introductory​

When we go to see a Chinese medicine practitioner, the doctor will often ask us to stick out our tongues. Everyone jokes.There's no such thing as a secret when it comes to Chinese medicine.That's because a TCM tongue diagnosis is a live medical report that you carry around with you, why do you say that?

According to Chinese medicine, changes in tongue texture and tongue coating can reflect the functional status of internal organs as well as the condition of qi, blood and fluids in the body. In TCM, tongue diagnosis is an important method of diagnosis. This article combines the theory of "Huang Di Nei Jing" with modern medicine to explain the tongue characteristics of gout patients and their management plan, which will help you realize the health management of "treating the disease before it occurs".

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​I. Why is tongue diagnosis called a "living body medical report"?​

1.The tongue is the external sign of the internal organs.​

Chinese medicine believes that the human body meridians connected to the tongue, visceral disease will be directly reflected in the tongue. Such as "tongue guide" said: "identify the tongue quality can distinguish the internal organs of the real, depending on the tongue coating can be observed in the depth of the six obscenities". Modern research has confirmed that changes in the tongue are significantly related to metabolic syndrome and inflammatory indicators.

2.Dynamic health monitoring​

The tongue is a sensitive reflection of the stage of disease development:

• ​Acute gouty attack: tongue coating turns from white to yellow, tongue texture becomes reddish
• ​chronic phase: aggravation of the teeth marks on the edge of the tongue, thickening of the sublingual veins

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​Second, gout tongue diagnosis three typical features​

​1. Red spots on the tongue - excessive internal heat

• ​cause of formation: Dampness, heat and stasis blocking the meridians
• ​manifestations: dark red spots scattered on the tongue surface, with a purplish-dark color on the sides of the tongue
• ​Associated Symptoms: severe joint pain at night, yellowish red urine, tortuous veins under the tongue
• These people often stay up late, greedy for cold, good spicy and stimulating food, manifested as dry mouth, constipation, yellow and red urine, irritability, insomnia and dreaming, facial acne.
• Suggestion: Adopt methods of clearing heat and removing toxins, nourishing yin and moisturizing dryness, such as using Chinese herbs such as Huang Lian (黄黄连), Huang Baicalin (黄芩), Zhimu (知母) and Maidong (麦冬).

​2. White tongue with cracks in the middle - Spleen and Stomach Qi deficiency

• ​cause of formation: Dampness, turbidity and heat in the middle Jiao.
• ​Distributional characteristics: Thick yellow moss in the middle root of the tongue, white and greasy at the edges
• ​Metabolic Tips: Impaired uric acid excretion and active inflammatory factors
• It means that the spleen and stomach function is poor, absorption is not good, and the body is in a long-term state of lack of water and nutrition. It is characterized by fatigue, loss of appetite, pale face, tiredness of limbs, abdominal distension and loose stools.
• Dietary advice: Eat more easily digestible food, such as porridge, stewed vegetables and meat. At the same time, add some foods with qi replenishing effect in moderation, such as yam, jujube and soybean.

​3. Pale white tongue with teeth marks - Dampness in spleen deficiency（中医必看！齿痕舌的成因与调理全解析，三型案例对症解决​）

• ​cause of formation: Spleen and kidney yang deficiency, water-dampness not transformed
• ​accompanying signs: Swelling of lower limbs, sticky mouth in the morning, loose stools
• It indicates deficiency of Yang in the spleen and kidney, water-dampness and phlegm in the body, and inability of the spleen to transport and transform water-dampness. Manifestations include loss of appetite, unformed or loose stools, heaviness, fatigue, abdominal distension, diarrhea, yellowish complexion, and in women there may be an increase in leukorrhea.
• Suggestion: Eat more easy-to-digest foods, such as yam, barley, lentils, etc. These foods have the effect of strengthening the spleen and promoting dampness. Reduce the intake of cold, greasy, sweet food and other easy to generate dampness.

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​III. Comparison table for improvement of tongue image

Observation indicators	Acute phase characteristics	Improvement in remission
Tongue color	Dark red with petechiae	pale red and moist
Tongue Thickness	Yellowish thick moss (>2mm)	Thin white moss (<0.5mm)
Crack depth	Longitudinal deep cracks	superficial crack
sublingual veins (medicine)	Roughly swollen and purple-black in color	Straighten up and lighten the color

Let's take an example., tongue diagnosis that may occur in patients with gout:
往期文章讲过如何看舌头：舌头是健康“晴雨表”！手把手教你3步自诊法，收藏备用​

1. Tongue texture: red or dark red manifestation, which is due to the presence of dampness-heat or blood stasis in the body.
2. Tongue coating: yellowish greasy or thick greasy, suggesting that the body is heavy in dampness and heat. There may also be thin white tongue coating, which may be related to spleen deficiency and dampness.
3. Tongue: it may appear fat or have teeth marks on the edges, which is usually caused by excessive water-dampness in the body and spleen deficiency that cannot be transported and transformed.

IV. Classic Gout Remedies

Gout is a disease associated with metabolic abnormalities, usually characterized by elevated levels of uric acid (hyperuricemia) and resulting joint inflammation. In Chinese medicine theory, gout may be categorized as "paralysis", which is related to pathological factors such as dampness, heat, phlegm, and meridian obstruction.

有个方子，是出自元代朱丹溪《丹溪心法•痛风》，有祛风除湿、清热化痰、活血通络的"Universal Gout Formula for Upper Middle and Lower Middle.". This formula cures gout from all causes.
Ingredients: Jiang Nanxing, Atractylodes macrocephala, Fried Huangbai, Rhizoma Ligustici Chuanxiong, Angelica dahurica, Fried Shenquan, Peach kernel, Wilsonia, Qiangwu, Fenghui, Gui Zhi, Safflower, Gentian Herb.

This formula, with the main effects of dispersing wind and clearing heat, dispelling dampness and resolving phlegm, activating blood circulation and relieving pain, is directed at the pain in upper, middle and lower peripheral bones and joints, which is commonly found in gout syndromes.
[Usage] All the drugs are finely ground, with the Shenqu cooking paste as pills, such as sycamore seed size, each time to take 9g, white water to send down.

Tip: Here many friends ask me why I do not write the number of grams, the same herbs, for different people, may need a very different dose. Chinese medicine emphasizes one person to one side, the dose of drugs need to be adjusted flexibly according to the patient's constitution, condition and other factors, not blindly pursuing specific grams or copying other people's prescriptions.