forehead and congenital insufficiency of kidney essence,

temporal regions with flat top of or postnatal improper regulation of the
head spleen and stomach
 Inspection of head and hair
Inspection of head
Performance
Sunken fontanel
Fontanel Protrusion of fontanel
Retard closure of fontanel and non-
closure of the bone fissure
Shaking
Inspection of fontanel must be done in examining
the infants under the age of 1 year and a half.
Diagnosis
asthenia syndrome
sthenia syndrome
congenital insufficiency of kidney
essence, or by chronic disease and
malnutrit after birth
internal disturbance of liver wind
 Inspection of head and hair
Inspection of hair

Performance Diagnosis
luster
In the yellow race, black,dense and sufficient kidney essence and exuberance
lustrous hair of qi and blood
and
Yellowishdry, thin,soft and brittle hair insufficiency of kidney essence and
asthenia of qi and blood
shape White hair in young people without relate to congenital constitution
pathological changes
Appearance of infantile hair like malnutrition due to impairment of the
tassels with yellowish lusterless spleen and stomach by improper feeding
dryness
 Inspection of head and hair
Inspection of hair
Performance Diagnosis
loss
Sparse, yellow and dry hair insufficient kidney essence, asthenia
of qi and blood
Sparse hair in young people blood heat or consumption of
of kidney essence
Greasy hair with obvious loss of internal accumulation of damp
hair at the top of the head heat
accompanied by pruritus and
hair desquamation
Sudden patch loss of hair with alopecia areata due to blood asthenia
round or elliptic exposed head and wind attack
scalp
 Inspection of the five sense organs
Colour of the eyes

Performance Diagnosis
Redness of eyes Heat
Red canthus Heart fire
Redness of the white part Pulmonary fire
Redness of the white part Exuberant fire due to yin
with reddish veins asthenia
Redness of the whole eyes Wind heat in the liver
meridian
Red,swelling and ulcerated Splenic fire or damp heat
eyelids
 Inspection of the five sense organs
Shape of the eyes

Performance Diagnosis
Sunken orbit Loss of body fluid
Dropsy of eyelids and cheeks Edema
Prolapse of the lower eyelid in the Not morbid
middle-aged
Exophthalums accompanied by Goiter
swelling
 Inspection of the five sense organs
Movements of the eyes
Performance
Staring straight upward and
obliquely
Immoblie straight staring
Slight fixation of the vision
Open eyes during sleep
Paltycoria and no reaction to light
Miosis
Anisocoria
Diagnosis
Internal disturbance of liver wind
Declination of visceral essence
Internal retention of phlegmatic heat
Weak function of spleen and stomach
Kidney essence exhaustion
Exuberant fire in liver and kidney and
up-flaming of asthenic fire
Blood stasis or phlegm and fluid
retention in the brain
 Inspection of the five sense organs
Inspection of the ears

Performance Diagnosis
Whitish Cold syndrome
Bluish and blackish Pain syndrome
Thin and dry Insufficiency of kidney
essence
Scorching dry and black Extreme loss of kidney
colour essence
Otorrhea of pus Damp heat in the liver and
gallbladder
 Inspection of the five sense organs
Inspection of the nose
Performance Diagnosis
Reddish swelling with sore Exuberant heat in stomach or blood heat
Enlargement of the nose tip with thickened Accumulation of heat in the lung and stomach
skin，bulging surface like
acne or wart（rosacea）
Asthma with flapping nose wings Retention of pathogentic heat or phlegm in the
lung or a critical condition of the exhaustion of
pulmonary and renal essence
 Inspection of the five sense organs
Inspection of the mouth and lips
Performance Diagnosis
Deep red and dry consumption of fluid by exuberant heat
Purplish and brownish dry extreme exuberance of stagnant heat
Bright red yin asthenia and exuberant fire
As red as cherry poisoning by coal gas
Pale asthenia of both qi and blood
Purplish qi stagnation and blood stasis
Blackish colour around the mouth kidney qi on verge to exhaust
Dry and fissured impairment of fluid
Swelling and painful or lips with Fumigation of heat accumulation in the
ulceration and sores spleen and stomach
 Inspection of the five sense organs
Inspection of gums

