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179 Cards in this Set
- Front
- Back
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Most famous book on tongue diagnosis
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Ao's Record of Golden Mirror on Cold Pathogenic Diseases (Aoshi Shanham Jinjing Lu)
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Internal Organs/Meridians and Tongue:
Heart |
The luo connecting channel connects to the root of the tongue
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Internal Organs/Meridians and Tongue:
Spleen |
Foot Tai Yin meridian travels to the root of the tongue and spreads over the lower surface of the tongue
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Internal Organs/Meridians and Tongue:
Kidney |
Foot Shao Yin meridian terminates at the root of the tongue
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Internal Organs/Meridians and Tongue:
three Yang meridians of foot & three yin meridians of foot |
Have connections to the tongue
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4 Clinical Significance of the tongue:
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1. Tongue body color
2. tongue body shape 3. Tongue coating 4. Tongue moisture |
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Tongue body color
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Indicates the conditions of blood, nutritive qi and yin organs
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Tongue body shape
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Indicates the state of blood and nutritive qi
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Tongue coating
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Indicates the state of the Yang organs
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Tongue moisture
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Indicates the state of the Body Fluids
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3 Conditions of Examining the Tongue
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1. Lighting
2. Techniques of observation of the tongue 3. External factors affecting the color of the tongue |
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3 Conditions of Examining the Tongue:
Lighting |
1. Natural light on a sunny day
2. Halogen bulb is the best artificial light |
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3 Conditions of Examining the Tongue:
Techniques of observation of the tongue |
1. Hold the tongue out no more than 15 seconds
2. Extended in a relaxed manner |
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3 Conditions of Examining the Tongue:
External factors affecting the color of the tongue |
1. Colored Food, sweets, drinks or pastilles
2. Tobacco smoking, colors the coating yellow 3. Antibiotics make the tongue partially peeled- bacteria, cold property 4. Oral corticosteroids tend to make the tongue red and swollen- Ex: inhaler, rheumatoid arthritis. 5. Most cytotoxic drugs used for cancer tend to create a very thick, dark-yellow or brown coating with red tongue body. |
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2 ways to divide the tongue area
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1. Three burners (San Jiao)
2. Internal Organs |
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Tongue according to 3 burners:
1. Lower Burner (kidney, bladder) 2. Middle Burner (stomach, spleen, liver, gall bladder) 3. Upper burner (heart, lung) |
1. Root
2. Middle 3. Tip |
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Tongue according to internal organs:
1. Tip of the tongue 2. Front third 3. Bilateral margins (side) of the tongue |
1. Heart
2. Lung 3. Liver and Gall bladder. Condition of spleen (teeth mark) |
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What is a normal tongue?
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Proper size, soft in quality, free in motion, slightly red in color and with a thin layer of white coating which is neither dry nor over moist.
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What does tongue body color indicate?
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Tongue color indicates the conditions of blood, nutritive Qi, and Yin organs
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Five pathological colors
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1. Pale
2. Red 3. Deep Red 4. Purple 5. Blue |
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Pale Tongue due to Yang Deficiency
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Pale, corpulence, tender, teeth mark, moist slippery, with Yang deficiency signs- cold limbs, blue color
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Pale tongue due to Qi deficiency
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Slightly pale, corpulence, tender, teeth mark, with Qi deficiency signs- fatigue, tired, poor appetite
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Pale tongue due to Blood deficiency
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Palen, thin, slightly dry with Blood deficiency signs- scanty menses, pale face, pale tongue, pale eyes, pale lips
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What does red tongue indicate?
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Red tongue indicates heat
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Whare are two types of heat?
