Zunge/Tongue
Vergleich: Siehe: Organen
[Dr. Muhammed Rafeeque]
The appearance of the tongue as it relates to various pathologies. The
tongue’s movement, moistness, color and coating are
discussed.
When you are confused between the words given by the patient, look at
the tongue!
The tongue (Lingua, Glossa) is a muscular
organ in the oral cavity that is associated with the function of deglutition,
taste and speech. It acts as an easily accessible mirror
of the health of a person and indicates the state of hydration of the
body. Some characteristic changes occur on the tongue in some abnormal
conditions or diseases.
Hence, the examination of the tongue is essential and will provide some
hints for the clinical and remedial diagnosis.
It is very easy to examine the tongue in a conscious patient. The
difficulty may arise in unconscious patients and in non-cooperative patients,
especially children.
Small children may cry if we forcefully open their mouth, hence it can
be easily examined by gently pressing above the mental-protuberance with the
index finger and gradually opening the mouth. The baby will protrude the tongue
automatically. Of course, it is a knack that can be gained only by experience.
The clinical examination of the tongue should be done with consideration
of the following aspects such as shape, size, colour, moisture, coating, nature
of papillae and the movements.
The appearance of tongue in some abnormal conditions:
1. Movements:
Hemiplegia:
Deviation towards the paralyzed side.
Tremors: Nervousness, Thyrotoxicosis, Delirium tremens and Parkinsonism.
Progressive Bulbar palsy:
Wasting and paralysis of the tongue with fibrillation; eventually the tongue
gets shriveled and lies functionless on the floor of
the mouth.
2. Moistness:
The moistness of the tongue gives some indication of the state of
hydration of the body. Water volume depletion in a person can lead to
peripheral circulatory failure characterized by weakness, increased thirst,
restlessness, anorexia, nausea, vomiting, dry and parched tongue.
Dryness of tongue is seen in:
Diarrhea
Later stages of severe illness
Advanced uraemia (with
brownish discolouration)
Acute intestinal obstruction
Hypovolemic
shock
Heat exhaustion
Hyponatraemia
(with hard reddish brown colour)
3. Colour:
Central Cyanosis – Bluish
discolouration
Jaundice –Yellowish
discolouration
Advanced uraemia – Brown
colour
Ketosis – Brown discolouration
Riboflavin deficiency –
Magenta colour
Niacin and some other
B-complex deficiency – Bright scarlet or beefy red tongue.
Severe anemia
– Pallor
4. Coating:
Enteric fever- Thick white
coating
Candidiasis
– sloughing white lesions
Diabetes mellitus and hypoadrenalism – Associated with white sloughing lesions.
Secondary syphilis – Mucous
patches that are painless, smooth, white, glistening, opalescent places which
can’t be scraped off easily.
Leukoplakia
– Keratotic white patch
HIV infection – Hairy leukoplakia
Peritonitis – Furring of the
tongue
Acute illness – white furring
5. Papillae:
Hairy tongue – Due to
elongation of filiform papillae which is provoked by
poor oral and general debility.
Geographic tongue – Irregularly
shaped red and white patches resembling a map on dorsal and lateral surfaces.
The cause is unknown.
Median rhomboid glossitis – Smooth nodular red area in the posterior
midline of the tongue.
Nutritional deficiency –Glossitis leading to papillary hypertrophy followed by
atrophy.
Thiamine and riboflavin
deficiency – Hypertrophied filiform and fungiform papillae.
Niacin and iron deficiency –
Atrophic linguae papillae.
Vitamin A deficiency –
Furrowed tongue
Iron deficiency and
nutritional megaloblastic anaemia: Smooth tongue is
encountered in both.
Folic acid deficiency – Macrocytic megaloblastic anaemia
with glossitis.
Cyanocobalamine
deficiency- Glossitis with macrocytic
megaloblastic anaemia and peripheral neuropathy.
Scarlet fever – Bright red
papillae standing out of a thick white fur, later the white coat disappears
leaving enlarged papillae on a bright red surface (= called strawberry
tongue.
6. Ulcers:
Syphilis :- Syphilitic fissures are
longitudinal in direction. In Primary syphilis extra-genital chancre with
enlarged submandibular and submental
lymph nodes. In secondary syphilis, multiple shallow ulcers on under surface
and sides. Hutchinson’s wart on the middle of the dorsum of the tongue. In
tertiary syphilis, Gumma is seen on the mid-line of
dorsum.
Tubercular ulcers:- Shallow
ulcers, often multiple and greyish yellow with slightly undermining margin.
Herpes Simplex:- Acute
vesicular eruption.
Carcinoma:- Ulcers with everted edges and a hard base.
In Homeopathy, we do not treat the diseases, but the diseased
individuals are treated by a holistic approach. The diseases are the dynamic
morbid phenomena which are not different entities, but a continuous process in
the life of an individual, wherein the miasms get
blended and evolved and finally affect the vital organs. The internal morbid
process is expressed by means of abnormal sensations and functions followed by
the appearance of structural changes. Here the peculiar signs and symptoms will
characterise the individual. That is why the individualization is the sole mean
for a prescription. Hence, the peculiar nature of the individual should be
perceived by taking the totality by exact observation and correct
interpretation. Merely looking at one pathological condition and prescription
does not come under the domain of Homeopathy. However, some abnormal signs on
the body can be helpful for the differential remedial diagnosis. Here the
nature of tongue can be taken into consideration along with other
characteristic signs. However, it should be kept in mind that over-importance
to one particular sign or symptom may not be always correct. Hence, one need
not expect a mapped tongue in all Natrum mur patients, and all patients with mapped tongue may not
be Natrum mur!
