MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM

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Chapter 60

MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM

Cracked corners of the mouth

Itching around the mouth

Dribbling from the corners of the mouth

Trembling mouth

Mouth open

Deviation of the mouth

TONGUE

Itchy tongue

Painful tongue

Numbness of the tongue

Upper teeth moist and lower teeth dry

Abnormal lip colour in pregnancy

Stiff-looking philtrum

Pale philtrum

Red philtrum

Bluish-greenish philtrum

Dark philtrum

MOUTH

Itching around the mouth

Stomach-Heat

Intense itching around mouth and especially at the corners and below the mouth, cold sores, foul breath, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Liver-Blood deficiency with Empty-Wind

Slight itching around the mouth, dryness around the mouth, greenish colour around the mouth, trembling mouth, facial tic, slight flapping of the eyelid, blurred vision, floaters, unilateral numbness/tingling of a limb, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Damp-Heat in Stomach and Spleen

Itching around mouth, wet rash around mouth, cold sores, sticky taste, thirst with no desire to drink, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Disharmony of Penetrating and Directing Vessels

Itching around mouth at period time or during the menopausal time, lower backache, dizziness, tinnitus, irregular periods.

Other symptoms and signs depend on whether there is a deficiency of Kidney-Yin or Kidney-Yang.

Clinical note

• The area around the mouth is controlled by the Liver channel and the Penetrating and Directing Vessels.

Dribbling from the corners of the mouth

Observation, Chapter 8

Spleen-Qi deficiency

Dribbling from the corners of the mouth, poor appetite, tiredness, slight abdominal distension, pale complexion, loose stools, Pale tongue, Empty pulse.

Lung-Qi deficiency with Empty-Cold

Dribbling from the corners of the mouth, chronic runny nose with watery white discharge, sneezing, slight shortness of breath, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch cold, tiredness, dislike of cold, a feeling of cold, cold limbs, Pale tongue, Weak pulse.

Stomach and Spleen-Heat

Dribbling from the corners of the mouth, painful tongue, mouth ulcers, dry mouth and lips, burning epigastric/abdominal pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, excessive hunger, red tip of the nose, dry stools, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

This dribbling is due to Stomach-Heat flaring upwards causing the fluids in the mouth to evaporate.

Wind-Phlegm

Dribbling from the corners of the mouth, severe dizziness, blurred vision, tremors, numbness or tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Invasion of external Wind

Dribbling from the corners of the mouth, numbness of the face, deviation of eye and mouth, inability to shut eyelid completely, watery eyes.

This is not an invasion of external Wind in the Lung’s Defensive-Qi system (as when one catches a cold) but an invasion of external Wind attacking the channels of the face causing facial paralysis (Bell’s palsy).

Trembling mouth

Liver-Blood and Liver-Yin deficiency with internal Wind

Slightly trembling mouth, dizziness, numbness/tingling of the limbs, blurred vision, floaters in the eyes, dry eyes, scanty menstruation, dull-pale complexion but with red cheek bones, withered and brittle nails, dry skin and hair, night sweating.

The tongue and pulse presentation depends on whether Blood or Yin deficiency predominates.

Qi stagnation and Phlegm

Trembling mouth, dribbling from the corners of the mouth, epigastric or abdominal distension, a feeling of muzziness of the head, sputum in the throat, a feeling of oppression of the chest, irritability, a feeling of a lump in the throat, Wiry-Slippery pulse.

Stomach-Heat

Trembling mouth, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Liver-Wind

Trembling mouth, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Mouth open

Observation, Chapter 8

Lung-Qi deficiency with Phlegm

Mouth open, chronic cough which is worse on exertion, scanty phlegm that is difficult to expectorate or dilute watery phlegm, spontaneous sweating, a feeling of cold, shortness of breath, a feeling of oppression of the chest, weak voice, tongue Pale and slightly Swollen in the front, pulse Empty on the right Front position and slightly Slippery.

Heart-Fire

Mouth open, tongue ulcers, red face, palpitations, thirst, mental restlessness, feeling agitated, insomnia, dream-disturbed sleep, a feeling of heat, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Qi deficiency

Mouth open, palpitations, mental dullness, palpitations, shortness of breath on exertion, pale face, tiredness, slight depression, spontaneous sweating, Pale tongue, Empty pulse.

Deviation of the mouth

Observation, Chapter 8

Liver-Wind

Deviation of mouth, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Liver-Wind and Phlegm

Deviation of mouth, severe dizziness, blurred vision, tremors, numbness/tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Invasion of Wind-Cold in the channels of the face

Sudden deviation of mouth, numbness of the face.

This is due to an invasion of Wind-Cold, not in the Lungs Defensive-Qi portion (as in the common cold and influenza) but in the channels of the face.

Liver-Qi stagnation

Intermittent deviation of mouth depending on emotional moods, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Deficiency of Qi and Blood

Slight deviation of mouth, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Toxic Heat in the channels of the face

Deviation of mouth, thirst, bitter taste, swelling and pain of the face, toothache, headache, red eyes, swollen face, Red tongue with red points with thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

TONGUE

The tongue signs discussed in this chapter deal only with a few unusual tongue signs; tongue diagnosis itself is discussed in full in Chapters 23–27.