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1. Full heat= coating
2. Empty heat= no coating |
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Red tongue due to excess heat
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Red, prickle, crack, thick yellow dry coating
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Red tongue due to deficiency heat
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Red, little coating or no coating with night sweating, low grade fever, steaming bone, palm heat, tidal fever, thin rapid pulse
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Red tip (heart fire flare up)
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Red tip, restless sleep, anxious
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Red sides
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Liver Fire, or GB heat
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Raised papillae
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Heat or heat and blood stasis
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Deep red (crimson) tongue:
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febrile disease, evil qi entering into yin level or blood level or pericardium
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4 Pathological changes caused by exterior wind heat
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1. Wei stage (defense)
2. Qi stage (vital energy) 3. Ying stage (nutrient) 4. Xue stage (blood) |
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Describe the 4 stages:
1. Wei stage (defense) 2. Qi stage (vital energy) 3. Ying stage (nutrient) 4. Xue stage (blood) |
1. lung and defensive qi
2. interior heat, dry yellow tongue, coating, or with thorns on the tongue 3. more sever than Qi stage, injury of Ying Yin and disturbance of mind, deep red tongue, faint rashes 4. dark deep red tongue, delirium, mania, bleeding |
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Febrile disease- deep red with greasy coatin
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Heat int he yin stage with dampness-turbidity obstructed in middle jiaop
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Febrile disease- deep red, dry with crack, prickle
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heat in the ying stage and insufficient body-fluid
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Febrile disease- deep red, big red spots on tongue
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toxic-heat invading the heart
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Internal miscellaneous disease- deep red, dry little coating or no coating, small thin tongue body with crack
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Yin deficiency
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Internal miscellaneous disease- deep red, withered, dry, no coating, smooth like mirror (mirror tongue)
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Kidney & stomach yin exhaustion (critical condition)
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Purple Tongue
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Indicates stasis of blood due to cold or heat.
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Extreme heat tongue color
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Dark purple
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Extreme cold tongue color
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bluish purple
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5 Causes of blood stasis
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1. trauma
2. cold 3. qi deficiency 4. qi stagnation 5. heat |
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Dark purple and moist
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Blood stasis due to cold
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Dark purple and dry tongue
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Blood stasis due to heat
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Reddish-purple, Swollen and cracked, peeled tongue
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Yin deficiency preceded the blood stasis
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Bluish purple, moist, slippery, small
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extreme cold
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2 types of blue tongue "buffalo tongue"
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1. Bluish and slippery
2. blue, slippery greasy |
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1. Bluish and slippery tongue
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cold or yang deficiency
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Blue, slippery, greasy tongue
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Damp-phlegm accumulation
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Tongue shape
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indicates the states of blood and nutritive qi
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Rough tongue, thorny and solid tongue
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Excess condition
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Delicate tongue, no thorny, smooth
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Deficiency condition
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Swollen tongue,
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Yang deficiency of the spleen and kidney, accumulation of dampness, water, phlegm, and fluid retention
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Pale swollen tongue
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retention of dampness due to yang deficiency
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swollen red tongue
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damp heat
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Thin tongue
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yin or blood deficiency
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Cracked tongue
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yin deficiency or blood deficiency but it can be seen in normal people
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Cracked red tongue
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excess heat
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Cracked pale tongue
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blood deficiency
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Thorny tongue- the papillary buds over the surface of the tongue
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excess heat sign (interior heat- qi and ying level)
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Teeth print
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Spleen deficiency, excess dampness
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Double tongue
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vessels under the tongue are swollen and like a small tongue. often seen in children
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Tongue carbuncle
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carbuncle in tongue is red and swelling with pain- toxic heat fire
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Tongue mushroom
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hard nodule in tongue. tongue cancer
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tongue bleeding
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blood overflowing, heat in the heart, lung, or st, liver fire or spleen fire
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Hypoglossal vessels
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vessels below tongue, dark, thick, black vesicles, blood stasis.
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Tongue movements
1. rigid movement 2. flaccid tongue 3. shortnened tongue 4. tremulous tongue (shaking) 5. deviation of tongue 6. protruding, lickin |
1. lacks flexibility
2. weak in motion 3. genetic defeat 4. due to wind 5.stroke 6. ht sp heat, mental retardation |
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Rigid movement tongue
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lacks flexibility and is difficult to protrude, retract, or roll
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Causes of rigid movement in tongue
1. febrile disease 2. retention of damp phlemg in the interior 3. excessive heat 4. stroke patient |
1. invasion of the pericardium by heat
2. coma- phlegm in the heart 3. consumes body fluid 4. early threatening signs of wind-stroke |
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Flaccid tongue
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weak in motion, and often indicates extreme deficiency of qi and blood or consumption of yin fluid depriving the tongue of the nourishment
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Extreme deficiency of qi and blood
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pale and flaccid tongue
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extreme deficiency of yin and body fluid
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flaccid, red, atrophy and dry tongue
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Shortened tongue-congenital short
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problem with the heart
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shortened tongue- normal tongue changed to shortened tongue
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critical condition
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short tongue with fever, red, and dry
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extreme heat consumed body fluids
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pale, moist, short tongue
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cold condition, excess or deficiency
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shorten tongue with greasy coating
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retention of damp phlegm
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Tremulous tongue deficient
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chronic qi and blood deficiency, yang deficiency, or body fluid deficiency
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Tremulous tongue extreme heat
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liver wind
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causes of liver wind
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1. hyperactivity of liver yang
2. extreme heat 3. blood deficiency 4. yin deficiency |
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Deviated tongue
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stroke patient or threatened sign of stroke
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2 types of stroke
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1. wind stroke
2. phlegm, blood stasis invading the heart |
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Wind stroke
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happen fast, on-set change, attacks meridian, not in a comma stage. Affects the body.
