Different Aspects of the Tongue Coating

Excess and deficiency are refiected in the thickness of the coating. However, the coating does not identify the cause. For example, a thick coating can appear in interior as well as exterior patterns of disharmony. Among patterns caused by internal factors, dampness, phlegm, food stagnation, interior heat, and cold are most prominent. Among patterns caused by external factors, externally-contracted wind-cold, wind-heat, or summer-heat are the leading factors.

To summarize, in acute cases it is especially important to note changes in the coating. If it is thin at the onset of an illness and starts to thicken, it is always an indication of the further penetration of the pathogenic factor. If the coating becomes thinner and lighter in color, this is a clear sign that the patient is recovering. The pathogenic factor is now becoming weaker, and the defensive (protective) qi is again gaining strength.

The moisture or degree of wetness of the tongue reflects the condition of the body fluids. A normal tongue should be slightly moist, which reflects proper circulation of the fluids. A dry, wilted tongue mirrors the exhaustion of the fluids.

In this chapter we will discuss the nature of the tongue coating and its moisture. Examples of wet, slippery, greasy, rough, and dry coatings are shown in the accompanying photographs.

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