Salvador Cefalu, M.S., L.Ac.
In Part 2 of this series we covered the topic of Wind with its many manifestations and psychological correlations. Wind is also associated with other pathological factors including Dryness, Heat, Dampness and Cold, which will be introduced in this finale of our three-part series (you can see the first two articles here and here).
Examining your tongue is an easy way to get direct insight into the pathological patterns of Dryness, Heat, Dampness and Cold that may be the key challenges for overcoming a chronic degenerative disease.
Different parts of the tongue reflect different internal organs and systems within the body. The center of the tongue for example reflects the Stomach behind which are the intestines. The sides of the tongue relate to the Liver. The tip of the tongue corresponds with the Heart system. When the tip of the tongue is red it often reflects mental over-activity, anxiety and potentially insomnia. Behind the tongue tip is the Lung zone and when heat is present you often see red dots in this area. The root of the tongue relates to the Kidneys, Bladder and genitals.
Tongue diagnosis can get quite complex, so for the purpose of this discussion we're going to look at the overall appearance of the tongue in exploring the factors of Dryness, Heat, Dampness and Cold which underlie all chronic degenerative diseases.
Dryness
If there is simple Dryness due to dehydration, the tongue coating will look dry reflecting a deficiency of thin fluids. These fluids can be restored by simply increasing one's fluid consumption, especially water, and eating hydrating foods such as juicy fruits and vegetables such as celery. Be cautious when hydrating with electrolyte beverages such as coconut water because these elements can increase heat in the body and exacerbate an imbalance if there is already internal heat within the body.
A deeper or more severe level of dryness is indicated when there is no distinct coating on the surface of the tongue. In this case, the tongue body may look like raw meat. When the tongue coating is essentially missing, we call this a peeled tongue, which reflects dryness due to Yin deficiency. Yin refers to the body's substance so we can say this Yin deficiency is an aspect of a hormonal depletion and an actual deterioration of an organ or organs.
Hormonal (Yin) deficiency relates to the thick fluids of the body.
If your car engine runs without enough oil, the engine will eventually overheat and burn out. In the same way, when the body is hormonally depleted, overheating will often occur. As the body overheats, calcium will be pulled out of the bones to cool down this heat by alkalizing the acid in the blood. This is the mechanism that drives osteopenia and osteoporosis especially in the time of peri-menopause and menopause when a women's hormonal status begins to decline.
When you drive yourself hard and overstimulate your adrenals, heat is generated in the body. If your status of thick fluids is weakened due to aging, poor lifestyle habits such as insufficient sleep, over-dependency of stimulants or drugs, poor diet or simply being born constitutionally deficient, Yin deficiency problems of overheating can occur at an early age. Emotionally this heat can show up as anxiety and attention deficit disorders.
Yin deficient dryness can manifest typical menopausal syndrome including hot flushing and dryness symptoms such as the thinning of the skin (collagen breakdown) and drying up of the body's mucosal tissues making the delicate tissues of the body more prone to irritation and inflammation.
In the upper body, dryness can lead to irritation of the eyes, sinus or the lungs.
In the middle of the body, Yin deficiency dryness can cause mucosal degeneration in the Stomach causing weak digestion and even gastro-esophageal reflux disorder (GERD). GERD often relates to a lack of proper HCL (hydrochloric acid) production due to stomach degeneration that occurs with aging.
Yin deficiency dryness in the Large Intestine leads to chronic constipation and in the Small Intestine relates to the very common problem of leaky gut syndrome caused by breakdown of the mucosal lining of the Small Intestine. Yin deficiency dryness that has lead to leaky gut syndrome causes un-digested proteins to escape the Small Intestine and leak into the bloodstream. These partially digested proteins are pro-inflammatory factors that create systemic problems of inflammation.
In the lower body, Yin deficiency dryness leads to conditions such as vaginal dryness and thinning of the bladder wall causing recurring cystitis (bladder inflammation).
For a chronic health problem, if your challenge to healing is a deep level of Yin deficiency, you must give yourself at least 6 months for sufficient healing to take place and it is usually longer for the body to repair itself after years of degeneration. The more severe the condition and the more depleted the patient, the more time will be required for the healing process.
