Most of scalloped tongues belong to spleen deficiency and host deficient syndromes. If the tongue body is pale pink and moist, it indicates spleen deficiency and excess of cold-dampness.

What causes scalloped tongue?

As we know that enlarged tongue is caused by spleen deficiency, which fails to transform the fluid and dampness and in turn the stagnation of fluid-dampness in tongue and make it the enlarged tongue. Therefore, the enlarged tongue is oppressed by the teeth and scalloped tongue is formed.

Scalloped tongue is very often associated with enlarged tongue, which can be seen in most cases of scalloped tongue.

The combination of scalloped tongue and enlarged tongue comes from two aspects:

• The stagnation of fluid-dampness. This aspect belongs to Yang deficiency and excessive dampness;
• Tongue muscle relaxation. This aspect belongs to Qi deficiency of spleen.

Main diseases indicated by scalloped tongue

• Pale, moist and scalloped tongue indicates excess of cold-dampness;
• Pale, pink and scalloped tongue indicates spleen deficiency or Qi deficiency;
• Red, enlarged and scalloped tongue in full mouth indicates that dampness-heat and excess of turbid phlegm.

Scalloped tongue

In general, scalloped tongue can be categorized into Qi deficiency and Yang deficiency.

(1) Deficiency of spleen Qi

Main Symptoms:

• Pale tongue body;
• Thin tongue coating;
• Tender tongue;
• Scalloped tongue;
• Pale or withered yellow complexion;
• Shortness of breath and no desire to speak;
• Heavy head and swelling body;
• Fatigue and weakness;
• Spontaneous perspiration;
• Diet decreased;
• Abdominal detention after eating;
• Nausea and feel like vomiting;
• Loose stools;
• Weak thready pulse.

Treatment method:
Invigorating spleen-stomach and replenishing Qi.

(2) Yang deficiency

Main symptoms

• Pale tongue;
• Moist tongue surface and plenty of saliva, or slippery tongue surface;
• Tender, plump and scalloped tongue;
• Pale or blue complexion;
• Physically and mentally fatigued and desire to lie down;
• Tastelessness and no desire for water;
• Appetite loss and eat less;
• Cold ached belly and symptoms relieve after warming;
• Cold stomach and limbs;
• Clear urine and loose stools;
• Or with edema;
• Deep faint pulse.

Treatment method:
Tonifying Yang with pungent and warm natured herbal drugs.

Ready herbal drugs recommended for scalloped tongue

• Ren Shen Zheng Qi Wan;
• Huo Xiang Zheng Qi Wan;
• Shen Ling Bai Shu Wan;
• Fu Zi Li Zhong Wan;
• Jia Wei Bao He Wan etc.

Tongue diagnosis

Enlarged tongue (also known as fat tongue):

Tongue body is deficient fat, or with scalloped edges, pale and tender, which is call enlarged tongue or fat tongue.

The causes of enlarged tongue

In some ancient documents of Traditional Chinese medicine, enlarged tongue was very often put together with swollen tongue.

But in reality, enlarged tongue is caused by the decline of the Yang Qi in spleen, or accompanied with cold-dampness.

Enlarged tongue refers to pale, tender and deficient fat tongue body, often with scalloped edges, which belongs to deficiency syndrome and should be distinguished from swollen tongue.

Enlarged tongue

(1) Spleen deficiency.

The symptoms include:

• Pale, tender and deficient fat tongue body;
• Scalloped tongue;
• Thin white tongue coating;
• Pale complexion and cold body;
• Qi deficiency and no desire to speak;
• Lethargy and eat very little;
• Distension of lower abdomen and loose stools;
• Weak moderate pulse or slow weak pulse.

The staying-water in tongue body, which is caused by the retention of fluid and phlegm-dampness, mostly result in enlarged tongue.

This kind of symptoms, which caused by failure of Qi transforming fluid and upsurging fluid-dampness, should treat with formulas such as Li Zhong Tang and Bu Zhong Yi Qi Tang for strengthening spleen and benefiting Qi.

Clinically enlarged tongues are commonly seen in patients suffering from obesity, thyroid dysfunction and anemia etc.

Ready herbal drugs recommended for enlarged tongue:
Ren Shen Jian Pi Wan, Huo Xiang Zheng Qi Wan, Shen Ling Bai Shu Wan, Fu Zi Li Zhong Wan, Jia Wei Bao He Wan etc.

(2) Kidney deficiency and upsurging fluid-dampness

The symptoms include:

• Pale, tender and deficient fat tongue body;
• Scalloped tongue;
• Severe swelling below the waist;
• Less urine;
• Lethargy and cold body;
• Cold limbs,
• Dull or pale complexion;
• Deep slow pulse or deep thin pulse.

The above-mentioned symptoms should treat with formulas such as Jin Gui Shen Qi Wan and Zhen Wu Tang alike to warm Yang and promote diuresis.

While it sees the symptoms of pink enlarged yellow tongue with greasy coating, mostly it is caused by the combination of upsurging dampness-heat and turbid phlegm in spleen and stomach.

This kind of symptoms should treats with herbal medicines such as Yin Chen, Mu Tong, Hua Shi, Shi Gao, Zhi Zi etc. to clear heat and promote diuresis.

Clinically enlarged tongues are commonly seen in patients suffering from chronic glomerulonephritis and pyelonephritis etc.

Ready herbal drugs recommended for enlarged tongue:
Jin Gui Shen Qi Wan, Ji Sheng Shen Qi Wan, Bu Yao Jian Shen Gao, Shen Yan Wen Yang Pian, and Shen Yan Xiao Zhong Pian etc.