Strawberry tongue in-depth analysis: the tongue code of the four depressions of qi, blood, water and fire - with 14 practical diagrams and conditioning program
Tip:The treatments and medications involved in this article are for the reference of fellow TCM practitioners only, and patients should not take them privately, or else they will be responsible for the consequences. Introduction:Deconstructing the strawberry tongue, the strawberry tongue here is not the traditional strawberry tongue, but the whole tongue as a strawberry, as long as there is a depression point on the top of the tongue are called strawberry tongue, this depression point can be fire depression point, water depression point, qi depression point, blood stasis point, some of them are flat, and some of them are raised.
I. Redefinition of the strawberry tongue: a new interpretation of the tongue image centered on the depression point pattern
1. Breakthroughs in traditional perceptions
classic definition: Strawberry tongue = red spots on the tongue like strawberry seeds (mange tout tongue).
This article is innovative:: Classification criteria based on the "depression point" pattern (the four depressions of fire, water, qi and blood), covering a wider range of pathologies.
Traditionally, strawberry tongue is often used to describe the appearance of red raised papillae on the surface of the tongue that look like the surface of a strawberry, also known as mango tongue or red star tongue.
The strawberry seeds on strawberries are mostly black or yellow, so the strawberry tongue I am expressing here is not in terms of color, but in terms of shape. Consider the whole tongue as a strawberry body, as long as there is a depression on the tongue surface, similar to the strawberry seeds on the strawberry, it is called strawberry tongue.
Usually the visible depression points are, fire depression points, water depression points, qi depression points and blood stasis points, some are flat and some are concave.
2. Traceability of the pathogenesis of the four depressive points
Fiery Point: Liver Depression turns into Fire / Phlegm-Dampness turns into Fire → raised red spots on the tongue. Fire Depression Points are the most common, manifesting as red dots on the tongue, some flat, some raised, and the raised ones are also called Mansard's Tongue, which we all know. This kind of Fire Depression Points is mostly seen in Liver Depression, Phlegm Dampness, and Heart Fire. Yin deficiency and deficiency fire upflaming, Yang deficiency and deficiency Yang floating. Deficiency and reality are both present.
hydroponics: Water-dampness internal storage → transparent blisters on the tongue (called "Pearl Tongue" in the Guide to Tongue Recognition). Water-rich spots, manifested as small blisters on the tongue, as small as grains of rice, crystal clear, also recorded in ancient books called pearl tongue. I have seen this kind of small blisters on the tongue mostly seen in children. After the use of antibiotics or infusion of fluids during an external infection, sweating is not complete, or there is still water-dampness retained inside after an external infection. Cao Bingzhang's "tongue identification guide" described: [tongue identification] tongue white bubbles such as pearls, is the fire extreme water phenomenon, compared to the purple, red, yellow, black ancient people called the mange more serious. It is appropriate to Ganlu Sterilization Drink increase gypsum, rhinoceros, Lian, Xuanshen, forsythia, plus pollen, silver flowers, gold juice water and so on. There are also white moss on the tongue, composed of columns of the circle, I have seen the winter months of typhoid fever vomiting, mistakenly served white tiger soup, pulse volts, tongue moss into a circle such as white leopard prints, with the positive qi scattered with cinnamon, cloves, ginger, several services, healed.
A little bit of gas and depression.: Liver-Qi stagnation → flat color dots (tongue base color consistent). A qi depression point, manifesting as a flat dot on the surface of the tongue, which tends to be consistent with the underlying color of the tongue, and which looks larger in comparison to other depression point tongues.
petechiae (medicine): Blood stasis obstructing the channels → dark purple petechiae (sticky tongue). Blood stasis points, manifested as dark purple or blackened depressions on the tongue, and in some cases, petechiae are formed, which are more extensive; this is known to all and will not be repeated.
Second, 14 tongue mapping analysis and conditioning program
1. Typical strawberry tongue classification
Below is a specific look at the tongue analysis of the tongue, only on the depression point tongue related content to expand said, not a comprehensive analysis of the tongue.
