Orange Tongue

[Guest guest]

I have a patient who I regularly see for a knee injury/overuse that recently

had a tremendous change to her tongue. Before it was pink, slightly

scalloped white coat in back with red spots (not raised, almost looks like

it's a lack of coat, but definitely not yin peeled patches) starting about a

week ago it got a very burnt orange look to it. I can't find any info on

burnt orange. And it doesn't look like the pale orange of blood xu. Any

ideas?

 

 

 

She is pretty healthy in general, exercises often as she is a marathon

runner, says she eats well, no obvious health issues. Kidney pulses are

somewhat weak. I have taken the spots on the tongue to be heat and/or yin

xu, but this burnt orange is tripping me out. I'd appreciate any thoughts.

 

 

 

Julie

 

 

 

 

[Guest guest]

If you look in the archives I had a similar question a few months back. The

pictures are probably still in the group's folder as well.

Is it the coating that got the burnt orange look to it? I am on the side of

something like deep, old internal heat. Someone looked at the pictures I posted

and said they were brown. I still think they're orange, having seen brown

coatings, but I do agree that they signify a type of heat.

 

Hugo

 

 

Julie Ormonde <cariadanam

Chinese Medicine ; alumni-ny;

alumni-sd

Wednesday, 16 May, 2007 12:47:55 PM

Orange Tongue

 

 

 

 

 

 

 

 

 

 

 

 

 

I have a patient who I regularly see for a knee injury/overuse that

recently

 

had a tremendous change to her tongue. Before it was pink, slightly

 

scalloped white coat in back with red spots (not raised, almost looks like

 

it's a lack of coat, but definitely not yin peeled patches) starting about a

 

week ago it got a very burnt orange look to it. I can't find any info on

 

burnt orange. And it doesn't look like the pale orange of blood xu. Any

 

ideas?

 

 

 

She is pretty healthy in general, exercises often as she is a marathon

 

runner, says she eats well, no obvious health issues. Kidney pulses are

 

somewhat weak. I have taken the spots on the tongue to be heat and/or yin

 

xu, but this burnt orange is tripping me out. I'd appreciate any thoughts.

 

 

 

Julie

 

 

 

 

[Guest guest]

I saw my patient again today and I uploaded two pics under the unusual

tongue coat album (on the tcm list), my patient is the last two pics. This

week it is looking somewhat better, that burnt quality to it seems to have

disappeared but still quite orange and its moved more up front.

 

 

 

She says no carrot juice, the only supplement she takes is endurox which is

pink colored. She uses this after a hard workout but she said she drank it

Friday night, her tongue actually got better on Saturday and then became

orange again on Sunday. It seems to be the coat, not the body, the spots I

mentioned before are visible through the orange coat. It doesn't brush off.

And as you can see it looks swollen w/ scallops, it looks a bit dusky in

the picture but that's just the lighting.

 

 

 

She tends to be constipated and at times has night sweats, that's about it.

At this point Im still leaning towards heat/yin xu induced.

 

 

 

I'd appreciate any insights.

 

Julie

 

 

 

 

[Guest guest]

Thanks for the upload, Julie. I took a look and it looks like strong heat &

stagnation in the middle warmer.

From looking at the photo of her tongue I would not say that she is healthy

generally. She has clearly developed signs of yin deficiency, spleen qi def with

damp accumulation, and it doesn't look recent. It's possible that your patient

cycles through this yearly, or according to some other pattern, but I doubt that

this is the first time her tongue has presented in this way.

It is important to query our patients carefully, and compassionately challenge

them when we believe there might be some dishonesty regarding important clinical

information. Some questions that might bring interesting things to light with

your patient:

Why does she take endurox, if she is so healthy? What happens if she doesn't

take it, when and why did she begin to take it?

When did she take up marathon running? What did she do before that? What was

her health like back then?

Ask yourself what the marathon running is doing to her. It may well be coursing

her qi and masking some pretty strong qi depression and congestion. And if it

takes a marathon to mask it...

Ask yourself why her kidney pulses are weak - she is still young, and strong

enough (?) to run marathons. Ask yourself if her marathon running may actually

be severely depleting her kidneys. Remember, your big clue there is her

presenting complaint: " knee overuse " . Don't leave it at the mechanics only,

you'll never become mroe than a technician.

 

Some ideas that came into my head, hope you find them useful.

Hugo

 

 

 

Julie Ormonde <cariadanam

Chinese Medicine ; alumni-sd;

alumni-ny

Thursday, 17 May, 2007 6:55:37 PM

RE: Orange Tongue

 

 

 

 

 

 

 

 

 

 

 

 

 

I saw my patient again today and I uploaded two pics under the

unusual

 

tongue coat album (on the tcm list), my patient is the last two pics. This

 

week it is looking somewhat better, that burnt quality to it seems to have

 

disappeared but still quite orange and its moved more up front.

 

 

 

She says no carrot juice, the only supplement she takes is endurox which is

 

pink colored. She uses this after a hard workout but she said she drank it

 

Friday night, her tongue actually got better on Saturday and then became

 

orange again on Sunday. It seems to be the coat, not the body, the spots I

 

mentioned before are visible through the orange coat. It doesn't brush off.

 

And as you can see it looks swollen w/ scallops, it looks a bit dusky in

 

the picture but that's just the lighting.

 

 

 

She tends to be constipated and at times has night sweats, that's about it.

 

At this point Im still leaning towards heat/yin xu induced.

 

 

 

I'd appreciate any insights.

 

 

 

Julie