Itchy tongue

Interrogation, Chapter 35

Heart-Fire

Itchy tip or front of the tongue, burning sensation of the tongue, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Slight itching of the tongue especially in the evening, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue redder on the tip with no coating, Floating-Empty and Rapid pulse.

Heart and Kidney-Yin deficiency

Itchy tongue, palpitations, insomnia, dream-disturbed sleep, anxiety, poor memory, dizziness, tinnitus, hardness of hearing, lower backache, night sweating, scanty dark urine, normal-coloured tongue without coating, Floating-Empty pulse.

Invasion of Wind-Heat

Itchy tongue with acute onset, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Painful tongue

Interrogation, Chapter 35

Heart-Fire

Painful tongue especially on the tip, tongue ulcers, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Slight pain of the tongue especially in the evening, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue redder on the tip with no coating, Floating-Empty and Rapid pulse.

Stomach-Fire

Painful tongue, bleeding gums, foul breath, intense thirst with a desire to drink cold liquids, burning epigastric pain, mental restlessness, dry mouth, mouth ulcers, dry stools, sour regurgitation, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, Red tongue with a thick, dry dark-yellow coating, Deep-Full-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Slightly painful tongue, dull or burning epigastric pain, a feeling of heat in the afternoon, dry mouth and throat especially in the afternoon, thirst with desire to drink in small sips, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Liver-Fire

Painful tongue, thirst, bitter taste, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Phlegm-Fire harassing the Heart

Painful tongue, thirst, bitter taste, sputum in throat, palpitations, mental restlessness, red face, a feeling of oppression of the chest, expectoration of phlegm, sputum in the throat, insomnia, dream-disturbed sleep, agitation, mental confusion, incoherent speech, rash behaviour, uncontrolled laughter or crying, shouting, depression, manic behaviour, Red tongue with redder swollen tip and Heart crack with a sticky, dry yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Numbness of the tongue

Interrogation, Chapter 35

Heart-Blood deficiency

Numbness of the tongue, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Phlegm obstructing the Heart

Numbness of the tongue, swollen tongue, dizziness, a feeling of oppression of the chest, sputum in the throat, numbness/tingling of the limbs, sticky tongue coating, Slippery pulse.

Liver-Wind

Numbness of the tongue, tremors, severe dizziness, tinnitus, headache, tics, convulsions, rigidity of the neck, tremor of limbs, stiff neck, opisthotonos, in severe cases coma, Stiff, Moving or Deviated tongue, Wiry pulse.

Liver Wind-Phlegm

Numbness of the tongue, deviated tongue, severe dizziness, blurred vision, tremors, numbness or tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Spleen-Qi deficiency

Numbness of the tongue, poor appetite, tiredness, slight abdominal distension, pale complexion, loose stools, Pale tongue, Empty pulse.

Chronic Blood stasis

Numbness of the tongue, dark complexion, headache, chest pain, mental restlessness, abdominal pain, dark nails, Purple tongue, Wiry pulse.

Tongue ulcers

Observation, Chapter 8; Interrogation, Chapter 35

Heart-Fire

Painful tongue ulcers with raised, red rim, bitter taste, thirst, palpitations, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Tongue ulcers with white rims, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue redder on the tip with no coating, Floating-Empty and Rapid pulse.

Full-Heat in the Small Intestine

Tongue ulcers with red rims, dry stools, dark urine, painful urination, blood in the urine, abdominal pain, dry yellow tongue coating, Overflowing-Rapid pulse.

Clinical note

• I use HE-5 Tongli as a point to reach the tongue (in addition to other points for the relevant pattern).

TEETH

Toothache

Interrogation, Chapter 35

Toothache obviously excludes causes such as abscesses or root canal problems.

Stomach-Fire

Toothache especially on the lower teeth, mouth ulcers, foul breath, intense thirst with a desire to drink cold liquids, bleeding gums, burning epigastric pain, mental restlessness, dry mouth, dry stools, sour regurgitation, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, Red tongue with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Damp-Heat in the Stomach

Toothache, swollen gums, sticky taste, thirst with no desire to drink, a feeling of fullness and pain of the epigastrium, a feeling of heaviness, facial pain, stuffed nose or thick sticky nasal discharge, nausea, a feeling of heat, dull-yellow complexion, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Toothache, mouth ulcers, dry mouth or thirst with a desire to drink in small sips, dull or burning epigastric pain, a feeling of heat in the afternoon, dry mouth and throat especially in the afternoon, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Stomach and Spleen-Qi deficiency

Dull toothache that comes and goes, weak gums, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Heat in Large Intestine

Severe toothache, especially of the upper teeth, mouth ulcers, bleeding gums, constipation with dry stools, burning sensation in the mouth, dry tongue, burning and swelling in the anus, scanty dark urine, thick yellow (or brown or black) dry tongue coating, Full-Rapid pulse.

