2012 INTERNATIONAL SYMPOSIUM ON INFORMATION TECHNOLOGY IN MEDICINE AND EDUCATION

Applied research of colorimetric in the teaching of tongue diagnosis

LIANG Rongl, WANG Zhao-ping2, YANG Xin-yul 2 Medical Examination Center of Beijing TongRen
REN Yu-jiel, ZHANG Yingl, YAO Xu-yingl Hospital, Beijing, China
1 Beijing University of Traditional Chinese Corresponding author: WANG Zhao-ping

Medicine , Beijing, China. Email: doctorzpw@yahoo.com. en

Ab st ract- Objective To provide a quantitative program that

can assess the teaching effectiveness of tongue diagnosis skills
B. Tongue collection and tongue color classification
training. Methods 2116 cases were selected in the Medical chromaticity value extraction
Examination Center of Beijing TongRen Hospital who According to the Diagnostics of Chinese medicine
undergoes a health examination in June 2011 to December. By textbooks [1], the tongue color is divided into eight
taking the digital tongue figure and extract the digital tongue categories: the light white tongue; the red tongue; the dark
color values (L*, a *, b *), this study used the colorimetric purple tongue; the ecchymosed tongue: the light dark tongue;
method to quantify the information of the tongue color. And
the dark red tongue; the light red tongue; the light
cluster analysis method was used to get the cluster centers of
purple tongue. The tongue diagnosis and tongue
the various types of tongue color. Results All types of tongue
color records was carry out by Chinese medicine
color gathered in lilac pink, pink, orange, pink color areas
practitioners.
around. Three-dimensional scatter plot shows the data
This research project selected the Canon 5DMark-II
clustered for the 11 regions, visible in the tongue color category
digital camera and EF60mm f/2.8 macro lens take digital
vector clearer state of aggregation, split between each other
tongue figure. Photo color picker software was used to
clear and gathered evenly. Conclusion Based on the
colorimetric method this study not only offers the basis of extract the digital tongue color values (L *, a *, b * ).
quantization for the diagnosis of tongue color teaching but also
C. Statistics
found objective criteria for learning outcomes assessment.
SPSS13.0 statistical package used for statistical
Keywords Tongue Diagnosis Teaching; Colormetric; K­ processing. Application of the mean plus or minus standard
means cluster deviation (x± S) was used to describe the characteristics of
the sample measurement data. Application of MATLAB
(MatrixLaboratory) software was used to make the tongue
color classification based on the K-means [2,3] clustering
I. INTR ODUCTION method.

It's an important educational purposes that teaching

students how to identity the normal tongue color and a III. RESULT
variety of abnormalities during the course of tongue
diagnosis teaching skills training. In the past the main form A. Sample population age distribution
of classroom teaching is teacher teaches and image
A total number of subjects to participate in the tongue
presentation.
color collection are 2116, male 856, female 1260; age 18-88
However, the judgment of the tongue color is dependent
years old, the average age of 36.37 ± 11.32 years old.
on each person's visual, therefore, the teaching effectiveness
cannot be evaluated; this study used the colorimetric method B. Distribution ofall kinds of tongue color in the CIELAB
to quantity the information of the tongue color. And cluster space
analysis method was used to get the cluster centers of the
In this study, the extracted tongue color chromaticity
various types of tongue color. Then provide a quantitative
values was put into the color space, found that overall central
program that can assess the teaching effectiveness of tongue tendency of the data is more obvious. All the color gathered
diagnosis skills training.
in lilac pink, pink, orange, pink color areas around. Three­
dimensional scatter plot shows the data clustered for the 11
II. SUBJECTS AND METHODS
regions, visible in the tongue color category vector clearer
state of aggregation, split between each other clear and
A. Object of study
gathered evenly. There are only small number of data was
In this study, subjects were selected in the Medical scattered around the main areas.
Examination Center of Beijing TongRen Hospital who
undergoes a health examination in June 2011 to December.
In the case of fully informed of the research purposes,
invited volunteers to take part in the collection of tongue
color information.

