Chinese Medicine

Hairy tongue is one of important tongue manifestations we should pay attention to.

So what reveals by white hairy tongue from the perspective of Traditional Chinese medicine?

White hairy tongue diagnosis

The tongue manifestation shows thick, white and greasy coating, on which the particles, tight or loose, can be filled with all the tongue, or thin coating at the tongue edges and medium/thick coating on the tongue middle and root.

White hairy tongue causes

• White hairy tongue is mostly caused by the devitalization of spleen-stomach Yang, which leads to retention of food and drink.
• White hairy tongue is the indication of accumulation of dampness and turbid phlegm.

Ancient document about white hairy tongue

From Bian She Zhi Nan (Tongue Diagnosis Guide)

“The patient, who is with white hairy tongue, oppression and dull pain in chest, upset and retching, desires for water occasionally but spit once water entered. In this case, the method of warming Yang and resolving fluid retention is appropriate.”

White hairy tongue

White hairy tongue hosts dampness, phlegm and cold.

1. White hairy tongue caused by exogenous diseases is the result of invasion by exogenous cold-dampness pathogen. Cold makes the tongue white, while dampness makes greasy coating. Due to the pathogen of cold-dampness only stays in superficies, it can be assumed thin, white and greasy tongue coating.The treatment should be dispelling cold and removing dampness with pungent and warm natured drugs, such as herbal formula of Qiang Huo Sheng Shi Tang.
2. White hairy tongue, which is caused by dampness blockade in interpleuro-diaphragmatic space, is the result of invasion by dampness-heat pathogen, or accumulation of turbid dampness combined with exogenous pathogen. The pathogenic dampness-heat invades from exterior to interior and lurks in interpleuro-diaphragmatic space. Yang Qi is depressed, in turn dampness overflows upwards and it can be assumed white, thick, greasy and dry tongue coating, or paved with white power.The treatment should be removing dampness and eliminating turbid pathogen combined with clearing heat, such as herbal formula of Da Yuan Yin.
3. White hairy tongue caused by internal stagnation of cold fluid is the result of weakness of spleen Yang. The fluid retention can lead to white, thick and greasy, or slippery tongue coating.The treatment should be warming Yang, refreshing spleen and diuresis, such as herbal formula of Wen Pi Tang.

It is worth to note that heat induced by fluid retention, which leads to pathogenic dampness overflowing upwards, renders the tongue white, thick and greasy coating, instead of yellow tongue.

After all the heat is stagnant in middle Jiao, the patients would upset and retch, desire for water. It needs to identify this tongue manifestation from yellow tongue by dampness-heat stagnation.

Clinically white hairy tongue can be seen very often in patients suffering from severe diseases such as bronchial asthma, emphysema, pulmonary heart disease, rheumatic heart disease, and heart failure.

Ready herbal drugs recommended for white hairy tongue

The conditions of patients with white hairy tongue, in general, are more complex. The treatment should be giving out medicine based on syndrome differentiation.

Some ready herbal drugs commonly used for white hairy tongue as follows:

• Xiao Qing Long Tang;
• Su Zi Jiang Qi Wan;
• Zhi Sou Ding Chuan Kou Fu Ye;
• Yu Ping Feng Kou Fu Ye;
• Yang Shen Bao Fei Kou Fu Ye;
• Ha Jie Ding Chuan Wan;
• Sheng Mai Yin Kou Fu Ye;
• ……