How to distinguish stomach diseases by observing tongue coating in traditional Chinese medicine? (group)

The picture below shows the tongue coating under high magnification microscope. How to observe tongue coating and distinguish stomach diseases in traditional Chinese medicine? Doctor Mu Lin's Guide: Chinese medicine pays attention to looking, listening and asking questions, and also attaches importance to the change of tongue coating. By observing the tongue picture, we can understand and understand the essence and development of the disease. The same is true for the treatment of stomach diseases. The change of tongue coating can really reflect some laws of spleen and stomach diseases. If you carefully observe your tongue coating, you will often find something unusual: extremely thick, greasy, black, yellow and peeling. If a person's tongue coating is abnormal for a long time, others will kindly remind him: go and see if there is stomach trouble! Facts show that the changes of tongue coating can really reflect the laws of diseases, especially some spleen and stomach diseases. Traditional Chinese medicine believes that the tongue is directly or indirectly connected with the essence of many zang-fu organs through meridians, making it flexible, so the pathological changes of zang-fu organs can often be reflected from the tongue image. Observing tongue picture and tongue coating is one of the main methods of TCM diagnosis. If we can often observe the changes of tongue coating and adjust our diet in time, we can nip in the bud. The normal tongue picture should be that the tongue is soft, free to move, reddish in color, with thin coating on the tongue surface and moderate humidity. Once you get sick, your tongue quality and coating will also change. This blog briefly introduces some knowledge of tongue coating to adjust diet and observe health. 1. What is tongue coating? Tongue coating is a thin, white and moist covering on the back of normal tongue, which is called tongue coating. From exfoliated keratinocytes. Saliva, bacteria, food scraps and oozing white blood cells. Under normal circumstances, due to chewing and swallowing, as well as saliva and diet washing, the substances on the surface of the tongue are often removed, leaving only a thin layer of white tongue coating. When sick, eating less or only soft food reduces chewing and tongue movement, or saliva secretion decreases and tongue coating thickens. The tongue coating of normal people is generally thin, evenly distributed on the tongue surface, and slightly thicker in the middle and root of the tongue surface. Because tongue coating is produced by stomach qi, and all the five zang-organs are endowed with qi in the stomach, the change of tongue coating can reflect the cold and heat deficiency and excess of viscera, the nature of pathogenic factors and the depth of diseases. The examination of tongue coating includes two parts: coating color and coating quality. Second, how to distinguish tongue coating? To observe the tongue coating, we should not only observe the color of the tongue coating, that is, the color, but also observe the tongue quality. On the back of a normal person's tongue, there is a thin, white and moist tongue coating, which is the tongue coating; The morbid coat color is white, yellow and gray-black. If it is moss, it is mostly transformed from white moss, which is common in epidemic dampness and warm dampness, and is a disease of damp-heat stagnation; If the performance is mildewed sauce coat, that is, red with black and yellow coat, it is common to eat heatstroke or internal heat for a long time, and the main damp heat is prolonged. Observing the quality of tongue coating means looking at the shape and texture of tongue coating. Mainly observe the thickness, dryness, rot, peeling, rootless and partial hair. The thickness of tongue coating is based on the bottom and the bottom. You can see the tongue coating through it, which is called thin coating, otherwise it is thick coating. The tongue coating is thin and the condition is generally mild; Thick tongue coating indicates serious illness. In the process of disease development, the tongue coating becomes thicker from thin, indicating that pathogenic factors enter the body and the condition changes from mild to severe; If the tongue coating turns from thick to thin, it means that the condition is exposed and the condition is getting better. Moistening the tongue coating and moistening the body fluid means that the body fluid is not damaged. This is called moistening the tongue coating. If it is slippery, it is called slippery moss, controlling cold and dampness, or stopping water due to yang deficiency; If the tongue looks dry, it is called dry fur, which is mostly caused by excessive heat hurting body fluid, vaginal fluid loss, or qi failing to dissolve