Skin Numbness in Traditional Chinese Medicine

Fine (Xi), Weak (Ruo), Empty (Xu), Slowed-down (Huan)

The tongue body is characteristically pale, reflecting both Qi and Blood insufficiency. It may be slightly thin due to Blood failing to fill the tongue body, or it may show teeth marks on the edges if the Spleen Qi component is pronounced, causing the tongue to become slightly swollen and soft against the teeth. The coating is thin and white, which is consistent with a deficiency pattern without Heat or Dampness involvement. In more chronic cases, the tongue may appear slightly dry if Blood deficiency is more severe, but this is not a primary feature of the base pattern. The undersurface veins should appear normal and not distended.

Fine (Xi), Weak (Ruo), Empty (Xu), Slowed-down (Huan)

The tongue body is characteristically pale, reflecting both Qi and Blood insufficiency. It may be slightly thin due to Blood failing to fill the tongue body, or it may show teeth marks on the edges if the Spleen Qi component is pronounced, causing the tongue to become slightly swollen and soft against the teeth. The coating is thin and white, which is consistent with a deficiency pattern without Heat or Dampness involvement. In more chronic cases, the tongue may appear slightly dry if Blood deficiency is more severe, but this is not a primary feature of the base pattern. The undersurface veins should appear normal and not distended.

Choppy (Se), Firm (Lao), Wiry (Xian)

The hallmark tongue finding is a dark purple or dusky body colour, which may be uniform or patchy. Stasis spots (purple or dark dots) can appear anywhere on the tongue surface. The underside of the tongue is especially important: the two sublingual veins are typically engorged, tortuous, and dark purple or even blackish. The tongue coating itself is usually thin and white and is not the primary diagnostic feature. In long-standing cases, the tongue may become somewhat dry if fluids are also affected.

Choppy (Se), Wiry (Xian), Slippery (Hua)

The tongue is typically purple or dark in colour, reflecting Blood Stasis, and may show visible stasis spots (purple dots or patches). The coating is characteristically white and greasy, indicating Phlegm-Dampness. The sublingual veins are often distended and tortuous, which is a reliable sign of Blood Stasis in the collateral vessels. In some cases, the tongue body may be slightly swollen with teeth marks along the edges, reflecting underlying Spleen weakness and Dampness accumulation.

Slow (Chi), Soggy (Ru), Slippery (Hua)

The tongue body tends toward pale or normal colour, often slightly swollen and puffy with teeth marks along the edges, reflecting the Spleen's inability to transform Dampness. The coating is the most diagnostically significant feature: it is white, greasy or sticky, and tends to be thicker in the centre and root. The tongue surface is usually excessively moist or slippery. In cases where Wind and Cold accompany the Dampness, the coating may be thin and white rather than thick, but the greasy quality remains.

Wiry (Xian), Rapid (Shu)

The tongue body is deep red to crimson (绛), indicating heat has penetrated to the nutritive (Ying) and blood levels. The surface is dry, reflecting severe fluid damage from extreme heat. In advanced cases, the tongue may appear scorched or develop raised prickles (thorny papillae), particularly at the tip and edges, signalling intense fire toxin. The coating is yellow and dry, sometimes becoming brown or burnt-looking. The tongue body may appear stiff and difficult to protrude, reflecting wind agitating the sinews. In the most severe presentations, the tongue may tremble when extended.

Wiry (Xian), Rapid (Shu)

The tongue body is deep red to crimson (绛), indicating heat has penetrated to the nutritive (Ying) and blood levels. The surface is dry, reflecting severe fluid damage from extreme heat. In advanced cases, the tongue may appear scorched or develop raised prickles (thorny papillae), particularly at the tip and edges, signalling intense fire toxin. The coating is yellow and dry, sometimes becoming brown or burnt-looking. The tongue body may appear stiff and difficult to protrude, reflecting wind agitating the sinews. In the most severe presentations, the tongue may tremble when extended.