978-1-4673-2108-2112/$31.00 ©2012 IEEE

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 Light red tongue data import Matlab software and k­
means cluster command was call to carry out classifies
TABLE T. CHROMATlCTTY VALUES COMPARISON OF VARIOUS TYPES
computing. The results showed that when light red tongue
OF TONGUE COLOR (X ± S) was divided into four categories, data classification results
Tongue are stable and good reproducibility. Chromaticity data of
N L* a* h* C* H*
color the light red tongue re-sorting center are as follows:
24. 79 12. :19 27.74 26.71
Light white 68.95 TABLE Ill . L1GIlT RED TONGUE CATEGORY FEATURE VECTOR COLOR
9 ± ± ± ±
tongue ±2.70 VALUES
:1. 98 I. 68 4.1:1 2.5:1
27.62 II. 99 :10.17 2:1.54 Categories L* a* b*
light red 66.27
695 ± ± ± ± 1 68.5976 24.6116 11.7171
tongue ±2.82
2. 97 I. 87 2.99 :1.50
2 67.8594 28.5368 13.4531
29.57 II. 92 :11. 94 22.00
64.18 3 64.7396 27.1670 10.5818
red tongue 426 ± ± ± ±
±2.95
:1.10 I. 95 :1.14 :1. :19 4 62.7042 31.9034 12.6034
:12. :1:1 10.77 :14.II 18.4:1
ecchymosed 59.15
19 ± ± ± ±
tongue ±:1.61 In this study, the same classification were used to
:1. 71 I. 82 :1.81 2.67
classifY the red tongue, dark red tongue, light dark tongue.
28.02 10.54 29.99 20.66
dark red 64.46 Result shown that the red tongue is divided into seven
692 ± ± ± ±
tongue ±:1.14 categories, whether increase or decrease the quantities
:1.06 I. 96 :1.II :1.60
26.05 9.24 27.71 19.55 of data classification may lead the results shown
dark purple 6:1.18 unstable in the cluster analysis, and reproducibility relatively
79 ± ± ± ±
tongue ±:1.7:1
:1.14 2.10 :1. 2:1 4.07 low.
25. 79 II. 62 28. :15 24.:11
light dark 66.85 TABLElV. R E D TONGUE CATEGORY FEATURE VECTOR COLOR
19:1 ± ± ± ±
tongue ±:1.20 VALUES
2.81 I. 85 2.85 :1.67
28.2:1 II. 14 :10. :17 21.95 Categories L* a* b*
light 65.5:1
:1 ± ± ± ± 1 68.1682 26.0392 12.3216
purple tongue ±4.40
7. :17 I. :12 7.:14 2.67
2 65.3928 29.4507 11.5692
C. Tongue color clustering analysis 3 64.9054 32.3409 13.7782
Based on the above characteristics, this study chose the
4 64.0077 26.4450 9.9641
k-means clustering method to calculate the cluster center of
5 62.1437 30.4333 13.1999
each type of tongue color. (Table II )
6 60.1960 36.0884 13.0456
TABLEl! . TilE CENTER COLOR VALUES O F TONGUE COLOR
CLUSTERlNG
7 59.8010 31.6291 10.4610

Chromaticity values
No. Tongue color While the dark red tongue data is divided into four
L* a* b* c* h* categories, the data classification results stable and
Light white repeatable.
1 68.94 24.78 12.39 27.70 26.5T
tongue
2 Light red tongue 66.27 27.61 11.99 30.10 23.4T TABLE V. DARK RED TONGUE CATEGORY FEATURE VECTOR COLOR
VALUES

3 R ed tongue 63.96 29.68 11.87 31.97 21.800

Categories L* a* b*
Ecchymosed
4 59.14 32.33 10.76 34.07 18.410
tongue 1 67.6093 25.2870 10.3002
5 Dark r ed tongue 64.45 28.01 10.54 29.93 20.620 2 65.2054 29.3602 11.7228
Dark purple
6 63.18 26.04 9.24 27.63 19.540 3 62.7187 26.4116 9.1494
tongue
Light dark 4 60.7689 31.5967 10.6925
7 66.84 25.79 11.62 28.29 24.250
tongue
Light
8 65.53 28.23 11.13 30.34 21.520 While the light dark tongue data is divided into six
purple tongue
categories, the data classification results stable and
repeatable.
This study found that within all kinds of tongue color
also showed a certain classification feature. By cluster
analysis, the same type of tongue color was further divided
into more categories.

427
 perceived by the human eye [4]. This study based on the
doctors tongue diagnosis; extract the color values of various
types of tongue color, put it into CIE Lab color space,
observe all kinds of tongue color spatial distribution
TABLE V I. L iGlIT DARK TONGUE CATEGORY FEATURE VECTOR
characteristics. Adapt K-means clustering analysis method;
COLOR VALUES
calculate the color values of the cluster center and
Categories L* a* b* eigenvectors of various types of tongue color. Further carry
out the cluster analysis to those tongue color showing a class
I 71.3931 22.3553 12.5840
reunion like light red tongue or red tongue, then obtained a
2 68.6349 22.7073 9.4680
series of tongue color feature vector color values.
3 68.4713 25.2512 12.5211 According to the chromic value, tongue diagnosis pictures
4 66.4625 27.7122 11.6456 could be arranged in accordance with the depth of the
color sequence [5]. In this way, this study not only offer the
5 63.0026 25.5586 10.3600
basis of quantization for the diagnosis of tongue color
6 62.5150 31.0904 12.7929 teaching but also found objective criteria for learning
outcomes assessment.
In this research, sample data collected is insufficient.
Some types of the tongue color sampled data are too little to REFERENCES

be further classified.
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Br usco (2011). Psychol Methods. 2011 Mar;16(1):82-8; discu ssion
Ecchymosed tongue 59.14 32.33 10.76 89-92.
[4] Tang S hu nqing. Colorimetry [M]. Beijing: Beijing Instit u te of
Dark purple tongue 63.18 26.04 9.24
Technology Press, 1990.
Light purple tongue 65.53 28.23 11.13 [5] Su W, Xu ZY, Wang ZQ, Xu JT. Objectified st u dy on tongue images
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IV. DISCUSS Med. 2011 Apr ;17(4):272-6. Epub 2011 Apr 21.

Colorimetric is a color science based on human visual,

which can measure and quantitative express the color

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Figure 1. Sample population age distribution schematic

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Figure 2. Dist tibution of all kinds of tongue color in t he CTEL AB space

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