The so-called tire tongue is a tongue that looks like the inner tube of a car, with a bulge around it and a depression in the middle, so it is called tire tongue, and its pathology is liver depression and spleen deficiency.
Tire Tongue as the name suggests is shaped like a tire and is an inner tube like this big car as shown below:

With a bulge around the periphery and a depression in the center, the pathogenesis is simple: Liver Depression and Spleen Deficiency.
When Liver-Qi is out of circulation and stagnant, it fills up the tongue and bulges out, which is very understandable. Liver depression multiplies the spleen, and when the liver wood overcomes the spleen earth, the spleen is deficient, which is manifested on the tongue as a collapse in the center, with a pit.

I. Redefinition of the tire tongue: the tongue code for liver depression and spleen deficiency

1. Morphological characteristics and basis for naming

• ​Morphological description: The tongue bulges around the body like the outer edge of a tire, with a depression in the middle shaped like the pattern of a car tire (with tongue image 1).
• ​core pathogenesis: Liver-Qi stagnation → Spleen deficiency and loss of transportation → phlegm-dampness internalization → tongue disorder.

2. Linkages with traditional doctrines

• ​Depression of the liver multiplies the spleen (idiom).: Liver-Wood attacks Spleen-Earth, leading to congestion of Qi in the Middle Jiao (Jin Gui Yao Liao: "When you see a disease of the Liver, you know that the Liver transmits to the Spleen").
• ​accumulation of phlegm and stasis:: Depression for a long time turns into heat → refining fluid into phlegm → blocking the tongue complex (white or yellowish tongue coating).

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​Second, 11 tongue mapping analysis and conditioning program

1. Typical tire tongue classification

The following look at the specific tongue analysis, because the disease mechanism is relatively simple, are only briefly analyzed:

2. Typical tire tongue medication logic

​Tongue Characteristics	​core pathogenesis	​Recommended Formulas
Tire Tongue + White Coated Tongue	Depression of the liver, deficiency of the spleen and phlegm-dampness	Four Reversed Pills + Xiangsha Liu Junzi Tang
Tire tongue + dark red tongue	lit. liver depression turns into fire and blood stasis (idiom); tranquilizing the liver and causing blood stasis	Dang jia jia chang san + peach kernel and safflower decoction
Tire Tongue + Cracked Tongue	deficiency of yin and blood, stagnation of blood (TCM)	Gui Shen Tang + Red Peony and Salvia Miltiorrhiza
Ice cap tongue + tire tongue	lit. upper heat, lower cold, mixed reality and emptiness (idiom); fig. a mixture of real and imagined conditions	Semixia Diarrhea Heart Soup + Jiaotai Pill

3. Analysis of basic formulas

The basic formula I commonly use is Si Reverse San + Si Jun Zi Tang, sometimes adding fried yam to fill in the holes. If there is phlegm turbidity then use Si Reverse San + Xiang Sha Liu Jun Zi Tang. If the phlegm turbidity turns into heat, combine it with Warm Gallbladder Tang. If the stagnation is heavy and there are petechiae or cracks, add some Blood-activating and dredging herbs such as Dan Pi and Red Peony.

• ​Four Reversed Pills + Four Gentlemen Soup::Chai Hu + Citrus aurantium (relieves liver and depression) Codonopsis pilosulae + Rhizoma Atractylodis Macrocephalae (invigorates spleen and strengthens qi) Poria Cocos + Glycyrrhiza Uralensis (induces dampness and harmonizes the center)
• ​addition and subtraction rules::
  • Heavy phlegm → add half-sia and Chen Pi
  • Resolve heat → add Scutellaria, Gardenia
  • Blood stasis → add Danpi and Panax ginseng

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​III. Clinical Cases and Dynamic Conditioning Guidelines

1. Analysis of typical medical cases

• ​Case 1: Female, 38 years old, tire tongue with yellowish greasy moss, chest tightness and dystocia, with Si-Rei San + Long-Gan-Diarrhea Liver Tang, the moss turned thin white after 2 weeks.
• ​Case 2: Male, 45 years old, tire tongue + teeth marks on the side of the tongue, abdominal distension and loose stools, with ginseng-ling-white-juju-san + Chai-hu-shuo-hepatitis-san, the tongue flattened out after 1 month.

2. Conditioning cycle planning

• ​Broken Depression (1-2 weeks): Chaihu Liver-Sparing Powder as a base, add yujin and xiangsui to clear the liver
• ​Spleen strengthening period (3-4 weeks): Sijunzi soup + yam, with abdominal manipulation
• ​Sterilization period (5-6 weeks): Alternate between Gui Spleen Pill + Easy Pill

3. Summary

This tire tongue is still very good to identify, the underlying pathogenesis is liver depression and spleen deficiency, and to extend it a little bit more that is to add phlegm, stasis, and transformed heat, plus plus minus.
The reason for the establishment of such a name, no other meaning, is to see a glance to know the disease mechanism, look at the tongue is very fast, to determine the disease mechanism is also very accurate, clinical use is very good to use, so I share it with you.
I feel like the tongue image is pretty interesting, the tongue looks like a tire one minute, and then it looks like Rudraksha the next, and then you name it and have fun with it.
Rudraksha tongue is in this article, so you can see if it looks like Rudraksha, it's interesting.
Technique | Deconstructing the Ruyi Tongue of Tongue Diagnosis (Lower Element Deficiency, Upper Jiao Atmosphere Sinking)