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All lessons   Module 1: Tongue   Lesson 6

Module 1   Lesson 6   Run Zao

Moisture, course and the tongue over time

What do wet and dry say, and how do you read a tongue that changes?

After this lesson you can distinguish five grades of moisture and the difference between wet and sticky, read every change in the coating as favourable, unfavourable or caution, know what changes first in the early weeks of a treatment, take follow-up photos you can compare, and recognise what season, time of day, age, smoking and medication change in a normal tongue.

day 1
Schematic, day 1: Pale-Red with a redder tip, thin white coating, slightly moist. The pathogen is still in the Exterior.
day 3
Schematic, day 3: Red, thick yellow coating, dry. Unfavourable: thicker, yellower and drier.
day 6
Schematic, day 6: the coating is thinner, yellowish-white and still rooted; the moisture is returning. Favourable.
day 10
Schematic, day 10: thin white, rooted, slightly moist. Recovery.

Know by heart

  • Five grades of moisture. Slightly moist: normal. Wet: Yang deficiency or Dampness. Dripping: Yang deficiency with water that stays put. Dry: Heat consuming the fluids, or Yin deficiency. Rough like sandpaper: the fluids are severely damaged; mnemonic: from droplet to sandpaper; the drier, the deeper the damage.
  • Wet is not sticky. Wet is water on the tongue; sticky is a layer that is attached (Dampness or Phlegm). They can occur together. Never write the word slippery without explaining it.
  • The course. Favourable: thick to thin with root, yellow to white, dry to moist, a bare area that grows a thin white coating. Unfavourable: thin to thick, moist to dry, suddenly gone with nothing coming back. Caution: white to yellow; mnemonic: illness comes in through thick, yellow and dry, and leaves through thin, white and moist.
  • What changes first. Moisture in minutes to days, the coating in days to weeks, colour and shape in weeks to months, a lifelong crack perhaps never. In an acute illness you mainly read the coating, in a chronic one mainly the body.
  • Following up. Progress is a coating that becomes thinner and stays rooted, a tongue that becomes moist and a colour that slowly shifts towards Pale-Red. Compare at the same time of day, without scraping or brushing, and trust the coating more than the colour.
  • Normal but different. Summer a slightly thicker and pale yellow coating, autumn drier, winter moister; over the day a thinner coating and a redder body; in children the coating comes away easily; smoking stains and dries; mnemonic: season, clock, age, smoke, pill.
  • Red flags. Dry with little urine or dizziness, especially after vomiting or diarrhoea: the same day; drowsy or confused: a doctor straight away. Suddenly bare and Deep-Red with high fever or drowsiness: a doctor straight away. A dry mouth all the time with dry eyes, or dry since a new medicine: a GP or primary care doctor.

The rest of this lesson is reference.

Three practice questions from this lesson

Case. Woman, 76, diarrhoea for three days, drinks little, dizzy on standing up and passing less urine. Her tongue is dry and feels somewhat rough. What do you do first?
  1. A GP the same day: suspected dehydration
  2. Nourish Yin: the tongue is dry; look again in a week
  3. A GP within a week for a glucose test

Answer: A GP the same day: suspected dehydration. Dry with little urine and dizziness after diarrhoea is dehydration first in an older person, and that cannot wait a week; in diabetes people pass more urine, not less. The TCM reading comes after that.

Two Pale, Swollen, wet tongues. On the first lies a thin white layer; on the second a thick, white layer that is attached and does not slide away. What does the difference say?
  1. The first is Yang deficiency; the second Yang deficiency with Dampness on top
  2. The first is Dampness; the second Yang deficiency without a pathogen
  3. No difference: both are Full-Cold, the layer is a side issue

Answer: The first is Yang deficiency; the second Yang deficiency with Dampness on top. Wet is water that is not transformed; a sticky layer that is attached is Dampness. So with the second tongue, deficiency and Dampness are at work together.

One tongue is dry. Another is dry and also feels rough like fine sandpaper. What does rough mean?
  1. Worse than dry: the fluids are severely damaged
  2. Sticky Dampness that builds up and feels rough
  3. Nothing extra: rough and dry are the same, described differently

Answer: Worse than dry: the fluids are severely damaged. In the Chinese textbooks rough follows dry: long-standing or strong Heat that has almost used up the fluids.

The rest of this lesson

In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 19 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 1: Tongue.

Try two lessons freeSee Tongue and Pulse