Damp-Heat in Large Intestine

Toothache, especially of upper teeth, thirst with no desire to drink, mouth ulcers, a sticky taste, abdominal pain that is not relieved by a bowel movement, diarrhoea, mucus and blood in stools, offensive odour of stools, burning in the anus, scanty dark urine, fever, sweating which does not decrease the fever, a feeling of heat, a feeling of heaviness of the body and limbs, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Heat in the Spleen and Heart

Toothache, bleeding gums, red lips, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, burning epigastric/abdominal pain, excessive hunger, red tip of the nose, dry lips, dry stools, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Invasion of external Wind

Toothache, aversion to cold, fever, stiff neck, occipital headache, sneezing.

Other symptoms and signs, including tongue and pulse, depend on whether the pattern is Wind-Cold or Wind-Heat.

‘Wind-Cold in the Brain’

Severe toothache extending to the brain after an invasion of external Wind that has not been cleared, Purple tongue.

Tooth cavities

Observation, Chapter 8

Damp-Heat in the Stomach and Spleen

Tooth cavities, especially of lower teeth, bleeding gums, red lips, thirst with no desire to drink, sticky taste, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Stomach and Spleen-Qi deficiency

Tooth cavities, loose teeth, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Damp-Heat in the Large Intestine

Tooth cavities, especially of upper teeth, thirst with no desire to drink, mouth ulcers, abdominal pain that is not relieved by a bowel movement, diarrhoea, mucus and blood in stools, offensive odour of stools, burning in the anus, scanty dark urine, fever, sweating which does not decrease the fever, a feeling of heat, feeling of heaviness of the body and limbs, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Kidney deficiency

Tooth cavities, loose teeth, lower backache, dizziness, tinnitus, weak knees.

Other symptoms and signs, including pulse and tongue, depend on whether there is a Kidney-Yin or Kidney-Yang deficiency.

Loose teeth

Observation, Chapter 8

Stomach-Heat

Loose teeth, toothache, mouth ulcers, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Kidney deficiency

Loose teeth, lower backache, dizziness, tinnitus, tiredness, pulse Weak on both Rear positions.

Other symptoms and signs depends on whether there is a Kidney-Yang or Kidney-Yin deficiency.

Spleen-Yin deficiency with Empty-Heat

Loose teeth, toothache, red cheeks, poor appetite, poor digestion, retching, gnawing hunger, loss of sense of taste, slight epigastric pain, dry mouth and lips, dry stools, thin body, sallow complexion with red tip of the nose, night sweating, a feeling of heat in the evening, Red tongue without coating and transversal cracks on the sides, Floating-Empty and Rapid pulse.

Kidney-Yin deficiency with Empty-Heat

Loose teeth, dizziness, tinnitus, vertigo, poor memory, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, menopausal hot flushes, thirst with a desire to sip fluids, lower backache, ache in bones, nocturnal emissions with dreams, constipation, scanty dark urine, infertility, premature ejaculation, tiredness, depression, anxiety, insomnia, excessive menstrual bleeding, Red tongue without coating, Floating-Empty and Rapid pulse.

Grinding teeth

Liver-Qi invading the Spleen

Grinding teeth when tense, irritability, abdominal distension and pain, alternation of constipation and diarrhoea, stools sometimes dry and bitty (small pieces) and sometimes loose, flatulence, tiredness, tongue normal coloured or slightly Red on the sides, pulse Wiry on the left and Weak on the right.

Stomach and Heart-Fire

Grinding teeth, bleeding gums, burning epigastric pain, intense thirst with desire to drink cold liquids, mental restlessness, dry mouth, mouth ulcers, bleeding gums, dry stools, sour regurgitation, foul breath, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, palpitations, insomnia, dream-disturbed sleep, red face, bitter taste, tongue Red with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Retention of food

Grinding of teeth in children, fullness, pain and distension of the epigastrium which are relieved by vomiting, nausea, vomiting of sour fluids, foul breath, sour regurgitation, belching, insomnia, loose stools or constipation, poor appetite, thick tongue coating, Full-Slippery pulse.

Deficiency of Qi and Blood

Weakly grinding teeth, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Internal Empty-Wind

Grinding teeth, dizziness, headache, tics, fine tremors, tiredness, blurred vision, poor memory, Fine and slightly Wiry pulse.

The tongue may be Pale or Red without coating depending on whether there is an underlying Blood or Yin deficiency.

Invasion of External Wind

Grinding teeth, shivering, aversion to cold, fever, stiff neck, occipital headache, body aches, Floating pulse.

Plaque

Observation, Chapter 8

Stomach-Heat

Plaque, teeth yellow at the junction with the gums, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Heat in the Stomach and Kidneys

Plaque, teeth yellow at the junction with the gums, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, dark urine, painful urination, backache, Red tongue with yellow coating, Overflowing-Rapid pulse.

Kidney-Yin deficiency

Plaque, teeth dull yellow at the junction with the gums, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, dry mouth and throat at night, lower backache, ache in the bones, nocturnal emissions, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Dry and white teeth

Observation, Chapter 8

Acute interior Heat following an invasion of Wind-Heat

White, dry teeth, a feeling of heat, fever, thirst, sweating, Red tongue with yellow coating, Overflowing-Rapid pulse.

