Diagnosis of pulmonary thromboemboli by tongue examination: an example for integration of Traditional Chinese Medicine and modern medicine

Phlegm in traditional Chinese medicine (TCM) is a sign for various problems caused by disturbance in fluid metabolism. We describe an example of using TCM concepts in combination with modern medicine investigations to diagnose pulmonary thrombo-emboli. A 71-year-old man with previous history of chronic obstructive pulmonary disease, heavy smoking and thrombosis in left leg vessels presented with signs and symptoms of lung infection. He was initially considered to be treated for pneumonia. Despite anticoagulant therapy his INR (international normalized ratio) was lower than expected. In addition on tongue examination we found a sign in TCM: dark reddish purple tongue with a thick greasy coat. Based on this clue we suspected that blood stasis could be the probable underlying cause for this condition. This primary diagnosis was confirmed by investigations including computed tomography-scan and doppler ultrasound. This sign helped us to think that thrombosis could be the possible cause for changes of tongue. [J Exp Integr Med 2012; 2(2.000): 185-188]