body fluid; If the tongue coating is dry and yellow, the stomach heat is excessive and the body fluid is damaged; The tongue coating is dry and dark, which belongs to heat toxicity and yin injury; If the tongue coating is dry, dull and prickly, it belongs to the exhaustion of body fluid. Tongue coating is greasy, with fine and dense particles, thick in the middle and thin in the edge, and easy to scrape, which is called greasy coating. Moss particles are large, loose and thick, like bean curd residue piled up on the tongue surface. What is easy to scrape is called rotten moss. Greasy coating is common in damp turbidity, phlegm turbidity, food retention, damp temperature, etc. Rotten fur is the syndrome of indigestion in the stomach and phlegm turbidity causing sores. The tongue coating is white and greasy, mostly due to wet phlegm or stomach yang deficiency. The tongue coating is yellow and greasy, mostly phlegm-heat, and food stagnation turns to heat. Thick and rotten tongue coating, mostly due to food accumulation in the gastrointestinal tract. The tongue coating is covered with white clothes, called chyme, which means that the stomach qi drops. Tongue coating falls off, if it disappears partially or completely, it is called shedding tongue coating. If all the moss falls off, it means that the stomach yin is exhausted and the stomach qi is greatly hurt; If the tongue coating is not completely peeled off and the peeling place is smooth without coating, it is called flower peeling, which means that the stomach is injured by both qi and yin; If the tongue coating is not smooth and there are similar new particles, which are called shedding, indicating that the patient's blood gas is discontinuous; If most of the tongue coating falls off, only a small piece is left, which is called chicken heart tongue, which is a syndrome of deficiency of both stomach qi and yin. The change of tongue coating thickness is a reflection of good and evil going forward and backward. Tongue coating changes from less to more, from thin to thick, which generally indicates that pathogenic factors are aggravated and the main disease is promoted; The tongue coating becomes thinner from thick, indicating that healthy qi is gradually recovering and the main disease is fading. If the tongue coating suddenly increases or decreases, it is mostly a sign of sudden change. The distribution change of total tongue coating, covering the whole tongue, is called total, and the distribution in some parts of the tongue, such as front, back, left and right, is called deviation. Check the tongue coating and judge the lesions. The whole fur represents the syndrome of damp phlegm blocking middle energizer. If there is only moss on the tip of the tongue, it is that the disease is not deep and the stomach is hurt; If there is no moss on the tip of the tongue and the rest are covered with moss, it means that there is stagnation or phlegm in the gastrointestinal tract; The tongue coating is on the left or right, indicating that the disease is half-exterior and half-interior, and the liver and gallbladder may also have damp heat; No coating in the center of the tongue, thick coating on the edge of the tongue and thin coating in the center are syndromes of yin deficiency, stomach gas injury or blood deficiency; Thick and greasy moss roots, mostly phlegm or gastrointestinal stagnation. True and false tongue coating can distinguish true and false tongue coating, and judge the severity and prognosis of the disease. True and false judgment has roots and no roots. Tongue coating clings to the place where it is difficult to scrape off the surface of the tongue, as if it grows from the body of the tongue, which is true coating, also called root coating. If the moss is not real, if it floats on the surface of the tongue, it will be scraped off, which is false moss, also called rootless moss. Root coating indicates stomach qi, which is common in excess syndrome and heat syndrome; Root-free coating indicates that stomach qi is decreased, which is seen in deficiency syndrome and cold syndrome. If there is a thin root moss, which belongs to normal moss, it means that healthy qi is not injured; If the rootless moss is thin or thick, it will be scraped off, and no new moss will be generated, indicating the decline of healthy qi. In the early and middle stages of the disease, the root quilt is deeper than the rootless quilt, and the root quilt is better than the rootless quilt in the later stage of the disease. If a thick layer of moss floats on the surface of the tongue, it appears rootless, and a new layer of moss grows below it, which is a sign of disease recovery. To distinguish false fur, we should pay attention to: First, the tongue fur is full in the morning, and the fur recedes after eating. Although it is fake fur, it is not rootless; If