Stomach-Heat

White, dry teeth, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Dry and dull teeth

Observation, Chapter 8

Kidney-Yin deficiency

Dry, dull teeth which look like dry bones, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, dry mouth and throat at night, lower backache, ache in the bones, nocturnal emissions, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Kidney-Yin deficiency with Empty-Heat

Very dry, dull teeth which look like dry bones, dizziness, tinnitus, vertigo, poor memory, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, menopausal hot flushes, thirst with desire to sip fluids, lower backache, ache in the bones, nocturnal emissions with dreams, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, depression, anxiety, insomnia, excessive menstrual bleeding, Red tongue without coating, Floating-Empty and Rapid pulse.

Liver-Blood deficiency

Dry, dull teeth, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Yellow and dry teeth

Observation, Chapter 8

Damp-Heat in the Stomach and Spleen with predominance of Heat

Yellow and dry teeth, dull-yellow complexion, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Kidney-Yin deficiency

Dull-yellow and dry teeth, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, dry mouth and throat at night, lower backache, ache in the bones, nocturnal emissions, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Accumulation of Cold in the abdomen with false Yang above

Yellow and dry teeth, abdominal pain, a feeling of cold, cold feet, Pale tongue, Tight-Slow pulse.

Grey teeth

Observation, Chapter 8

Kidney-Yin deficiency with Empty-Heat

Grey and dry teeth, dizziness, tinnitus, vertigo, poor memory, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, menopausal hot flushes, thirst with a desire to sip fluids, lower backache, ache in the bones, nocturnal emissions with dreams, constipation, dark scanty urine, infertility, premature ejaculation, tiredness, depression, anxiety, insomnia, excessive menstrual bleeding, Red tongue without coating, Floating-Empty and Rapid pulse.

Upper teeth moist and lower teeth dry

Observation, Chapter 8

Kidney and Heart-Yin deficiency with Heart Empty-Heat (Kidneys and Heart not harmonized)

Upper teeth moist and lower teeth dry, dry mouth with a desire to sip water, palpitations, mental restlessness, insomnia, dream-disturbed sleep, anxiety, poor memory, dizziness, tinnitus, hardness of hearing, lower backache, nocturnal emissions with dreams, a feeling of heat in the evening, night sweating, five-palm heat, scanty dark urine, dry stools, Red tongue with redder tip and a Heart crack, Floating-Empty and Rapid pulse or a pulse that is Deep and Weak on both Rear positions and Overflowing on both Front positions.

GUMS

Inflamed gums

Observation, Chapter 8; Interrogation, Chapter 35

Stomach-Heat

Inflamed gums, foul breath, mouth ulcers especially on the lower gum, thirst, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Inflamed gums, especially lower gum, bleeding gums, mouth ulcers with a white rim, dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, dull or burning epigastric pain, a feeling of heat in the afternoon, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Invasion of Wind-Heat

Inflamed gums, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Purple Leg and Teeth Nutritional Impairment Pattern

Swollen, inflamed and bleeding gums, cracked lips, painful legs, swelling of the legs in patches like clouds and discoloured like unripe aubergine seeds, hardness of the flesh, difficulty in walking.

There are actually two manifestations of this pattern, one with Damp-Cold and the other with Toxic Heat. If there is Damp-Cold there will also be a feeling of heaviness, cold limbs, oedema and ache in the joints. If there is Toxic Heat, there will be a bitter taste, dry mouth, thirst, foul breath, Red tongue with red points and thick, sticky, dry yellow coating and an Overflowing-Slippery-Rapid pulse.

‘Walking Crow’ Teeth Nutritional Impairment Pattern

In the beginning hard, red nodules on the gum, after 1 or 2 days the gums become inflamed and then greyish-black, bleeding gums that are neither painful nor itchy, foul breath, Red tongue with sticky yellow coating.

This pattern is more common in children.

Bleeding gums

Observation, Chapter 8: Interrogation, Chapter 35

Deficient Spleen-Qi not holding Blood

Bleeding gums, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, slight depression, tendency to obesity, Pale tongue, Empty pulse.

Stomach-Fire

Bleeding and painful gums, foul breath, intense thirst with a desire to drink cold liquids, burning epigastric pain, mental restlessness, dry mouth, mouth ulcers, bleeding gums, dry stools, sour regurgitation, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, Red tongue with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Stomach-Yin deficiency with Empty Heat

Bleeding gums, dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, dull or burning epigastric pain, a feeling of heat in the afternoon, constipation (dry stools), a feeling of hunger but no desire to eat, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Kidney-Yin deficiency with Empty-Heat

Bleeding gums, dizziness, tinnitus, vertigo, poor memory, deafness, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, menopausal hot flushes, thirst with a desire to sip fluids, lower backache, ache in bones, nocturnal emissions with dreams, constipation, scanty dark urine, infertility, premature ejaculation, tiredness, depression, anxiety, insomnia, excessive menstrual bleeding, Red tongue without coating, Floating-Empty and Rapid pulse.