This tongue is obviously a fire-depleted point of the tongue, but also the classic, traditional sense of the strawberry tongue, usually take the pungent and cool penetration of the surface, the fire-depleted hair of the solution, in order to comply with its momentum. Here you can learn from Yin's tongue diagnosis, according to the area of the red spots in the upper focal area to determine the amount of medicine to use, just use the drugs inside the Yin Qiao San. If the red spots are small, you can use mint and forsythia, if the red spots are more, you can use honeysuckle, forsythia, mint and burdock, and if the red spots are more, you can use the whole formula, which is a more concise way of thinking. Of course, the addition and subtraction of Elevation and Dispersion can also be used.This tongue is a Yin deficiency and fire inflammation tongue, the tongue moss is there, but not a lot, the patient usually also present five heart heat. This condition is usually nourishing Yin and lowering fire. You can choose to treat it with Fire Inducing Soup, San Cai Sealing Marrow Dan and so on. One of the formulas I usually use is Xuanwu Sealing Marrow Dan, which consists of ume, xuanshen, raw oyster plus sealing marrow Dan. This is an empirical formula that I have developed myself. Generally, I use this formula with additions and subtractions to astringe deficiency fire. For Yin deficiency with excessive fire, use Xuan Shen, plus Radix Rehmanniae Praeparata. Plum, Xuan Shen and raw oyster can nourish Yin. It is mentioned in the ancient books that Radix Panax Ginseng can stimulate Kidney water to control the floating fire, Peng Zi Yi mentioned that Wu Mei can astringe the phase fire, and Sheng Oyster can submerge the Yang, so there is no need to say more. If we have time to discuss them in detail later, we will not go into details here.This is an ice-covered tongue with a base of Yang deficiency and cold condensation. The patient's symptoms manifested as sore throat, and he was usually prone to mouth ulcers. This is caused by the floating fire of Yang deficiency, again the fire cannot be cleared, and the main focus should be on astringing and subduing the floating fire. You can use Submerged Yang Sealing Marrow Dan. I usually use Xuanwu Sealing Marrow Dan with gunpowder seeds, cinnamon or Ba Ji Tian to treat it. Chen Shiduo mentioned Ba Ji Tian as a medicine that can also draw fire back to the origin. Especially for those with yin deficiency, using Radix Psoralea and Cinnamon to draw fire back to the center of the body is afraid of hurting the yin with its pungent heat, so Ba Ji Tian is used to draw fire back to the center of the body, which is warm but not dry. This tongue, it's this depressed point not red, but some dark, this is from the depressed fire point slowly turned into blood stasis point, blood activating drugs should also be used. However, from the symptomatic point of view, this floating fire mechanism still exists.This tongue is a water-damp spot, blister tongue, with many rice-sized blisters in front of the tongue, crystal clear. Often it is caused by external infection, sweat is not complete, or after the external infection, water dampness remains. The formula used more often are Jingpang septic powder, ephedra and forsythia and red bean soup, Sanren Tang, Ganluo disinfectant Dan, etc., and more combinations of Xiao Chaihu Tang. In short, if there is superficial evidence, it will go from sweating, and if there is no superficial evidence, it will go from urination.This is also a water-depleted point, water-damp tongue, this kind of tongue, some people may see less, put more points, disease mechanism and solution with the last tongue. Like this kind of tongue or children are more common.This tongue sign is the Qi Depression Points, which are slightly bulging on both sides of the tongue and have many larger points that lay flat on the surface of the tongue, are not raised, and are the same color as the base of the tongue texture. This is a certain amount of qi depression, which slowly opens up the inside of the tongue. If the qi is more heavily depleted, it will slowly turn into fire and protrude, forming awn thorns. At this time, the main focus should be on soothing the liver qi, which can be