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Module 1   Lesson 7   Fen Qu

The tongue map

Where is it, and how much does the place tell you?

After this lesson you can place a finding on the area map and on the Three Burners, you know the third map (the Stomach in three parts) and which map goes with which question, you know the variants between sources, you read area and finding together as a hypothesis, and you know which spots must first go to a dentist, or to a GP or primary care doctor.

back of the mouth Lower Middle Upper root: Kidneys, Bladder, bowels sides: Liver, Gall-Bladder centre: Spleen and Stomach chest area (variant) behind the tip: Lungs tip: Heart tip, towards you Three maps lower middle upper lower middle upper organs chronic, internal Burners external, fever Stomach stomach, bowels The place is an address, not a diagnosis. Area and finding together, checked against history and pulse.
Schematic. The organ map and the Three Burners on the tongue are textbook; the chest area is a variant you meet mainly in the book's tradition. The Stomach in three parts (upper, middle, lower) comes from Chinese tongue books and textbooks.

Know by heart

  • The map. Tip Heart; just behind it Lungs; centre Spleen and Stomach; sides Liver and Gall-Bladder; root Kidneys, Bladder and Intestines; mnemonic: the tongue is a person facing you, with chest and heart at the front, the belly in the middle, the pelvis at the back and the flanks at the sides.
  • Three Burners. Front part Upper (Heart, Lungs), centre Middle (Spleen, Stomach, on the sides Liver and Gall-Bladder), root Lower (Kidneys, Bladder, Intestines).
  • Three maps, three questions. Organs for internal and chronic complaints; Three Burners for external disease and fever; the Stomach in three parts (tip upper, centre middle, root lower) for stomach and bowel complaints.
  • Variants. Both sides for Liver and Gall-Bladder, or left Liver and right Gall-Bladder; the Lungs on the tip with the Heart, or a strip of their own behind it; a chest area between the centre and the tip; the Spleen also on the edges of the centre.
  • Area and finding. The area says where, the finding says what; an area without a finding says nothing. Red over the whole tongue is not read area by area; mnemonic: the place is an address, not a diagnosis.
  • Five fixed combinations. Red tip: Heart-Heat, or acutely an early Wind-Heat. Red sides: Liver-Heat. Purple sides: Liver-Blood stasis. Bare centre: Stomach-Yin deficiency. Yellow sticky on the root: Damp-Heat in the Lower Burner.
  • Red flags. A spot, small ulcer or hardening on the side (or anywhere) that persists after three weeks: dentist or GP. Sore throat with drooling, inability to swallow or breathlessness: emergency services (112 in Europe, 999 in the UK, 911 in North America).

The rest of this lesson is reference.

Three practice questions from this lesson

Which organ goes with the strip just behind the tip?
  1. The Lungs
  2. The Heart
  3. The Stomach

Answer: The Lungs. The tip is the Heart, the strip behind it the Lungs; some sources put the Lungs together with the Heart on the tip.

Which map do you prefer for an acute febrile disease from outside?
  1. The Three Burners: how deep is the pathogen?
  2. The organ map: which organ is affected?
  3. The Stomach in three parts: which part of the Stomach?

Answer: The Three Burners: how deep is the pathogen?. The Three Burners on the tongue are used mainly for external disease; the organ map for internal complaints; the Stomach in three parts for stomach and bowel complaints.

Case. Man, 55, has had a burning stomach and a dry mouth for years; he is hungry but can eat little. The coating is missing in the centre; the rest of the tongue is normal in colour. Which hypothesis?
  1. Stomach-Yin deficiency, still without Empty-Heat
  2. Stomach-Heat burning away the coating
  3. Kidney-Yin deficiency with a bare root

Answer: Stomach-Yin deficiency, still without Empty-Heat. Bare in the centre is the Stomach, and bare is Yin. Red would add Empty-Heat; a thick dry yellow coating would be Stomach-Heat; the root is not bare here. A burning stomach that persists: also have it assessed medically.

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, 17 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