Receding gums

Observation, Chapter 8: Interrogation, Chapter 35

Deficiency of Qi and Blood

Receding gums, pale lips, pale gums, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Stomach-Fire

Receding gums, red gums, mouth ulcers, bleeding gums, foul breath, burning epigastric pain, intense thirst with a desire to drink cold liquids, mental restlessness, bleeding gums, dry stools, dry mouth, mouth ulcers, nausea, vomiting soon after eating, sour regurgitation, a feeling of heat, tongue Red with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Kidney-Yin deficiency with Empty-Heat

Receding gums, bleeding gums, dizziness, tinnitus, vertigo, poor memory, deafness, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, menopausal hot flushes, thirst with desire to sip fluids, lower backache, ache in bones, nocturnal emissions with dreams, constipation, scanty dark urine, infertility, premature ejaculation, tiredness, depression, anxiety, insomnia, excessive menstrual bleeding, Red tongue without coating, Floating-Empty and Rapid pulse.

Clinical note

• Remember that, apart from the Stomach, the Kidneys also influence the gums. ‘Loose teeth’ is a sign associated with a Kidney deficiency in Chinese medicine, but teeth also become loose from gum disease.

Gums oozing pus

Observation, Chapter 8

Stomach-Fire

Gums oozing pus, tooth abscess, red and swollen gums, bleeding gums, toothache, foul breath, burning epigastric pain, intense thirst with a desire to drink cold liquids, mental restlessness, dry stools, dry mouth, mouth ulcers, nausea, vomiting soon after eating, sour regurgitation, a feeling of heat, Red tongue with a thick, dry, dark-yellow coating, Deep-Full-Rapid pulse.

Invasion of Wind-Heat with Toxic Heat

Gums oozing pus, swollen glands, bleeding gums, aversion to cold, sore throat, fever, tonsillitis, tonsils oozing pus, headache, tongue red on the sides with red points and a yellow coating, Floating-Rapid pulse.

Severe deficiency of Qi and Blood with Toxic Heat

Chronic, recurrent bouts of gums oozing pus, ulcers on the gums which are slow to heal, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Pale gums

Observation, Chapter 8

Spleen-Qi deficiency

Pale gums, pale lips, poor appetite, tiredness, slight abdominal distension, pale complexion, loose stools, Pale tongue, Empty pulse.

Blood deficiency

Dull-pale gums, tiredness, dizziness, blurred vision, scanty periods, Pale tongue, Choppy or Weak pulse.

Spleen-Yang deficiency with Empty-Cold

Bright-pale gums, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, slight depression, tendency to obesity, a feeling of cold, cold limbs, oedema. Pale and wet tongue, Deep-Weak pulse.

Red gums

Observation, Chapter 8

Stomach-Heat

Bright-red gums, swollen gums, bleeding gums, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Red gums, bleeding gums, a feeling of heat in the afternoon, dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, dull or burning epigastric pain, a feeling of heat in the afternoon, constipation (dry stools), feeling of hunger but no desire to eat, a slight feeling of fullness after eating, night sweating, five-palm heat, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Spleen-Heat

Red gums, dry and red lips, burning epigastric/abdominal pain, excessive hunger, red tip of the nose, mouth ulcers, thirst, dry stools, a feeling of heat, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Spleen Empty-Heat

Pale-red gums, poor appetite, poor digestion, retching, gnawing hunger, loss of taste, slight epigastric pain, dry mouth and lips, dry stools, thin body, sallow complexion with red tip of the nose, night sweating, a feeling of heat in the evening, malar flush, Red tongue without coating and transversal cracks on the sides, Floating-Empty and Rapid pulse.

Purple gums

Observation, Chapter 8

Blood stasis in the Stomach

Purple gums, bleeding gums, toothache, purple lips, severe, stabbing epigastric pain that may be worse at night, dislike of pressure, nausea, vomiting, possibly vomiting of blood, vomiting of food looking like coffee grounds, Purple tongue, Wiry pulse.

Heat at the Blood level in febrile diseases

Purple gums, bleeding gums, dark macular rash, mental confusion, fever at night, high fever, irritability, vomiting of blood, epistaxis, blood in stools, blood in urine, Dark-Red tongue without coating, Fine-Wiry-Rapid pulse.

LIPS

Pale lips

Observation, Chapter 8

Deficiency of Qi and Blood of the Spleen

Pale lips, dull-pale complexion, poor appetite, slight abdominal distension after eating, tiredness, lassitude, weakness of the limbs, loose stools, thin body, scanty periods or amenorrhoea, insomnia, joint ache, Pale tongue, Weak or Choppy pulse.

Liver-Blood deficiency

Pale lips, dull-pale complexion, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, Pale tongue, Choppy or Fine pulse.

Spleen-Yang deficiency with Empty-Cold

Pale and slightly bluish lips or bright-white lips, pale complexion, poor appetite, slight abdominal distension after eating, abdominal pain, tiredness, lassitude, weakness of the limbs, loose stools, a feeling of cold, cold limbs, Pale and wet tongue, Deep-Weak-Slow pulse.

Red lips

Observation, Chapter 8

Full-Heat

Red and swollen lips, thirst, dry stools, a feeling of heat, Red tongue with yellow coating, Overflowing-Rapid pulse.

