Introduction
to tongue and pulse assessment - .pdf
version
We have at our disposal two very sensitive and complex ‘windows’
on the interior function of the body: the tongue and the pulse.
Both of these should be observed for everyone you can, and with
practice you will develop experience reading the signs. A word of
caution: as with the observational exam, do not rely solely on information
from these techniques. They are more designed to reinforce patterns
you may have uncovered in other areas. As with all things: think
holistic!
NOTE:
organ names are given in Chinese terms. These are not always 100%
equal to the Western systems we have been discussing. Here is a
rough equivalence:
“Kidneys”
Reserves / Kidneys and water balance
“Spleen” Digestive energy mover
“Lungs” Immune function / Respiration Qi mover
“Liver” Metabolism / Nervous system
“Heart” Metabolism / Circulation
Additional
organs are closer to their ‘western’ counterparts (i.e.
intestine, stomach, bladder). The gallbladder is usually paired
with the liver.
Tongue
diagnosis:
Given
here are the general organ locations for the tongue. In addition
to these, look for the general condition of the tongue itself: a
nice pink color, with some light white ‘moss’ covering
it, stable, not swollen. Infection can show up as little red ‘pimples’
on the tongue, in the area in question. Signs of imbalance are given
in the diagnostic categories.
Pulse diagnosis:
LEFT
WRIST: Heart, Liver, Kidney YIN / Bladder
RIGHT
WRIST: Lungs, Spleen / Stomach, Kidney YANG / Heater
These
are the positions of the visceral pulses. They are all taken on
the radial pulse, right beneath the thumb, the first one being the
one closest to the thumb joint. They are also taken at three depths:
superficial, middle, and deep. In addition, notice the overall qualities
of the pulse: fast or slow, superficial or deep, pounding or yielding.
Does it flood back when strong pressure is released? Is it choppy?
Any changes in rhythm? Is there any sluggishness, or signs of ‘congestion’?
Specific signs are given in the diagnostic categories.
Diagnostic categories. Here follows a brief list
of some signs and symptoms that are associated with excess, deficiency
of congestion in a specific system. This is by no means a complete
list.
1. Digestive (also includes some liver function – bile)
a. Excess: Heartburn, ulcers, quick transit time, very frequent
bowel movements, inflammation in the lower intestines (cramps, irritable
bowel), tongue shows redness and lack of moss in the ‘spleen’
area (occasionally red tip of tongue), strong pulse at ‘spleen’
with no depth.
b. Deficiency: Burping, gassiness, incomplete digestion, occasional
constipation, digestive ‘line’ like a crack down the
middle of the tongue with thick mossy coating, weak or sinking ‘spleen’
pulse
c. Congestion: Chronic constipation, fluid retention, edema, very
mossy tongue that can be somewhat pale in the ‘spleen’
area, sluggish pulse in the ‘spleen’ and ‘kidney
yin’.
2. Respiratory
a. Excess: Somewhat rare, except for acute respiratory infections
like colds and flus. Chronic symptoms can be tickling cough, allergic
symptoms. Tongue will show heat (redness – red ‘pimples’)
in the ‘lung’ area; ‘lung’ pulse may be
a bit overactive.
b. Deficiency: Chronic cough, recurrent infections, shallow breathing,
history of infection in the lungs, pale complexion (bordering on
gray), melancholy. Tongue will show paleness and somewhat thicker
coat of moss at the ‘lung’ area; ‘lung’
pulse may be deep and weak.
c. Congestion: Either acute or chronic mucus production, wheezing,
lack of deep breaths. Looks for similar signs as deficiency, but
with yellower moss and a more moderate but ‘slippery’
pulse.
3. Reserves
a. Deficiency: Exhaustion, especially in early afternoon, general
depletion due to stress, potential nervous system implications.
Tongue will be pale and thickly coated in the ‘kidney’
area; pulses may all be weak, with the ‘kidney’ pulses
almost completely absent.
4. Circulation
a. Excess: High blood pressure, fast pulse, red coloration in the
face with potential flushing, warm skin, red tongue (especially
in the front) with little moss (even entirely ‘stripped’),
vigorous pulses throughout especially in the ‘heart’
area, perhaps a bit superficial relatively.
b. Deficiency: Edema, hypotension (low blood pressure). Tongue can
be paler, especially in the front; pulses will be thready, hard
to find when compressed too much, or both. Bruises easily.
c. Congestion: Atherosclerosis, cold hands and feet, high blood
pressure. More moss in the ‘heart’ area of the tongue;
potentially excessive-feeling pulses, with a bit of ‘flooding’
and ‘slipperyness’, especially in the ‘heart’
area.
5. Immune function / repair processes
a. Excess: Allergic reactions, autoimmune conditions. Tongue may
look fairly normal, or exhibit some redness in the ‘lung’
area.
b. Deficiency: Chronic, recurrent illness. Slow wound healing. Protracted
illness. Chronically swollen lymph glands. Tumors. History of mononucleosis,
incompletely healed. Tongue can have some red blotches, especially
in the ‘lung’ area, while overall a bit pale. Pulses
deficient in the ‘lung’ area.
6. Adjustment / metabolism (thyroid / liver included)
a. Excess: Elevated heart rate, blood pressure, goiter, irritability,
profuse sweating, elevated body temperature, wiry build, quick intestinal
transit time. Tongue can be completely stripped of moss, and quite
red, potentially ‘quivering’ (a sign of ‘disturbed
qi’); pulses will all be choppy, intense, especially in the
‘heart’ and ‘liver’ positions (left side).
b. Deficiency: Low blood pressure, sometimes overweight, weak hair
and nails, low basal temperature, cool skin. Tongue will be paler,
more mossy, and also potentially ‘quivering’ a bit.
Pulses will be weak, perhaps lower although not necessarily, predominantly
in the ‘heart’ and ‘liver’ positions (left
side).
7. The Nervous system
a. Excess: Anxiety, nervousness, irritability, insomnia, ‘scalloped’
edges to the tongue (in liver area), thin, thready pulse that is
often faster and excessive in the ‘liver’ area
b. Deficiency: Depression, fatigue, flat affect; alternatively,
or in addition, anxiety, impotence, inability to relax, depletion,
insomnia. Tongue may exhibit similar signs as above, but with a
paler color and more white moss; pulse will be more sinking and
probably missing some strength in the ‘kidney’ and ‘liver’
areas.
c. Congestion: Inability to concentrate, suppressed emotions, ‘guarded’
postures, lack of expression. Tongue will be quite mossy, although
potentially red underneath, especially in the ‘liver’
areas.
