Hi Andrew, Since we had the tongue diagnose classes with you, I started to observe my own tongue to practice and become more familiar with detecting changes according to my own health and cycle. Very interesting :-) One thing that struck me most is that my tongue often looked very different in the morning after a good night’s sleep (often no cracks at all) compared to in the evening, especially on demanding days (cracks in st/sp area and e.g. heat signs when working outdoors in summer). So if, for example, a client would come in in the morning, would we miss something that we’d possibly be able to see if that client would have come to see us in the late afternoon instead? I am looking forward to hear your thoughts and how you deal with this in clinical practice. Thank you very much, Annette

Andrew said: Hi Anette. I am so glad you are observing your tongue, what a great practice! I have several answers to your question: 1. I think you are observing the effect of the daily rhythm. Daytime is yang and nighttime is yin. When you look at the tongue in the morning, the body has had time for the yin and fluids to replenish due to rest (yin) overnight (yin). This one way to understand why sleep is so important! Over the course of the day (yang) we are active (yang) and use up our yin and fluids. The tongue reflects these changes in some subtle way in most people. However, if a person has a clinically significant deficiency, the cracks will be visible all the time. There may be diurnal changes in the severity of the cracks but you will see them even at the most yin replete time of the day. If the cracks are present only some of the time, I would think the person is on the verge of a yin deficiency but it is not severe enough to treat. This could also be something simple, the person may not be drinking enough water. Here is a little brain-teaser for you to ponder: Think of a woman experiencing menopause--related night sweats. Why would the yin deficiency manifest most at night when the yin of the world is greatest? 2. We always use tongue and pulse in context of the symptoms. The tongue is best used to confirm or reject the diagnosis(es) we have already made at that point in the session. Over examining the tongue or attempting to draw too many conclusions from the tongue is a common pitfall. 3. We should get to know the client over time. Regular follow-ups with each client are very important. If you see the client every 1-4 weeks to reassess how the formula is working, you will also look at the tongue every 1-4 weeks. In this way you will get a better picture of the tongue and how it contributes to understanding the physiology of the client. All my best- Andrew