Heat in the Heart, Lungs, Stomach, Liver, Kidneys and Spleen may all cause red lips and other symptoms and signs depend on the organ involved.

Yin deficiency with Empty-Heat

Red, cracked and dry lips, dry mouth, thirst with a desire to drink in small sips, feeling of heat in the evening, night sweating, five-palm heat, Red tongue without coating, Floating-Empty and Rapid pulse.

Empty-Heat in the Heart, Lungs, Stomach, Liver, Kidneys and Spleen may all cause red lips and other symptoms and signs depend on the organ involved.

Invasion of Wind-Heat

Red lips (especially in children), aversion to cold, fever, sore throat, headache, body aches, slight sweating, tongue with Red sides or front or both, Floating-Rapid pulse.

Acute Heat at the Qi level in febrile diseases (Heat)

Red and swollen lips, fever, a feeling of heat, throwing off of the bedclothes, thirst, profuse sweating, Red tongue with yellow coating, Overflowing-Rapid pulse.

Acute Heat at the Qi level in febrile diseases (Fire)

Red, swollen, dry and cracked lips, fever, a feeling of heat, thirst, dry mouth, dry stools, dark urine, mental restlessness, Red tongue with dry, dark-yellow or brown coating, Deep-Full-Rapid pulse.

Purple lips

Observation, Chapter 8

Blood stasis

Purple lips, dark complexion, headache, chest, hypochondrial or abdominal pain, palpitations, Purple tongue, Wiry pulse.

Other symptoms and signs depend on the organ involved, which may be the Liver or the Heart.

Severe Spleen-Yang deficiency with Empty-Cold

Purple lips, pale complexion, poor appetite, slight abdominal distension after eating, abdominal pain, tiredness, lassitude, weakness of the limbs, loose stools, a feeling of cold, cold limbs. Pale and wet tongue, Deep-Weak-Slow pulse.

Severe Kidney-Yang deficiency with Empty-Cold

Purple lips, lower backache, cold knees, a feeling of cold, bright-white complexion, weak knees, tiredness, lassitude, abundant clear urination, urination at night, impotence, decreased libido, Pale and wet tongue, Deep-Weak pulse.

This is a severe deficiency of Kidney-Yang with internal Empty-Cold that leads to some Blood stasis; for this reason the complexion is dark rather than pale, as it should be in Yang deficiency.

Internal Full-Cold

Bluish-purple lips, bright-white complexion, a feeling of cold, cold limbs, abdominal pain, bright-pale complexion, thick white tongue coating, Deep-Full-Tight-Slow pulse.

Other symptoms and signs depend on the organ involved.

Turbid Phlegm in the Lungs

Bluish-purple lips, sticky taste, breathlessness, expectoration of phlegm, wheezing, inability to lie down, a feeling of oppression of the chest, sticky, dirty tongue coating, Slippery pulse.

Heat at the Nutritive-Qi or Blood level in acute febrile diseases

Reddish-purple lips, fever at night, mental restlessness and confusion, macular rash, bleeding, Red tongue without coating, Fine-Rapid pulse.

Bluish-greenish lips

Observation, Chapter 8

Internal Cold

Bluish lips, bluish-white complexion, a feeling of cold, cold limbs, abdominal pain.

Other symptoms, including tongue and pulse, depend on whether it is Full or Empty-Cold and also on the organ involved.

Stagnation of Qi and stasis of Blood

Greenish lips, greenish complexion, abdominal distension and pain, irritability, chest pain, Purple tongue, Wiry or Choppy pulse.

Qi and Blood stagnation of the Heart, Lungs, Stomach or Liver may cause greenish lips and other symptoms and signs depend on the organ involved.

Yellow lips

Observation, Chapter 8

Damp-Heat in the Stomach and Spleen

Bright-yellow lips, sticky taste, dull-yellow complexion, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Cold-Dampness in the Stomach and Spleen

Dull-yellow lips, dull-yellowish complexion, sticky taste, abdominal pain, a feeling of cold in the abdomen, cold limbs, a feeling of fullness and heaviness, Pale tongue with sticky white coating, Slippery-Slow pulse.

Full-Heat with Blood stasis

Dark-yellow lips, a feeling of heat, thirst, abdominal pain, headache, chest pain, Reddish-Purple tongue, Wiry or Choppy and Rapid pulse.

Other symptoms and signs depend on the organ involved.

Dry or cracked lips

Observation, Chapter 8

Stomach and Spleen-Yin deficiency

Dry lips, dry mouth, no appetite or slight hunger but no desire to eat, constipation (dry stools), dull or slightly burning epigastric pain, dry mouth and throat especially in the afternoon, thirst but with no desire to drink, or a desire to drink in small sips, a slight feeling of fullness after eating, normal-coloured tongue without coating in the centre, Floating-Empty pulse.

Full-Heat

Cracked, red and swollen lips, thirst, dry stools, a feeling of heat, Red tongue with yellow coating, Overflowing-Rapid pulse.

Heat of the Lungs, Stomach, Spleen and Large Intestine may cause cracked lips and other symptoms and signs depend on which organ is involved.