[Synthesis Repertory>> Mouth >> Mapped tongue: Ant-c. Ars.
Cham. Dulc. Hydr. Kali-bi. Kali-m. Lach.
Lil-t. Lyc. Merc. Merc-c. Nat-m. Nit-ac. Ox-ac. Phyt.
Ran-s.
Rhus-t. Sep. Sul-aci. Syph. TARAX. Ter. Thuj. Tub.
The peculiar appearance of the tongue in some important remedies
Acon.:
Tongue is swollen and white
coated.
Tingling on the tip.
Dryness with intense thirst.
Bitter taste of everything
except water.
Ant-c.:
Tongue coated thick white as
if white-washed.
White-furred appearance.
Cracks in the corners of the
mouth.
Saltish
saliva, loss of appetite and absence of thirst.
Desires acids
Apis mellifica:
Tongue is fiery red, swollen,
sore, raw, and with vesicles.
Feels scalded.
Red hot and trembling.
Stinging and burning pain with
thristlessness.
Protrusion is difficult.
Ars.:
Tongue is dry, clean and red.
Vesicles with stinging and
burning pain.
Ulcerated with blue colour.
Blackish discoloration.
The edges and the tip has got
redness.
Shriveled
appearance.
Gangrene of tongue.
Thirst for small quantity of
cold water in shorter intervals.
Bapt.:
Indicated in typhoid tongue.
Furred appearance with yellow
dirty white coating.
Tongue feels scalded.
Red and shining edges.
Cracked and sore surface.
Fetid breath with bitter taste
in the mouth.
Loss of appetite, can swallow
liquids only.
Bell.:
Tongue is swollen and painful.
The edges are red.
Strawberry appearance.
Dryness and heat in tongue.
Erect papillae.
Mouth dry as if glazed.
Great thirst for cold water,
but dread of drinking.
Bry.:
Marked dryness of tongue.
Coated dark white, yellow or
dark brown.
Lips parched dry and cracked.
Dryness with a great thirst
for cold water.
Chel.:
Yellowish tongue with the
imprint of teeth.
White furred with red edges.
Large and flabby tongue.
Bitter taste in the mouth.
Nausea and vomiting
ameliorated by drinking very hot water.
Crot-h.:
Tongue red and small but feels
swollen.
Fiery red appearance.
Dryness in the centre.
Smooth and polished
appearance.
Difficult to protrude.
Cancer of tongue with hemorrhages.
When protruding, goes to right
side.
Hydr.:
White swollen and flabby.
Shows imprint of teeth.
Scalded sensation.
Fissures in the edges.
White-furred tongue with
bitter taste.
Hyos.:
Tongue is red, dry and
cracked.
It is stiff and immovable.
Protruded with difficulty.
Impaired speech.
Foams at mouth.
Leather-like appearance of
tongue.
Indurated
and looks like burnt.
Lach.:
Tongue is swollen, red and
dry.
Cracked at tip.
Trembling with difficulty in
moving.
It catches on teeth.
Snake like protrusion is
characteristic
Merc.:
Furrow in the upper surface
length-wise.
Heavy, thick with moist
coating.
Feels as if burnt.
Ulcers with fetid odour from
mouth.
Blackish discoloration and
softness.
Moist mouth with great thirst.
Metallic taste in the mouth.
Mur-ac.:
Tongue is pale, swollen, dry
and leathery.
Deep ulcers with bluish red
edges, black base.
Feels longer.
Paralysis of tongue.
Hard lumps can be felt.
Nat-m.:
Frothy coating with bubbles on
sides.
Sense of dryness and numbness
with tingling.
Sensation of hair on the tip.
Mapped tongue.
Herpes on the tongue.
Red insular patches on the
surface.
Loss of taste.
Nit-ac.:
Painful pimples on the sides.
Clean, red and wet with center furrow.
Ulcers with splinter-like
pains, with bleeding.
Red shining ulcers on the
edges.
Sensitive even to soft food.
Bloody saliva with fetor oris.
Nux-m.:
Very dry and adheres to the
roof of mouth.
There is no thirst.
Saliva looks like cotton.
Numb and paralysed.
Nux-v.:
First-half clean and posterior
half covered with deep fur.
White and cracked edges.
Bitter taste in the mouth.
Pyrog.:
Dry, red, clean, cracked.
Smooth as if varnished.
Breath is horrible.
Taste terribly fetid.
pus-like taste in mouth.
Tarax.:
Mapped tongue.
Covered with a white film,
which comes off in patches leaving red spots.
Feels raw.
Bitter taste and bilious
vomiting.
Rhus-t.:
Red and cracked.
Coated except for red
triangular space at the tip.
Dry and red at edges.
Fever blisters around mouth.
Bitter taste in the mouth.
Desire for milk.
Conclusion:
The intention behind this article is not to make you prescribe just by
looking at the tongue, but to show you the importance of appearance of the
tongue in differentiating diseases and the indicated remedies. When you get confused
between the words given by the patient, just look at the place from where those
words come – the tongue.
Vorwort/Suchen. Zeichen/Abkürzungen. Impressum.