Inflammation is the key issue when trying to resolve chronic degenerative diseases and the pathological factors of Heat, Cold and Dampness underlie many inflammatory problems.
Heat
Heat can manifest from dryness, but often heat is due to toxicity. In this scenario, the tongue coating can be normal but the tongue body is very red rather than the healthy pink of a normal tongue body color. When it becomes red there is too much heat, or inflammation, in the corresponding organ associated with that zone of the tongue.
This type of Excess Heat is due to a toxic body in need of clearing and an alkalizing diet to cool down the acidic terrain.
Excess heat may also present with a yellow cast on the tongue coating. This is a more complex issue because this is a mix picture of Dampness combined with Heat. To keep our discussion simple, a thick tongue coating, either white or yellow, indicates that Dampness is present. This relates to a fungal (Candida) or parasitic issue in the body which we will explore next in our discussion on dampness.
Internal heat can be generated from many factors ranging from mental and emotional stress to an acidic or overly spicy diet as well as allergies and sensitivities to various substances one is exposed. Heat can also be generated from stagnation in the body. Chinese Medicine differentiates 5 types of stagnation which will be the topic of another article. These stagnations are based on Food, Qi, Blood, Fluid and Cold.
Dampness
If the condition of dampness relates to a more simple problem of fluid metabolism you might see an overly swollen tongue that’s wet, and often the sides of the tongue are pinched or scalloped. A more severe presentation of dampness relates to a fungal problem, which can take months and even years for a person's health problem to be resolved.
A damp, fungal problem will be indicated when the tongue coating is thick and white or even yellowish.
Fungal issues are difficult to resolve because they spread insidiously. It takes a very strict diet regimen often requiring the elimination of grains, dairy, alcohol and most sugars to get an aggressive problem of dampness under control.
Dampness can also cause swelling in the body and is associated with arthritis. One of my patients got rid of his Rheumatoid Arthritis condition simply by switching from a vegetarian diet to a Paleo diet.
According to Chinese Medicine, over time grains can lead to an infestation of parasites and fungus. After being on a grain-based vegetarian diet for over 40 years, this patient was able to resolve the pathological dampness underlying his Rheumatoid Arthritis by eliminating grains over the period of just two years!
Cold
Internally, cold is generated by diet such as a lot of raw food, including smoothies and Western pharmaceutical drugs especially those which suppress inflammation, pain and the immune system or antibiotics. Western medicine relies heavily on anti-inflammatory and analgesic medications to relieve pain. The problem is that these drugs induce what Chinese Medicine describes as Cold, which is another pathological factor.
Cold freezes pain and inflammation to bring temporary relief, but Cold also freezes the problem into the tissues and inhibits the circulation of Yang Qi and blood, both of which are needed for longterm healing. Yang Qi is metabolic energy that creates body warmth and supports healthy immunity. Once the Yang Qi is compromised, a person's healing capacity is weakened.
A person with Yang Qi insufficiency will show signs of fatigue, low metabolism, gets sick easily and tends to feel cold. This type of patient will usually present with a tongue that is pale (lacking warmth), swollen and very wet.
Cold leads to the stagnation of circulation and pain and can also be induced by working in a cold environment such as the fish department in a grocery store. I have seen in my clinical practice arthritis conditions develop over long term exposure to cold environments.
A condition of cold with dampness will show a white pasty tongue coating and this is often the case with the use of medications especially antibiotics which lead to fungal problems.
A tongue that is overly swollen and pale, shows a system that has fluid stagnation due to a lack of Yang Qi to properly stimulate the circulation for good fluid metabolism.
For any condition of cold, you need to focus on warming your core energy.
The factors of Dryness, Heat, Dampness and Cold must all be considered in the healing of chronic illness. Looking at your tongue can give you an idea of what is going on in your body.
Other articles in this series: Overcoming the Challenges to Healing: Wind and Overcoming the Challenges to Healing
Salvador Cefalu, M.S., L.Ac. is the Founder and Co-Director of A Center for Natural Healing in Santa Clara, California, a wellness clinic that specializes in Classical Chinese Medicine & Japanese Meridian Therapy, a rare non-insertion form of Acupuncture. More information at www.acenterfornaturalhealing.com.