there is little or no moss after retreating, it is internal deficiency; The second is colored moss, which can be scraped off and the disease is light and shallow; Wipe it clean, and the disease will be lighter; Thirdly, there is a thick rootless capsule, under which the new capsule can't continue to grow, which is the original stomach gas, and then the stomach gas can't evaporate the gastric juice. Most of them are caused by taking cold medicine to hurt yang or taking hot medicine to hurt yin. Third, how to distinguish the disease of moss? (1) The coating is white and the tongue coating is thin, white, moist and normal. Thin and white fur also means that the disease is on the body surface but not in the body, which often belongs to exterior syndrome and cold syndrome. The thin and white tongue coating is too smooth, which is more common in exterior cold syndrome; Thin, white and dry fur indicates exterior heat syndrome or dryness; The tongue coating is white, thick and dry, which means that body fluid is injured by dampness, turbidity and heat; There is white fur on the tongue coating, which is not dry to the touch, and it is called "powder white fur", which means plague; The white and dry fur is called "chapped fur", which is more common in febrile diseases; The tongue is pale and the coating is white and slippery, which represents cold syndrome or cold-dampness syndrome; The tongue coating is white, slippery and sticky, which is found in people with phlegm-dampness or spleen-stagnation. The tongue coating is white, slippery and rotten, and heat accumulates in the stomach and intestines. If the fur is as white and dry as snowflakes, it is called "snowflake moss", indicating that the spleen is cold. The tongue and mouth are covered with clothes, and mildew spots or erosion spots appear, which is the harm of decreased stomach gas and dirty gas. (2) The yellow fur is thin, thick and dry, so the interior heat is abundant, and the body fluid is damaged, and there are many interior heat syndromes. Withered yellow fur, cracked tongue, extremely hot body, severe body fluid injury, and visceral fever; Thick and greasy tongue coating is mostly caused by phlegm-heat, food retention or damp heat; The tongue coating is yellow and smooth, showing yang deficiency. (3) The gray fur is thin and slippery, mainly manifested in the interior syndrome. Mostly due to cold and dampness resistance, or phlegm drinking; The fur is gray and dry, which is a fever or a fire of yin deficiency. (4) Black moss with severe symptoms. The appearance of lichen nigrum usually indicates a serious disease, or excessive use of antibiotics, or poor oral hygiene. Most of them are transformed from yellow fur or gray fur, indicating that the condition is extremely serious; Black and withered fur is caused by insufficient heat and body fluid; The tip of the tongue is black and dry, full of heart fire; The coating is black and slippery, and it is extremely rich in yang deficiency and yin cold. When black fur appears, try to apply it with Huanglian Decoction10g several times a day. If the black moss becomes shorter and softer, and the color becomes lighter or disappears, it means that this black moss is caused by poor oral hygiene. Otherwise, we should find out the reason as soon as possible. (5) There is a diamond-shaped peeling area in the center of the tongue surface, which is likely to have diabetes. At this moment, if symptoms such as overeating, hunger, thirst and weight loss occur at the same time, we should pay more attention. (6) strawberry tongue, strawberry tongue, is a kind of red strawberry with swollen tongue nipple, which is called strawberry tongue. If accompanied by a high fever, there is a small rash with scarlet fever on the skin, which is probably scarlet fever. (7) Flower peeling tongue coating, also known as map tongue coating, shows that a part of the tongue coating falls off, revealing red tongue quality. Adults see this kind of moss, which is a manifestation of yin deficiency and blood deficiency; Seeing flowers peeling at the front end of tongue is deficiency of heart yin; Exfoliation of tongue root is yin deficiency of liver and kidney. The appearance of this kind of moss on children is a sign of poor physical fitness. Such children often have allergic constitution and are prone to allergic diseases such as asthma and ringworm of milk. Children who are partial to food and don't like fresh vegetables, or children who are malnourished, have parasites in the intestines and often catch a cold are also prone to peeling. Fourth, observing the changes of tongue coating can check the Chinese medicine of gastropathy, pay attention to seeing and asking, and attach great importance to the changes of tongue coating. By observing the tongue picture, we can understand and understand the essence and development of