Yin’s Modern Tongue Diagnosis Series Part 2: The Discovery of the Heart Localization Area and Its Clinical Applications

Yin Hongchun

In the 1980s, Professor Zhang Yingqing proposed the theory of holographic biology, centered on the concept of the holographic embryo. He posited that relatively independent parts of an organism (such as the ear, hand, or potato) contain the complete information of the whole. These parts, known as holographic embryos, are structural units between cells and the whole organism. Based on this, he developed holographic diagnostic and therapeutic methods. The tongue, as a relatively independent organ, can be regarded as a relatively complete holographic embryo. Traditional Chinese medicine recognized the importance of tongue diagnosis as early as the era of the Huangdi Neijing. By the time of Zhang Zhongjing in the Eastern Han (25-220CE) tongue diagnosis had already been specifically applied in clinical practice. For example, Treatise on Cold Damage clause 130 states: “For visceral binding, if there are no yang signs, no alternating chills and fever (some versions state ‘chills without fever’), the person is unusually calm, and the tongue coating is slippery, purgative methods must be avoided.” This clause uses the slippery tongue coating to determine that the patient has severe yang qi deficiency and should not be treated with purgative methods. This is also a common tongue presentation in modern clinical practice: once a pale tongue with a white, slippery coating is observed, purgative methods must be avoided, and medications that support yang qi should be used instead. The tongue image below (Figure 2-1) is an example of a white, slippery coating on the tongue of a patient in the terminal stage of life. The patient passed away one day after this tongue photo was taken.

Clause 137 of the Treatise on Cold Damage states: “In a taiyang disease, if heavy sweating is induced and purgation is repeated, leading to no bowel movement for five or six days, a dry tongue with thirst, slight tidal fever in the late afternoon (some versions describe great vexation in the chest during the late afternoon), and hardening, fullness, and pain from the epigastrium to the lower abdomen that is unbearable to touch, Da Xian Xiong Tang (Major Chest-Draining Decoction) should be prescribed.” This clause describes a dry tongue with thirst and a tongue coating that is dry and lacking moisture. Zhang Zhongjing determined the use of Da Xian Xiong Tang based on this tongue presentation.

During the Qin and Han periods, tongue diagnosis was far less emphasized than pulse diagnosis. However, over time, by the Jin and Yuan dynasties, tongue diagnosis began to develop rapidly, with the emergence of Ao Shi Shang Han Jin Jing Lu (Ao’s Golden Mirror Record of Cold Damage) as a representative work. This book, completed in the first year of the Zhizheng era (1341) of the Yuan Dynasty, is the earliest extant monograph on tongue diagnosis, marking the beginning of its rapid development. By this time, tongue diagnosis had already taken on the characteristics of a primitive holographic representation of the body.

Liang Yuyu’s She Jian Bian Zheng (Corrections and Elucidations on Tongue Mirror), written in the Qing Dynasty during the reign of Guangxu in the year 1894, is an outstanding and practical ancient book on tongue diagnosis. Three points in this book are particularly noteworthy:

1. Tongue diagnosis is used not only to differentiate cold damage but also to identify the cold, heat, deficiency, and excess patterns in miscellaneous diseases.

2. Differentiating the tongue is somewhat easier than differentiating the pulse, as the pulse is hidden beneath the skin while the tongue is exposed.

3. The whole-tongue meridian division chart, which is a primitive holographic tongue chart (see the figure in the previous installment of this series). This chart indicates that ancient practitioners already had a conceptual understanding of biological holography. This division still guides clinical syndrome differentiation and diagnosis today.

Mr. Guo Zhichen was the first to apply Professor Zhang Yingqing’s biological holographic theory to draw a relatively realistic holographic tongue chart (Figure 2-2). However, this chart has a perplexing aspect: the heart is positioned at the tip of the tongue. In traditional tongue diagnosis, the tip of the tongue corresponds to the heart. For example, a reddened tip indicates heart fire flaring upward. However, the essence of holographic tongue diagnosis is to view the tongue as a microcosmic anatomical map of the human body. Placing the heart at the tip of the tongue in Guo’s chart clearly contradicts human anatomy.

Driven by doubts about Guo’s tongue chart, I conducted careful clinical observations. The following tongue image (Figure 2-3) was sent to me by a German doctor seeking consultation for a patient. Through observation of the tongue, I concluded that the patient likely had a pathological change in the right breast, possibly already surgically treated. The doctor confirmed my initial diagnosis: the patient had already undergone surgery for right breast cancer. According to TCM theory, the occurrence of breast cancer is closely related to liver qi stagnation and heart qi deficiency. The patient’s tongue showed raised edges on both sides, indicating clear liver qi stagnation. But where was the sign of heart qi deficiency? No obvious changes were visible at the tip of the tongue. However, by applying the principle of holographic localization based on microcosmic anatomy, a noticeable depression and crack could be seen on the midline of the tongue at the junction of the upper and middle burners (indicated by the black circle). I hypothesized that this area should correspond to the heart’s reflex zone. The German doctor later confirmed that the patient had undergone heart replacement surgery. Based on this hypothesis, I observed the tongues of hundreds of patients with heart disease, all of which validated my speculation. Consequently, I developed the modern tongue diagnosis visceral holographic chart (Figure 2-4).

The following tongue images all indicate heart pathologies, confirmed by modern medical diagnostic methods. Figure 2-5 shows the tongue of a patient with coronary heart disease; Figure 2-6 is from a patient experiencing palpitations after a viral infection; and Figure 2-7 is from a patient who had two stents implanted.

The resolution of the heart reflex zone greatly boosted my confidence. Applying TCM syndrome differentiation theory to this heart-corresponding area on the tongue proved equally effective. Depression in the heart area indicates heart qi deficiency; the presence of cracks signifies further aggravation of deficiency, which I term “heart qi dissipation”; a raised heart area often suggests stagnant or obstructed heart qi; and if accompanied by dullness in the heart area or sublingual blood stasis, it indicates heart blood stasis. The following case involves a patient with chest pain and tachycardia, severely affecting sleep, who had undergone various Chinese and Western treatments without success. The patient’s cardiologist had scheduled radio-frequency ablation. As a last resort, the patient came to see me. The tongue image showed depression and cracks in the heart area (Figure 2-8), with a slightly red tongue body and raised edges. This was differentiated as liver qi stagnation and dual deficiency of heart qi and yin. The following formula was prescribed: Bai Ji Li 1, Dang Shen 1, Wu Wei Zi 1, Gan Cao 1, Fu Shen 1, Yu Jin 1, Mu Dan Pi 1, Chen Pi 1, Fa Ban Xia 1, Bai Zi Ren 1, Chao Yi Yi Ren 2, Chai Hu 1.The herbs were prepared into 98 grams of concentrated powder according to the above proportions, with a dosage of 7 grams taken twice daily. One week later, the patient returned for a follow-up, reporting that chest pain and palpitations had disappeared, and sleep had significantly improved. The patient was confident and cooperated actively with treatment. After four weeks of herbal powder treatment, all symptoms resolved. The depression in the heart area showed notable improvement, though the cracks had not completely disappeared. It was recommended to continue treatment for another month. The post-treatment tongue image is shown in Figure 2-9.

The establishment of heart localization and the application of TCM syndrome differentiation and treatment in this area have elevated TCM diagnosis to a new level and refined Guo’s holographic chart. The panoramic fetal prone position holographic chart (Figure 2-10) represents a milestone leap, making the secrets of the human body vividly apparent on the tongue.