C14 Chinese tongue diagnosis chart

Illustration of 'ren fissure' (ren lie), 'worm-eaten' (chong sui), 'black within' (li hei) and 'jueyin' tongue from a manuscript copy of Shanghan diandian jin shu (The Gold-dust Book of Cold Damage) dated '1st year of the Zhengyuan reign period of the Yuan dynasty' (1341), section entitled Yanzheng she (Examining the Tongue). All four illustrations appear on the same half-folio.

This book incorporates the teachings of Ao Jiweng (Song period, 960-1279) on the movement of Qi and those of Du Ben (Tao Hua) (Yuan period, 1206-1368) on pulse and tongue diagnosis, etc. Yanzheng she is based on an original text by Ao Jiweng, edited by Chen Shiwen and Shi Buni (Song period). It is a guide to the diagnosis of cold damage conditions according to the coating of the tongue, with 36 illustrations in colour.

The text states: In Ren fissure tongue image, the body of the tongue is red, and has fissures on it in the shape of the Chinese graph 'ren' [like a reversed lamda]. In light of this tongue image, the appropriate treatment is Diaphragm Cooling Powder (liang ge san) with Chinese Goldthread (huanglian).

In Worm-Eaten tongue image, the body of the tongue is red, and has red spots irregularly distributed over it, giving it a worm-eaten appearance. It should be treated with Qi Supporting Decoction (cheng qi tang).

In Black Within tongue image, the body of the tongue is pale red, with a stiff, black part in the centre. This should be treated with Stomach Regulating and Qi Supporting Decoction (tiao wei cheng qi tang), and Poison-Removing Decoction (jiedu tang).

In jueyin tongue image, the body of the tongue is pale red with black patterns on it. It should be treated with Centre-Regulating Pills (li zhong wan) and Four Retrograde/Cold Extremities Decoction (sini tang).

HEADINGS (R to L): Ren fissure (ren lie) tongue. Worm-eaten (chong sui) tongue. Black within (li hei) tongue. Jueyin tongue.