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Tongue diagnosis case


Can you please help me with a diagnosis to this case:

Symptoms:Anxiety,dryness(dry skin ,dry eyes),shortness of breath,night sweats

Here are the images:


Thank you very much

With respect,



What exactly is it that you need help with? What is the diagnosis you have come to and what treatment methods (acupuncture?, herbs?, etc.?) have you tried in exact terms? If you have treated the patient already, why do you feel what you are doing is not working, or not working well enough - what did you expect to happen at this point?

Also, you should include more information about the patient - age, gender, other related symptoms and how the anxiety is impacting them. Are they doing anything else - meditation, counseling, etc. - what is their diet like, etc.? - all the basic information that is used to help derive a treatment plan....


Thank you for the quick answer.

I&#39m a tcm student and this is a case that I&#39m having trouble with.

What I wanted to know is the deficiencies that can be seen only from the tongue.

the patient can try only acupuncture and diet now and unfortunatley shortness of breath and the dryness don&#39t seem to resolve with my actions

My diagnosis from the tongue was:

- Spleen Qi deficieincy (tongue red dots and teeth marks)

- lung heat

-dampness (not sure the fur and white coat on the tongue?)

- heart yin deficiency

-liver blood dryness

I recommended a diet with cooling vegetables and grains mostly cooked (boiled) and some nourishing foods( cod liver oil ,some milk , butter) while the anxiety almost dissapeard the shortness of breath and dryness remained the same)

+ 5 accupuncture sessions

+daily Qi Gong

age: 30

gender: male

no counseling ,active lifestyle

a lot of work related stress

What I was mostly interested in was the opinion of a more experienced practitioner regarding the diagnosis that can be seen only from the tongue.(I know that this is not enough for a really accurate diagnosis but this is the place where I"m really not sure I made a correct diagnosis )

If you could tell me your opinion of the deficiencies based on the tongue alone I&#39d really appreciate

Thanks again


Again... when you say "don&#39t seem to resolve with my actions" - what are your "actions" (i.e. what points are you using)? And when you say it "hasn&#39t resolved yet" - what points were you using and what points did you switch to and when did this happen - the last 2 treatments? the most recent treatment?

Generally the tongue shows damp-heat. So having the patient increase (or even use) dairy consumption would not be correct in my opinion. The breathing can be from the underlying liver qi stagnation and/or dampness - so reducing damp producing foods should help and including damp eliminating points would help as well as harmonizing the liver and strengthening the spleen.

Also, as you mention the patient is doing daily qi gong, I would ensure that they are not holding their breath or breathing incorrectly during qi gong practice. This can create lots of trouble.

To resolve the dryness you have to eliminate the heat. Part of eliminating the heat is resolving the dampness which contributes to the stagnation, which then generates heat. A point such as SP 10 (as an example) could be useful as it clears heat from the blood layer.

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