Performance Diagnosis
Pale blood asthenia
Reddish swelling and painful Stomach of fire
Slight swelling gums without pain up-flaming of asthenic fire
Bleeding and reddish swelling impairment of the collaterals by gastric
fire
Bleeding gums without red- dish swelling impairment of the collaterals by asthenic
fire
 Inspection of the five sense organs
Inspection of the throat
Performance
Reddish swelling and pain
Reddish swelling and ulceration
Bright red and tender throat with
slight swelling and pain
Unilateral or bilateral reddish and
painful lumps like mastoid process
Reddish swelling and ulceration with
erasable yellowish white pus-like
substance or suppurative points
Diagnosis
virulent wind heat attacking the upper or due
to stagnant heat in the lung and stomach to
fumigate the upper
extreme exuberance of heat virulence
up-flaming of asthenic fire
accumulation of heat in the lung and stomach
or due to wind heat attacking the upper
exuberant virulent heat as well as heat
fumigation and muscle decaying
 Inspection of neck
Goiter: Goiter refers to unilateral or bilateral lumps like
tumor below the laryngeal protuberance which is either
small or large and movable with swallowing, usually caused
by stagnation of liver qi and retention of phlegm, sometimes
due to local climate and environment.
Scrofula: Scrofula refers to cervical clustered nod. ules,
usually caused by asthenic fire scorching phlegm into
nodules due to asthenia of lung and kidney yin, or by accu-
mulation of qi and blood in the neck due to attack by wind
fire and seasonal pestilence.
 Inspection of skin
Inspection of macules
Reddish or purplish and silk texture or cloud like macules
Yang macules with fever, dysphoria and fast pulse is called yang macules,
usually seen at the exuberant heat stage in exogenous
febrile disease.

Light colored or purplish thin macules with varied

size,unfixed location, occasional appearance and
Yin macules
disappearance, pale tongue and weak pulse are yin macules,
usually seen in miscellaneous diseases of internal
impairment resulting from failure of qi to control blood
and extravasation of blood.
 Urticaria
caused by internal accumulation of damp heat Eczema
complicated by invasion of pathogenic wind.
 Inspection of excreta
Inspection of sputum
Performance
Yellowish and sticky, or hard and
coagulated
Whitish, thin or blackish
Thin and frothy
Whitish, slippery and easily expectorated
Scanty, sticky sputum difficult to
expectorate, or with unproductive cough
Diagnosis
exogenous wind-heat, or by accumulation
of endogenous heat which fumigates the
lung
consumption af yangqi by cold, failure of
qi to transform fluid and accumulation of
dampness
pathogenic wind attacking the lung
asthenia of the spleen and exuberance of
dampness
pathogenic dryness attacking lung and
consuming fluid in exogenous disease
 Inspection of excreta
Inspection of saliva
Performance
Reduced spittle and dry mouth
and throat
Frequent salivation from the
corners of the mouth in infant
Distorted mouth with inability
to close the mouth and
spontaneous drooling in adult
Frequent regurgitation of clear
and thin fluid in the mouth
Diagnosis
exhaustion of body fluid or failure of body
fluid to flow upwards
failure of the asthenic spleen to control fluid
or due to attack of wind- heat
wind stroke
often caused by athenic cold in the middle
energizer or insufficiency of kidney yang
 Inspection of excreta
Inspection of snivel

Performance
Stuffy nose with clear snivel
Turbid and yellowish
Snivel mingled with blood
Diagnosis
exogenous wind-cold
exogenous wind-heat or wind-
cold transform into heat
dry-heat impairing collaterals
 Inspection of excreta
Inspection of vomitus
Performance Diagnosis
Thin vomitus without foul smell cold syndrome due to consumption
of gastrospler yang or invasion of
pathogenic cold in the stomach
Turbid and sour vomitus heat syndrome due to exuberant
heat in the stomach or liver fire
attacking the stomach
Sour and fetid vomitus with indigested retention of food due to
food accompanied by unpressable intemperance of food and
abdominal distension and pain indigestion
Vomiting of indigested food without asthenic cold in the spleen and
sour and fetid smel stomach
 Inspection of excreta
Inspection of vomitus
Performance
Vomiting of clear fluid, sputum and
saliva
Vomiting of yellowish and greenish
bitter fluid
Vomitus with pus and blood
Diagnosis
dysfunction of the spleen due to
retention of fluid in the stomach
accumulation of damp heat in the liver
and gallbladder or due to adverse flow
of liver and gallbladder qi which invades
the stomach
Stomach abscess due to accumulation of
heat toxin in the stomach and
putrefaction of blood stasis
Inspection of tongue
 Zang-fu organs with the tongue
• The tongue is the window of the heart.
• The tongue body is nourished by qi and blood transformed by the spleen.
• The tongue fur is formed by qi and fluid of the stomach.