Yin deficiency with Empty-Heat

Cracked and dry lips, dry mouth, night sweating, five-palm heat, thirst with a desire to drink in small sips, a feeling of heat in the evening, Red tongue without coating, Floating-Empty and Rapid pulse.

Empty-Heat of the Lungs, Stomach, Spleen and Large Intestine may cause cracked lips and other symptoms and signs depend on which organ is involved.

Liver-Blood deficiency

Slightly cracked and dry lips, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Blood stasis

Cracked, dry and purple lips, dry mouth with desire to drink without swallowing, headache, chest pain, abdominal pain, Purple tongue, Wiry or Choppy pulse.

Blood stasis of the Heart, Lungs, Stomach or Liver may cause cracked lips and other symptoms and signs depend on the organ involved. As there is an interchange between Blood and Body Fluids, severe, long-standing Blood stasis impairs the metabolism of Body Fluids and causes Dryness.

Clinical note

• In women, dry lips is often a sign ‘clinching’ the diagnosis of Spleen-Yin deficiency.

Trembling lips

Observation, Chapter 8

Spleen-Qi deficiency

Slow, trembling lips, pale lips, pale complexion, poor appetite, tiredness, slight abdominal distension, loose stools, Pale tongue, Empty pulse.

Blood deficiency with Empty-Wind

Trembling and dry lips, itching around the mouth, dry skin, slight tremor of the head or hand or both, facial tic, dizziness, blurred vision, unilateral numbness/tingling of a limb, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Stomach-Fire

Fast, trembling lips, red lips, bleeding gums, intense thirst with a desire to drink cold liquids, foul breath, dry mouth, mouth ulcers, burning epigastric pain, mental restlessness, bleeding gums, dry stools, sour regurgitation, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, tongue Red with a thick, dry dark-yellow coating, Deep-Full-Rapid pulse.

Peeled lips

Observation, Chapter 8

Spleen-Heat

Peeled, fresh red, cracked and swollen lips, dry lips, mouth ulcers, thirst, burning epigastric/abdominal pain, excessive hunger, red tip of the nose, dry stools, a feeling of heat, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Spleen-Yin deficiency with Empty-Heat

Peeled, dry, cracked lips, poor appetite, poor digestion, retching, gnawing hunger, loss of taste, slight epigastric pain, dry stools, thin body, sallow complexion with red tip of the nose, night sweating, a feeling of heat in the evening, malar flush, Red tongue without coating and transversal cracks on the sides, Floating-Empty and Rapid pulse.

Swollen lips

Observation, Chapter 8

Toxic Heat affecting Stomach and Spleen

Swollen, dark lips, thirst, feeling of heat, mental restlessness, pustular rashes, swelling, pain, headache, Red tongue with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Damp-Heat in the Stomach and Spleen

Swollen and bright red lips, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Wind-Heat in the skin

Swollen and bright-red lips with acute onset, urticarial rash, swelling of the throat, itching, red eyes.

This corresponds to an allergic reaction to foods or a bee sting.

Inverted lips

Observation, Chapter 8

Severe Yang deficiency

Inverted lips, cold limbs, sweating, feeling cold, lassitude, backache, dizziness, tinnitus, loose stools, Pale and wet tongue, Deep-Weak or Scattered pulse.

Other symptoms and signs depend on the organ involved.

Severe Yin deficiency

Inverted lips, a feeling of heat, dry skin, dry mouth, dry nails, dizziness, tinnitus, night sweating, tongue without coating, Fine or Minute pulse.

Other symptoms and signs depend on the organ involved.

Drooping lips

Observation, Chapter 8

Spleen-Qi deficient and sinking

Drooping lips, a feeling of bearing down in the abdomen, prolapse, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, Pale tongue, Empty pulse.

Spleen and Kidney-Yang deficiency

Drooping lips, lower backache, cold and weak knees, a feeling of cold, bright-white complexion, impotence, decreased libido, tiredness, lassitude, abundant clear urination, urination at night, loose stools, poor appetite, slight abdominal distension, a desire to lie down, early-morning diarrhoea, Pale and wet tongue, Deep-Weak pulse.

Abnormal lip colour in pregnancy

Observation, Chapter 8

Blood deficiency

Pale lips in pregnancy, dizziness, blurred vision, floaters, numbness/tingling of limbs, dull-pale complexion, palpitations, Pale tongue, Choppy or Fine pulse.

Severe Blood deficiency

White-coloured lips, dryness of the corners of the mouth, exhaustion, palpitations, dizziness, blurred vision, floaters, numbness/tingling of limbs, dull-pale complexion, dry skin, tongue Pale and dry or Pale and without coating, Choppy or Fine pulse.

Blood stasis from Cold

Bluish lips in pregnancy, abdominal pain that is alleviated by the application of heat, chest pain, headache, cold limbs, Bluish-purple tongue, Tight pulse.