done with Si Reverse San, Chai Hu Shu Liver San, and so on.This tongue has blisters and red dots, and some of the dots are darker. This is water-dampness, heat and blood stasis mixed together, then the treatment is three-pronged, clearing dampness and heat, blood circulation and blood stasis. San Ren Tang and Angelica Paeoniae Radix can be added and subtracted.This tongue is similar to what Cao Bingzhang said on the tongue white bubbles such as pearls, is the fire extreme water phenomenon, compared to the purple, red, yellow, black ancient people called the mange more serious. It is appropriate to Ganlu Sterilization Drink increase gypsum, rhinoceros, Lian, Xuanshen, forsythia, plus pollen, silver flowers, gold juice water and so on. You can see that this one is mossless, and the internal fire is holding up the True Yin to form blisters; instead, cool the Blood and nourish the Yin.This is a Blood Stasis Tongue, this is a bad picture of the tongue, the root of the tongue is not exposed, but this bruise image is very obvious, so I put it up to share. There are a lot of blood stasis spots on the surface of the tongue, as well as petechiae, which are purplish or grayish. The tongue coating is sticky and greasy, and the pathology of phlegm and stasis is definitely present. The formula commonly used to invigorate Blood is Gui Zhi Fu Ling Wan, and then the focus needs to be on breaking up the Blood, and I usually use Yuan Hu, San Ling, Curcuma, and then the focus will be on Tu Bei Worm and Di Long.This one is also a Qi Depression Tongue, where the depressed spots on the top of the tongue are larger and flat, and the base is the same color as the tongue, usually with these three features. Of course this one is already a bit to stand out. The sides of the tongue are also bulging, the liver is very obvious.This tongue image has been seen before, in the article on skin diseases. It is also a tongue sign of Phlegm and Stasis. Dark colored petechiae protrude and are obvious.This tongue is also characterized by obvious stasis, and the whole tongue is cold, undoubtedly an ice-covered tongue. Cold, stasis and phlegm condensation of the tongue.This tongue as a whole looks like an ice-capped tongue, and the tundra at the base of the tongue was particularly thick, and after using the medicine, the tundra fell off in one piece. After using the medicine, a piece of the tongue moss fell off. There were some small red spots at the root of the tongue under close scrutiny. The patient's urine was also yellow and turbid. Huang Bai was added to the formula based on warming Yang to slightly clear the fire in the lower Jiao.The last picture is a spoon tongue bottom (spoon tongue analysis turn over the last article), this tongue image can see the tip of the tongue and both sides of the fire point, tongue bulging on both sides of the tongue, there is also liver depression fire. Liver depresses fire general danpi, gardenia I will use on. Upper burner can still mint, forsythia fire depressed hair.
2. Typical strawberry tongue medication logic
Tongue Characteristics
core pathogenesis
Recommended Formulas
Fire and Depression Points + red tongue with reddish color
(TCM) inflammation of the liver and constipation of internal heat
Longdian Diarrhea Liver Tang + Dangdian Yiufu San
Water depletion point + white slippery tongue
dampness prevents the spleen from getting stuck
San Ren Tang + Wu Ling San
Qi-depressed points + bulging on the side of the tongue
pent-up frustration in the liver
Four Reversed Powder + Chaihu Liver-Sparing Powder
Blood stasis + purple tongue
Blood stasis obstructs the channels (idiom).
Gui Zhi Fu Ling Wan + Tao Hong Si Wu Tang
3. Analysis of classic formulas
Gan Gan Sterilization Drink Plus Reductions(Dampness and heat are combined):Talc + Yin Chen + Scutellaria Baicalensis (clearing heat and inducing dampness) Forsythia + Mentha piperita (transmitting the surface to dissipate heat) Radix et Rhizoma Polygoni Multiflori + Phellodendron Bidentatum (resolving phlegm and inducing sore throat)
Xuanyu quintessence of immortality(Yin deficiency and fire): "Umei astringes phase fire, Xuan Shen enlightens kidney water, and raw oyster submerges yang" (《医学衷中参西錄》化裁).
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