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Phlegm, blood stasis invading the hear
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coma, lost conscience, attacks organs
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Protruding, licking tongue
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heart or spleen heat, or mental retardation of children
critical cases: 1. toxin invading heart 2. pre-stage of wind stroke |
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Tongue body thin and pale
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blood deficiency
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Tongue body thin, red and dry
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heat deficiency
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Tongue body is red, swollen
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damp heat
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tongue body is pale, delicate, swollen
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spleen qi deficiency, yang deficiency
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Tongue coating category
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1. colors (changes easily)
2. texture 3. combination of tongue body and tongue coating (won't change over night) |
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Tongue coating is made of
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Stomach Qi
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Tongue coating reflects:
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Physiology activity of stomach, spleen, and kidney
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Normal tongue coating
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should be white, and thin enough to see the body color through it
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Indication of tongue coating color
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brightness of coating can give the indication of its duration- the duller the coating, the more chronic is the condition
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White tongue coating
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exterior disorder, cold syndrome, can be normal
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Yellow tongue coating
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interior and heat syndrome
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Grey/black tongue coating
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severe interior heat or severe interior cold
Ex: cancer patient, with chemo (cold) with radiation (warm) |
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Thin white coating moist (slippery)
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wind cold
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Thin white dry coating
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exterior dryness invading or wind heat just entering hand tai yin meridian- transition, no heat (yellow) but dry.
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White greasy coating
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damp cold obstruction or phlegm retention (damp phlegm or damp cold)
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White thick dry coating
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dampness turbidity transform into heat, start to injure yin
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White thick slippery coating
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cold with dampness or phlegm ,
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white thick curd-like
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food stagnation due to cold type (sp def. deficiency)
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Thin yellow coating
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exterior wind heat syndrome, or wind cold starts to generate heat
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yellow greasy coating
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damp heat, food stagnation, phlegm heat
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yellow dry coating
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heat into interior, injured fluids, or heat accumulation in intestine
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yellow slippery coating with pale tender corpulence
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yang deficiency with damp fluid retention (damp & Qi def. heat creates it more yellow)
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Grey/black coating
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cold
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Grey/black moist-slippery, pale tongue
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yang deficiency, cold accumulation, damp cold, phlegm retention
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grey/black, dry, prickle, deep-red tongue
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extreme heat injure yin (fluids)
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White coating with pale swollen, moist tongue
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cold, sp qi def
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red, yellow and dry coating
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heat itnerior
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red, yellow and greasy coating
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Damp heat (food stag, dry not greasy)
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Moist and grey coating with pale tongue
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Yang deficiency
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Red, dry and grey coating
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extreme heat, injury yin
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Black, dry coating, thorny
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extreme heat
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Fever, constipation, black and dry coating
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Extreme heat
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Grey/black moist coating
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Extreme cold, yang def
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Pale, swollen tongue, black and moist coating
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Qi def, cold accumulation
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Tongue coating texture
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1. thickness and thinness
2. Moistness and dryness 3. Sticky (greasy) and granules 4. Exfoliation (peel) |
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Thin tongue
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normal,e xterior (wind cold or wind heat), disease or mild internal disease
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Thick tongue
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evil qi in interior (damp, phlegm, food stagnation, constipation, etc)
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Thin coating turn into thick coating
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disease progress
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Thick coating turn into thin coating
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disease improving
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Difference between phlegm and damp
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Phlegm- sticky, thicker, condense, less water.
More serious condition and comes from dampness. |
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Visible phlegm
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cough with sputum
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Invisible phlegm
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phlegm obstruct the heart
Ex: coma, delirium, epilepsy, dizziness, vomiting, vertigo, nodule, numbness |
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Dampness
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heavy sensation, diarrhea, leukorrhea.
Salty food- creates dampness Congestive heart patient yang deficiency |
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Poor appetite, epigastric pain, dislike pressure, nausea, history of overeating, likes to eat swee.