PALATE

Pale palate

Observation, Chapter 8

Stomach and Spleen-Qi deficiency

Pale palate that looks like the skin of milk, poor appetite, slight abdominal distension after eating, tiredness, lassitude, pale complexion, weakness of the limbs, loose stools, an uncomfortable feeling in the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Stomach and Spleen-Yang deficiency

Pale palate that looks almost white, poor appetite, slight abdominal distension after eating, tiredness, pale complexion, weakness of the limbs, loose stools, uncomfortable feeling of the epigastrium, lack of taste sensation, a feeling of cold, cold limbs, Pale and wet tongue, Weak-Deep pulse.

Dull-pale palate

Observation, Chapter 8

Spleen and Liver-Blood deficiency

Dull-pale palate, poor appetite, slight abdominal distension after eating, tiredness, dull-pale complexion, weakness of the limbs, loose stools, thin body, scanty periods or amenorrhoea, insomnia, dizziness, numbness of limbs, blurred vision, ‘floaters’ in eyes, pale lips, cramps, withered and brittle nails, dry hair and skin, Pale and dry tongue, Choppy or Fine pulse.

Deficiency of Qi and Blood

Dull-pale palate, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Yellow palate

Observation, Chapter 8

Chronic Stomach and Spleen-Qi deficiency

Dull-yellow palate, poor appetite, slight abdominal distension after eating, tiredness, pale complexion, weakness of the limbs, loose stools, uncomfortable feeling of the epigastrium, lack of sense of taste, Pale tongue, Empty pulse.

Dampness in the Stomach and Spleen

Bright-yellow palate, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Red palate

Observation, Chapter 8

Full-Heat

Red palate, thirst, mouth ulcers, a feeling of heat, mental restlessness, Red tongue with yellow coating, Overflowing-Rapid pulse.

Other symptoms and signs depend on the organ involved.

Purple palate

Observation, Chapter 8

Blood stasis

Purple palate, abdominal pain, chest pain, headache, mental restlessness, Purple tongue, Wiry or Choppy pulse.

Other symptoms and signs depend on the organ involved (usually the Liver, Lungs, Stomach or Heart).

PHILTRUM

Flat philtrum

Observation, Chapter 8

Kidney deficiency

Flat philtrum, lower backache, dizziness, tinnitus, tiredness.

Other symptoms and signs, including pulse and tongue, depend on whether there is a Kidney-Yang or Kidney-Yin deficiency.

Damp-Heat in the Stomach and Spleen

Flat philtrum, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Clinical note

• According to the ancient Chinese art of face reading, a flat philtrum in women may indicate infertility.

Stiff-looking philtrum

Observation, Chapter 8

Blood stasis

Stiff-looking philtrum, dark lips, abdominal pain, chest pain, headache, Purple tongue, Wiry or Choppy pulse.

Pale philtrum

Observation, Chapter 8

Qi deficiency

Pale philtrum, tiredness, poor appetite, loose stools, weak voice, Pale tongue, Empty pulse.

Other symptoms and signs depend on the organ involved.

Full-Cold

Bright-pale philtrum, greyish-pale complexion, abdominal pain, epigastric pain, cold limbs, pain alleviated by exposure to heat and by drinking warm drinks and aggravated by exposure to cold and by drinking cold drinks, thick white tongue coating, Tight pulse.

Other symptoms and signs depend on the organ involved.

Empty-Cold

Pale philtrum, greyish-pale complexion, dull abdominal pain, dull epigastric pain, cold limbs, pain alleviated by exposure to heat and by drinking warm drinks, and aggravated by exposure to cold and by drinking cold drinks, a feeling of cold, tiredness, Pale tongue with thin white tongue coating, Deep-Weak pulse.

Other symptoms and signs depend on the organ involved.

Red philtrum

Observation, Chapter 8

Heat in the Blood

Red philtrum, skin rashes, a feeling of heat, thirst, bleeding, mental restlessness, Red tongue, Overflowing-Rapid pulse.

Invasion of Wind-Heat

Red philtrum, aversion to cold, fever, sore throat, headache, body aches, slight sweating, tongue with Red sides/front, Floating-Rapid pulse.

Damp-Heat in the Intestines

Red philtrum with skin spots oozing fluid, abdominal pain that is not relieved by a bowel movement, diarrhoea, mucus and blood in stools, offensive odour of stools, burning in the anus, scanty dark urine, fever, sweating which does not decrease the fever, a feeling of heat, thirst without a desire to drink, a feeling of heaviness of the body and limbs, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Bluish-greenish philtrum

Observation, Chapter 8

Internal Cold

Bluish philtrum, a feeling of cold, abdominal pain, cold limbs, Pale tongue, Deep pulse.

Other symptoms and signs depend on whether there is Full or Empty-Cold.

Liver-Qi stagnation

Greenish philtrum, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Dark philtrum

Observation, Chapter 8

Heat in the Blood

Dark philtrum, skin rashes, a feeling of heat, thirst, bleeding, mental restlessness, Red tongue, Overflowing-Rapid pulse.

Damp-Heat in the Lower Burner

Dark philtrum, yellow, itchy vaginal discharge, lower abdominal pain, dark/cloudy urine, tongue with sticky yellow coating on the root, Slippery-Rapid pulse.

Diagnosis in Chinese Medicine A Comprehensive Guide

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MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM

MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM