Pre Menstrual Tension in Traditional Chinese Medicine

Wiry (Xian)

The tongue body is typically normal or light red. In early or uncomplicated cases, the tongue may appear entirely normal. The most distinctive feature is redness or a slightly purplish hue along the sides of the tongue, which correspond to the Liver zone in tongue diagnosis. Some patients show frothy saliva along the tongue edges. The coating is usually thin and white. If the stagnation has begun to generate Heat (a common progression), the sides may become redder and the coating may start to thin or turn slightly yellow. If there is concurrent Spleen involvement, the coating may become slightly greasy.

Choppy (Se), Wiry (Xian)

The tongue body is characteristically dark purple or has an uneven dusky hue. Stasis spots (purple-blue dots or patches) may be scattered across the tongue surface, particularly along the edges. The sublingual veins are often the most telling feature: they appear distended, tortuous, and dark purple or even blue-black in colour. When Blood stasis is more advanced, these veins may branch into a web-like pattern. The coating is typically thin and white, though if the stagnation has begun generating Heat over time, a slight yellow tinge may appear. In cases where Qi stagnation predominates early on, the tongue may only appear slightly dark red rather than fully purple, progressing to deeper purple as Blood stasis worsens.

Wiry (Xian), Rapid (Shu)

The tongue body is red, often most prominently along the sides (the Liver/Gallbladder zone), and the tip may also be redder than normal. The coating is yellow, reflecting internal Heat, and tends toward dryness as the Fire consumes fluids. In milder or earlier presentations, the coating may be thin yellow rather than thick. Prickles (small raised dots) may appear on the sides or tip if Fire is more intense. The tongue edges may also show a slight swelling or appear darker red compared to the centre.

Choppy (Se), Wiry (Xian)

The tongue body is characteristically dark purple or has an uneven dusky hue. Stasis spots (purple-blue dots or patches) may be scattered across the tongue surface, particularly along the edges. The sublingual veins are often the most telling feature: they appear distended, tortuous, and dark purple or even blue-black in colour. When Blood stasis is more advanced, these veins may branch into a web-like pattern. The coating is typically thin and white, though if the stagnation has begun generating Heat over time, a slight yellow tinge may appear. In cases where Qi stagnation predominates early on, the tongue may only appear slightly dark red rather than fully purple, progressing to deeper purple as Blood stasis worsens.

Wiry (Xian), Rapid (Shu)

The tongue body is red, often most prominently along the sides (the Liver/Gallbladder zone), and the tip may also be redder than normal. The coating is yellow, reflecting internal Heat, and tends toward dryness as the Fire consumes fluids. In milder or earlier presentations, the coating may be thin yellow rather than thick. Prickles (small raised dots) may appear on the sides or tip if Fire is more intense. The tongue edges may also show a slight swelling or appear darker red compared to the centre.