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Food stagnation, sp deficiency, phlegm
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Diarrhea for 2 days, heaviness, poor appetite
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Dampness
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Diarrhea for 2 days, heaviness, poor appetite, burning sensation, thick and yellow coating
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Damp heat
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Normal tongue
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neither too moist and dry
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Slippery coating
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damp, cold phlegm, yang deficiency with damp retention
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Dry coating
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heat injure Yin (fluids)
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Too much thick saliva
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note enough saliva , water makes it better, no salty.
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Body fluids
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belong to yin, a small part of yin
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Body fluids deficiency
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only has dryness
Yin includes both body fluids, blood, essence, marrow Yin deficiency: dryness and heat signs |
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2 Febrile disease
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1. Acute- consume body fluids
2. chronic= yin deficiency, low grade fever -> excess heat -> yin deficiency -> deficiency heat |
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Red tongue with yellow dry coating
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excess ehat- consume body fluids
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red & thin tongue with dry or no coating
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heat, deficient yin, empty heat
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Red, thorny tongue and dry coating
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heat extreme
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Fever, cough, chest pain, yellow phlegm with blood, red tongue, yellow dry coating, rapid plse
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lung heat, excess heat, damp, acute tuberculosis
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Cough for 20 years, low degree fever, thin body, weight loss, night sweat, dry cough with blood, dry mouth, red thin tongue, little coating, thin and rapid pulse
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lung yin deficiency, chronic tuberculosis
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Sticky greasy & granule coating (st fire)
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due to retention of damp, phlegm and food.
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Sticky coating (more dampness)
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thick and more sticky than granules and difficult to clean (like oil)
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Granules coating
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Excess yang steaming the turbidity in stomach (bringing the dampness) thick coating but easy to scrape it. Stomach fire can cause thick granules coating.
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Sticky coating
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greasy,. phlegm
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Slippery coating
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dampness
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Mouldy- curd like
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thick, patchy or crumbly, dampness or phlegm with stomach yin deficiency with empty heat. Seen only in the ederly.
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Sticky and white coating
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phlegm cold
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Sticky and yellow coating
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heat phlegm/dampness
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Sticky and grey coating
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Cold/ phlegm/ damp
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Red tongue, yellow and sticky coatign
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excess heat phlegm
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Exfoliation peel coating
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not tongue body, but tongue coating. can be partially peeled or completely peeled
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Deep red and dry tongue with peeled coating
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heat injure yin
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Geography tongue
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stomach qi and yin deficiency- looks like a map (poor digestion) take years to develop.
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Mirror coating
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exhaustion of stomach qi and yin
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thin Pale tongue with slippery coating
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deficiency with wind cold
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pale tongue, thick white slippery coating
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damp cold, with sp deficiency
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Pale tongue with yellow greasy coating
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deficiency and damp heat
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Pale tongue with yellow, crack, dry
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heat injure fluids with deficiency
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Pale, tender, corpulence tongue with black/grey slippery coating
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severe yang deficiency
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Deep red with thin white coating
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wind cold start enter into Qi and Ying level or attacked by Wind Cold with chronic Yin deficiency.
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Deep red with white greasy coating
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dampness qi/heat in ying level, superficial
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Deep red with white powderish coating
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heat toxin
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Deep red with yellow greasy coating
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damp heat/ phlegm heat
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Deep red, brown dry crack
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heat (yangming fu sydnrome)
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Purple tongue with white slippery coating
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blood stasis stasis & damp cold
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Purple tongue with yellow slippery coating
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blood stasis & damp heat
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Purple tongue with yellow dry coatign
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blood stasis & excess heat
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Purple tongue with grey slippery coating
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Blood stasis & Heat/Cold dampness
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Indication of Cracked tongue
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yin deficiency or blood deficiency but it can be seen in normal people
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Horizontal cracks
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yin deficiency, usually of the stomach & kidneys or both, common in elderly
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Irregular cracks
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stomach yin deficiency or the tendency to it
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Stomach crack
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stress related, st issues, stomach yin deficiency or the tendency to it
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Heart crack
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central long crack in the midline of the tongue is also common
-important depends on depth and on the color of the tongue body, especially the tip. -deep crack = person suffer from a heart pattern due to emotional stress, all the more so if the tip is red. many years of stress |
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Transverse spleen cracks
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spleen yin deficiency and is not common.
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Lung cracks
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Short, transverse cracks behinds the tip in the lung area.
-history of lung pathology such as pneumonia, whooping cough or repeated lung infections during childhood. |
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Dep midle cracks with small cracks
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usually seen in a red tongue without coating.
Kidney yin deficiency with empty heat in the kidneys and heart. ADHD kids- yin deficiency (night sweat) |
