Geographic tongues & autoimmune disorders

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" A particular type of coating without root is that seen in " geographic "

tongues (PLATES 44, 57, & 59). From a Western anatomical perspective,

geographic tongues are characterized by a loss of filiform papillae and

hyperemia. From a Chinese perspective, these tongues are peeled in patches,

which have quite well-defined contours. The coating in the non-peeled areas

is without root. Although this tongue can be constitutional and is regarded

by some as having no clinical significance, it does, in my opinion, always

indicate Stomach yin deficiency, whether constitutional or not. In modern

biomedicine, this type of tongue is frequently associated with autoimmune

disease (such as rheumatoid arthritis and systemic lupus erythematosus);

there is also an association with a past history or family histroy of

asthma, atopic eczema and allergic rhinitis with raised levels of IgE.3 "

(Tongue Diagnosis in , Giovanni Maciocia, Revised Ed.,

p.94.) (Footnote from D.W. Beaven and S.E. Brooks, A Colour Atlas of the

Tongue in Clinical Diagnosis (London: Wolfe Medical Publications, 1988), p.

117.)

 

For those new to TCM: A normal tongue has a coat which is neither too thick

or too thin. If the tongue coat is missing, this is a sign of Stomach Yin

(and probably Stomach Qi) Deficiency.

 

The entire tongue can lack a coat, or, the coat may be missing in patches.

A " geographic " tongue is a special kind of patchy tongue in with the contour

of the patches is very well-defined. There is no gradual change from areas

which are lacking coating to a boundary where there is a little bit of

coating to an area where the coating is thicker and so on. The contours are

very sharply-defined.

 

In geographic tongue, the areas that do have coating have coating that is

without root. " The normal tongue coating has root, i.e., it is closely

attached to the tongue surface. It grows out of it much like grass grows

from the soil. The coating is hard, firmly adhering to the tongue body. It

is also thin, uniformly distributed and cannot be scraped or wiped off. The

question of whether or not the tongue coating has root is of extreme

importance in clinical practice. It is also important that this not be

confused with the question of whether the coating is thin or thick. A

coating with root can be thick or thin, and so can a coating without root. "

(Maciocia, p. 93.)

 

" In severe cases the coating without root may look like powder, snow or salt

(PLATES 5, 13, 20, 31, 57 & 59). " (p. 93.)

 

" A coating loses its root when the Stomach, Spleen and Kidney fuctions are

impaired, i.e., when the SToimach is not transforming and " ripening " the

food, the Spleen is not separating the essences of food and the Kidneys are

not " evaporating " the fluids upward. " (p. 93.)

 

" To summarize, a coating without root always indicates a condition of

deficiency and a weakening of the body's energies. Specifically, a

condition of Stomach qi, Stomach yin or possibly Kidney yin deficiency is

indicated. " (p. 94)

 

A thick tongue coat indicates Excess. A thin tongue coating is normal or

may also be seen in Deficiency. (Excess problems are those caused by there

being too much of something - temperature in the environment too cold, the

person eating too many foods with Hot or Warm energy, Dampness, Stagnation,

Stasis, or Phlegm. Deficiency problems are those caused by there not being

enough of something - too little Qi, too little Blood, too little Yang, or

too little Yin. Excess problems are treated by removing the Excess and/or

the cause of the Excess. Deficiency problems are treated by adding what the

person needs. " Tonic " herbs are those that supply/ build Qi, Blood, Yang,

or Yin.)

 

" One particular kind of coating without root is found on the tongue when one

awakens; it disappears after breakfast. This indicates a mild weakness of

Stomach qi. A coating without root can also be due to an overdose of herbal

medicine used to tonify the Kidney yang or Kidney yin (either an excess of

cooling medicines which injure the Kidney yang, or of warming medicines

which injure the Kidney yin). Antibiotics can also cause the coating to

lose its root. " (p. 94.)

 

When treating Kidney Yin or Kidney Yang Deficiency, this before breakfast

lack of root can indicate that the thermal energy of the formula is too

extreme. For example, a person with severe Kidney Yin Deficiency may

require a lot of Yin tonic herbs for a long time. In time, the Kidney Yin

Deficiency starts to improve, and the old formula is no longer correct and

needs adjusting. This pre-breakfast tongue without root can be a sign that

one needs to adjust the formula, that it is too cooling (in the case of Yin

tonic formulas and damaging the Yang), or, in the case of treating Kidney

Yang Deficiency, the formula is now too warming and starting to damage the

Yin. (Yin cools and calms; Yang heats and activates. Yin can be damaged by

Heat, and Yang can be damaged by Cold. All herbs (and foods have thermal

energy. This thermal energy can be Cold, Cool, Neutral, Warm, or Hot. Many

Yin tonic herbs have cooling energy (cooling effects on the body). Many

Yang tonic herbs have warming energy (warming effects on the body).)

 

Always suspect and rule in or rule out Stomach Yin Deficiency when the

tongue is without coating. Another term for a tongue without coating or

without coating in spots is " peeled " .

 

Victoria

 

 

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