the disease. In the treatment of stomach diseases, we can indeed observe some laws of spleen and stomach diseases from the changes of tongue coating. If you carefully observe your tongue coating, you will often find some abnormalities: some are particularly thick and greasy, some are black, some are yellow, and some fall off. If a person's tongue coating is abnormal for a long time, others will kindly remind him: go and see if there is stomach trouble! So, how should we observe and analyze the tongue picture? (1) Stick out your tongue naturally, relax your tongue, make your tongue flat, with the tip of your tongue slightly downward, and open your mouth as wide as possible, but don't use too much force to fully expose your tongue. If the tongue is stretched too hard, or the tongue is tense and curled, it will affect the blood circulation of the tongue, causing the change of tongue color or the change of tongue dryness and wetness. (2) Look at the tip of the tongue first, then at the middle and side of the tongue, and finally at the root of the tongue. Look at the color of the tongue, the thickness and color of the tongue coating at the same time. (3) Tongue diagnosis focuses on observing the tongue picture, that is, tongue diagnosis. It is necessary to master two key points, mainly to observe the changes of tongue body and tongue coating. Look at the tongue. What color is it? Is the shape fat or thin? Is the texture shiny or dry? Is the activity flexible? Look at the tongue coating-is the tongue coating thick or thin, moist or dry? Is the moss white, yellow or brown? (4) Normal tongue picture Normal tongue picture characteristics, normal tongue picture can be summarized as six words: "reddish tongue coating is thin and white", specifically, the tongue color is reddish and bright, the tongue quality is moist, the tongue body is moderate in size, soft and elastic, and the tongue coating is even, thin, white and moist. Generally speaking, the tongue coating changes from thin to thick for disease progression, and from thick to thin for disease regression. (5) Tongue images of stomach diseases The most common tongue images of patients with stomach diseases are as follows: thin white coating-in the early stage of onset, the condition is mild and the stomach qi is not hurt; The tongue coating turns from thin to thick, the color turns from white to a little yellow, the tip of the tongue turns from pale red to red, and there are teeth marks on the tongue-the condition is aggravated, suggesting indigestion, gastrointestinal stagnation, and so on; The tongue coating turns from white to yellow, and the tip of the tongue is red-there is a heat image; The tongue coating turns from yellow to brown, or from brown to black, and it is dry and less fluid, and the tip of the tongue turns dark red-hot, often accompanied by dry stool; The tongue coating is thick and greasy, and there is a layer of white mucus on the tongue surface-phlegm dampness; The tongue coating is thick and greasy, and the tip of the tongue is red and hot; The tip of the tongue is crimson, even purple-blood in the sputum; The tongue is red without coating, and the surface of the tongue is smooth as a mirror-stomach yin deficiency; Tongue coating falls off, and the tongue is pale-deficiency of both qi and yin. According to the above different tongue images, combined with other diagnostic methods such as smell, questioning and pulse, Chinese medicine can make comprehensive analysis and treat according to syndrome differentiation. 5. Take care of yourself (1) with thick tongue coating and abnormal breath. If a person has a thick tongue coating and breath all the year round, it generally means that there is something wrong with the stomach. If there are no other uncomfortable feelings at present, you can start with diet and daily life. Keep a regular life, feel comfortable and happy, eat digestible food, eat more vegetables and fruits, eat less greasy and fried food, and it is best not to drink or smoke. After a period of nursed back to health, abnormal tongue coating and breath are expected to heal themselves. (2) The tongue coating is black and sticky. If you only see this abnormal tongue coating, the tip of the tongue is normal and reddish, and there is no other obvious discomfort, sometimes it belongs to the phenomenon of "staining". The patient may have eaten some colored food or taken some drugs. For example, taking "Julie Dole" will lead to black fur and black stool; When taking antibiotics, sometimes there will be black moss. The above situation is not morbid, so don't be nervous. However, patients with severe stomach diseases should also be vigilant when observing black moss. If the tip of the tongue is crimson or even blue-purple, it means that the condition is getting worse and you should go to the hospital in time. (3) When the tongue coating falls off, some people's tongue coating appears irregular "map-like" changes, some places have thin coating, and some places are smooth without coating, which is called "map tongue". This tongue picture, if there is no discomfort, is mostly a physiological change and does not need treatment. If you have stomach trouble or other chronic diseases for a long time, you have never seen such a tongue picture before, and there is a "map tongue", which is mostly a manifestation of yin deficiency. While treating the primary disease, you can drink American ginseng tea, 9 grams a day, brewed with boiling water, and drink frequently, which can promote self-healing. (4) Cracked tongue Some people have many "cracks" on the tongue surface, and most of them have no tongue coating, which is called "cracked tongue". If there is no discomfort, it is also physiological and does not need treatment. For example, after a serious illness, there is a cleft tongue, red tongue without coating, and discomfort, which also belongs to yin deficiency and needs medical treatment. (5) Some people with teeth marks on the tongue are fat, and the tongue is also fat. There are teeth marks on the tongue and the tongue coating is thin and white. If there is no obvious discomfort, it is too fat. Traditional Chinese medicine believes that "fat people are full of phlegm and dampness", and the spleen and stomach transport function of fat people is relatively insufficient, and the digestion and absorption of food are prone to obstacles. These people should eat less greasy and indigestible food, eat more vegetables and fruits and light food, and exercise properly. If the tongue coating is thick and greasy, there are teeth marks on the edge of the tongue, you don't want to eat, abdominal distension is full, and loose stool is thin, which belongs to excessive phlegm and dampness. You should cooperate with drug treatment and eat light and digestible food at the same time. (6) Some people with red tongue and thick fur don't understand the stool for a few days, which is called constipation. Often accompanied by bad breath, thick tongue coating, sharp red tongue edge and yellow urine, this is stomach fire. The stomach is full of fiery heat, and the turbid gas rushes up and fumigates the mouth and tongue, so bad breath, yellow tongue coating, heat injury to body fluid and intestinal disharmony lead to dry stool. At this time, you can take rhubarb, coptis root, scutellaria root, gardenia and other traditional Chinese medicines for clearing away heat and purging fire. In diet, avoid alcohol and spicy food, such as pepper and mutton, eat more vegetables, fruits and light food, and drink more water. (7) The blue veins at the root of the tongue are rolled on the tip of the tongue, and two veins can be seen running at the root of the tongue, which are only faintly visible under the tongue of normal people. If its diameter is more than 2.7 mm and its length is more than three-fifths of the connecting line between the tip of the tongue and the terminal point of the lingual frenulum, it is considered pathological. Sometimes blue spots or countless small vascular plexus can be seen at the same time. It reflects the phenomenon of blood stasis in the whole body or an organ. Abnormal indexes such as hematocrit and blood viscosity often appear in blood tests. Tip: Don't get angry when your tongue is thick. The most common symptom is not getting angry, but stopping food accumulation. That is, the decline of the function of the whole digestive system is generally more common in people who eat big fish and big meat, and are spicy and sweet. At this time, it is best to take some drugs that stimulate appetite, strengthen the spleen and help digestion. If you catch fire blindly, it will "burn your body" and aggravate your condition. Thick and greasy tongue coating is more common in children with spleen and stomach weakness, the elderly, and patients who have recovered from a long illness or serious illness. These people can't digest, absorb and excrete normally because of insufficient qi and blood, which leads to thick and greasy tongue coating. This situation is called virtual reality. If it is classified as excessive internal heat, taking some drugs that cause excessive internal heat will make the already weak spleen and stomach function, even the whole body, suffer greater losses under the heavy blow of clearing away heat and purging fire and bitter cold. How can we correctly judge whether the tongue coating has excessive internal heat? The method is simple. When the tongue coating is thick and greasy, it is accompanied by bitter taste, bad breath, oral ulcer, thirst, constipation in lower energizer, Huang Chi in urine, burning anus, etc., which is the real "getting angry". 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