Center of the tongue Root of the tongue

Spleen and stomach Kidney

Liver and gallbladder

Margins of the tongue Heart and lung Tongue tip
 Methods
• Position：Sitting or laying down

• Tongue extending：naturally to the front, the tip is slightly

pointing down
• Order：tip—— center——sides——root，tongue body——
tongue fur
• To combine with other methods：scraping or wiping the
tongue fur, inquiry
 Precautions
• Light
-daytime, sufficient and soft natural light
• Time
-no longer than 15 sec.
• Food and drink
-coffee, green tea, and candy may alter the color of the
tongue fur
• Brushed tongue
 Inspection of tongue
• Normal states of the tongue
Light - reddish tongue
Thin and whitish fur

• Normal functions of zang-fu organs

• Sufficient qi, blood and body fluid
• Sufficient of stomach qi
 Inspection of tongue
• Physiological changes
• Age
• children——pale tongue with thin fur
• Old people——dark with cracks
• Constitution
• Obese people——pale and swollen tongue
• Thin people——red and smaller tongue
• Climate
• Summer——thicker and yellowish fur
• Autumn——dry tongue
 Normal states of tongue

• Light-reddish tongue with thin and withish furss

• Suitable size, softness,flexiblity, light-red colour,luster

• And moisture;withish thin fur which is neither dry or greasy and

• slippery.
 Inspection of the tongue body
• Colour of tongue

• Shape of tongue

• Movement of tongue

• Sublingual collateral vessels

 Colour of tongue
•Light-reddish tongue
【Characteristic】

Moist, lustrous

【Clinical significance】

Healthy person , sufficiency of qi and blood

Or in mild cases
 Colour of tongue
•Light-whitish tongue
【Characteristic】

Lighter than that in normal condition, more white and less

red, or even showing no signs of blood

【Clinical significance】
• Deificiency of qi and blood or asthenia of yangqi
 Colour of tongue
•Red tongue
【Characteristic】

Redder than normal

【Clinical significance】

Excess heat——red tongue with thick yellow fur or

swollen papillae

Internal heat from yin deficiency——red thin tongue

with less fur
 Colour of tongue
•Deep-red tongue
【Characteristic】

The deep or dull red

【Clinical significance】

• Severe condition than red tongue

• Excess heat
 Colour of tongue
•Cyanotic and purplish tongue
【Characteristic】

Cyanotic or purplish

【Clinical significance】
inhibited circulation of
qi and blood.
 Shape of tongue
•Rough tong
【Characteristic】
rough or curved texture
dry surface and dull colour
【Clinical significance】
sthenia syndrome
heat syndrome
 Shape of tongue
•tender tongue
【Characteristic】
fine texture, moistened and lustrous surface，
light color and bulgy appearance
【Clinical significance】
asthenia syndrome
cold syndrome
 Shape of tongue
•Bulgy tongue
【Characteristic】
bigger than usual, fills almost all the space of
the mouth
【Clinical significance】
internal retention of dampness or phlegm
 Shape of tongue
•Swollen tongue
【Characteristic】
the tongue is swollen, makes the mouth full
or difficult to close
【Clinical significance】
sthenia syndrome
exuberant heat in the heart and spleen
Shape of tongue
 Shape of tongue
•Thin and emaciated tongue
【Characteristic】
thinner than usual
【Clinical significance】
• asthenia of qi and blood

• consumption of yin fluid

 Shape of tongue
• Fissured tongue
【Characteristic】
various fissures with no fur
【Clinical significance】
• Deficiency of fluid or essence and blood
 Shape of tongue
• Prickly tongue
【Characteristic】
covered with reddish prickles
【Clinical significance】
superabundance of pathogenic heat
• 刺，即芒刺，舌面红色颗粒高起棘手，称“芒刺舌”。

• 主邪热炽盛。
芒刺越多，邪热越甚。

舌尖有芒刺，为心火亢盛；
舌边有芒刺，属肝胆火盛；
舌中有芒刺，主胃肠积热。
点刺舌
 Shape of tongue
• Teeth-marked tongue
【Characteristic】
the margins of the tongue are printed with
tooth marks
【Clinical significance】
qi asthenia and internal retention of dampness
 Movement of the tongue
• Stiff tongue
【Characteristic】
not soft;inflexible or stiff and immolile
【Clinical significance】
• exogenous diseases

• exuberant heat consuming body fluid

• invasion of heat into the pericardium

• phlegm and turbid substance confusing the

heart
 Movement of the tongue
• Shivering tongue
【Characteristic】
involuntarily tremoring
【Clinical significance】
endogenous liver wind
 Movement of the tongue
• Deviated tongue
【Characteristic】
deviates to one side
【Clinical significance】
• wind storke or premonitory sign of wind storke
• liver wind complicated by phlegm or liver wind
complicated by stagnation in the collaterals of
the tongue.
 Movement of the tongue
• Flaccid tongue
【Characteristic】
too weak to protrude and withdraw
【Clinical significance】
extreme consumption of fluid or decline
of qi and blood
 Movement of the tongue
• Shrunk tongue
【Characteristic】
the tongue is contracted and cannot protrude,
or cannot even reach the teeth
【Clinical significance】
critical condition
 Tongue Movement
• Protruding and wagging tongue
【Characteristic】
the tongue that protrudes out but is unable to retreat is called
protruding tongue;the tongue that frequently protrudes out but
immediately draws back or licks the lips or corners of the mouth called
wagging tongue
【Clinical significance】
Heat in heart and spleen
 Sublingual collateral vessels
Normal sublingual collateral
vessels
• Less than 2.7mm in diameter

• Less than 3/5 of the distance

between the sublingual caruncle

and tongue tip in length
• Light purple
 Sublingual collateral vessels
• Abnormal sublingual collateral vessels

Deficiency in qi and blood Blood stasis

 Inspection of tongue fur
• Tongue fur

• A layer of moss-like matter spreading on the surface of the tongue

• Produced by stomach qi and fluid

Normal tongue fur
• Thin
Nature of the tongue fur
• White
• Neither dry nor wet
The colours of tongue fur
 The colours of tongue fur
•White fur——external, cold, damp syndrome
Thin and moist white fur
• Primary stage of exogenous dieases

• Wind-cold external syndrome

 The colours of tongue fur
•White fur
Thin and dry white fur
wind-heat external syndrome
 The colours of tongue fur
•White fur
Thick and slippery white fur
• Cold-dampness

• Spleen yang deficiency

• Retention of body fluid

 The colours of tongue fur
•White fur
Thick and greasy whitish fur
• Internal retention of damp turbid substance

• Phlegm and fluid or due to food retention

without transforming into heat

 The colours of tongue fur
•Yellow fur——heat, interior syndrome

Light yellow dark yellow Sallow yellow

 The colours of tongue fur
• Yellow fur
Greasy yellow fur
• Accumulation of damp-heat
• Phlegm and fluid retention
transforming into heat
• Food retention and heat
putrefaction
 The colours of tongue fur
•Yellow fur
tough yellow fur
• Pathogenic heat consuming body

fluid or by retention of heat in the

intestines.
 The colours of tongue fur
•Yellow fur
Yellow, slippery,moist fur
• If the tongue is light-white and
bulgy,it is due to decline of yang
qi and failure of dampness and
water to transform.
 The colours of tongue fur
•Grayish black fur——excessive heat, yin-cold or
long-term retention of dampness
 Nature of the tongue fur
•Thin or thick fur
【Characteristic】
thin fur——a tongue coating through which the underlying tongue surface is
faintly visible
thick fur——a tongue coating through which the underlying tongue surface is not
visible
 Nature of the tongue fur
•Thin or thick fur
【Clinical significance】
• Thin fur——primary stage of exogenous disease, mild disease

• Thick fur——exuberance of pathogenic factors, severe disease, stale food or phlegm

retains in the stomach and intestines

• Thin → Thick——gradual exuberance of pathogenic factors

• Thick → Thin——predomination of healthy qi over pathogenic factors

 Nature of the tongue fur
•Moistening and dryness fur
【Characteristic】
moist fur——moist with moderate dampness
dry fur—— dry,without fluid or even fissured
 Nature of the tongue fur
•Moist or dry fur
【Clinical significance】
• Moist tongue fur——sufficiency and upward distribution of body fluid

• Slippery tongue fur——cold-dampness,or retention of fluid and internal invasion of

cold-dampness,or asthenia of yangqi and failure of qi to transform fluid

• Dry and rough tongue fur——consumption of fluid by exuberant heat

or consumption of yin fluid

 Nature of the tongue fur
•Greasy or putrid fur
【Characteristic】
greasy fur——compact and difficult to exfoliate, thick on the center
and thin on the margins
putrid fur—— loose,sparse and easy to exfoliate with thickness on
both center and margins
 Nature of the tongue fur
•Greasy or putrid fur
【Clinical significance】
• Greasy fur——internal exuberance of dampness and

obstruction of yangqi
• Putrid fur——fumigation of excess of yang-heat
 Nature of the tongue fur
• Exfoliating fur
【Clinical significance】
• Exfoliating fur with red tongue——consumption of yin by
exuberant heat
• Exfoliating fur and light colour——consumption of both qi-
• and yin
• Mirror-like tongue——exhaustion of stomach yin
 Nature of the tongue fur
•Exfoliating fur
【Characteristic】
the fur on the tongue has exfoliated partially or completely