• The Journal of the Society of Korean Medicine Diagnostics
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• v.17 no.3
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• pp.215-223
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• 2013

Objectives Although tongue diagnosis is one of major diagnostic methods in east Asian traditional medicine, the standard of normal tongue color have not established. So we tried to suggest the method to establish the standard of normal tongue color range and the pilot data about the normal range. Materials and methods: 22 precedent study papers that presented the numerical data of normal (light red) tongue color were analyzed. At the same time, 46 adult people tongue color data were also collected and analyzed. Results Precedent studies showed remarkable fluctuations of the range of normal tongue color. Collected tongue color data of the 46 people showed mean Hue value 2 and standard deviation 14 in HSB system. Additionally, 3 ways of standard establishment for normal tongue color were suggested. Conclusion We suggest statistical method as a reasonable method for tongue color standard establishment and $2{\pm}14$ as a reference Hue value for normal tongue color.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.4
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• pp.191-200
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• 2020

The purpose of this pilot study was to examine the effect of tongue color change due to food ingestion on tongue diagnosis by both Korean Medicine doctors and digital tongue diagnosis system. In order to obtain objective and quantitative data, we used digital camera to collect the data. Prior to our investigation, we conducted a brief survey of 26 Korean Medicine doctors and found out that tongue diagnosis is frequently used and food-stained tongue could be commonly observed in clinics. Depending on their color, viscosity, and amount of intake, various foods caused stains with different colors and thicknesses. Also, duration and amount of food stain on tongue were different from person to person. Since coffee-stained tongue was the most frequently observed one in clinics according to the survey, we used coffee to evaluate the effect of food-stained tongue on tongue diagnosis. Korean Medicine doctors tended to interpret coffee-stained tongue as having yellow tongue coat but their judgement on tongue body color did not differ in spite of the coffee stains. Meanwhile, tongue diagnosis system algorithm tended to judge coffee-stained tongue as having normal but yellowish tongue coat and reddish tongue body. Altogether, food color on tongue can influence tongue diagnosis outcomes. Further research is needed in order to develop more efficient tongue diagnosis algorithm and digital medical service system.

• The Journal of the Society of Stroke on Korean Medicine
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• v.9 no.1
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• pp.1-7
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• 2008

Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

• Advances in Traditional Medicine
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• v.6 no.2
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• pp.112-120
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• 2006

The purpose of this study was to analyze whether quantitative evaluation of the color of the tongue substance using $L^*a^*b^*$ color coordinates system could minimize the problems arising from the different illuminating conditions or not. In controlled 4 different illuminating conditions (by natural light, flashlight, f-number, shutter speed),12 healthy subjects were photographed of their tongue substance through a digital camera (C-2100uz, Olympus Co.), both on the top surface and on the bottom surface of the tongue substance by two examiners, twice at 3 day intervals. Clinician evaluation was also performed grading the redness of the tongue substance in the form of 5-points scale by 6 clinicians. As a result, there was no significant difference in color differences between the color of the tongue substance and the reference red card in the 4 different illuminating conditions. Intra-rater reliability was satisfied and even though limitedly, inter-rater reliability was satisfied. Color differences were significantly correlated with the results by the clinicians, although they were applicable limitedly to specific illuminating conditions. Our results indicate that the application of the color differences in tongue diagnosis could not only evaluate the color information quantitatively, but also minimize the problems arising from the different illuminating conditions and that there was the significant difference in the visual evaluation of the red color of the tongue substance, both between the clinicians and between the illuminating conditions.

• Journal of Sasang Constitutional Medicine
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• v.22 no.1
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• pp.1-8
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• 2010

1. Objectives: This study was performed to research the relationship between Sasang Constitution and characteristics of tongue diagnosis based on Donguisusebowon's Experience prescriptions(經驗方). 2. Methods: We searched tongue diagnosis factors in Donguisusebowon and classified this. Based on Donguisusebowon's Experience prescriptions(經驗方), we find tongue diagnosis factors in 6 contemporary Oriental medicine prescription books. 3. Results: Most So-eumin has white thin tongue coating and clear redish tongue color. Yellow tongue coatings are found in symptoms for Yinjinho-tang(Yinchenhao-tang), Soseungki-tang(Xiaochengqi-tang), Daeseungki-tang(Dachengqi-tang). Shortened Tongue is found in So-eumin's experience prescription and So-yangin's treat histroy. It didn't shown that So-eumin's Semen Crotonis included 6 prescritions' factors of tongue diagnosis. So-yangin's white tongue coating is found in Hyungbangpaedok-san(Jingfangbaidu-san), Sipjo-tang(Shizao-tang), Sosiho-tang(Xiaocihu-tang), Shinki-hwan(Shenqi-wan). Most of other So-yangin's tongue coatings are Yellowish and tongue color is deep red. Tae-eumin have thin white tongue coating at the Mahuang-tang(Mahuang-tang). Red tongue color and drying tongue are found at Jowiseungki-tang(Tiaoweichengqi-tang)Daesiho-tang(Dacihu-tang)Saengmaek-san(Shengmai-san) 4. Conclusions: Following So-eumin's Experience prescriptions, So-eumin's tongue color is clear red and tongue coatings are thin white and greasy. Following So-yangin's Experience prescriptions, So-yangin's tongue color is deep red and tongue coatings are yellowish and scarce except Exterior cold disease. And So-yangin has specific symptom of irritability, oral sores. Tae-eumin's tongue has two sides of white thin tongue coatings and Red and drying tongue.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.683-687
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• 2013

Evacuation disorder(ED) is frequently observed in the elderly people. In this study, we investigated the tongue color properties in the elderly. 327 subjects were participated in this study and classified into normal group (n=95) and ED group (n=23) by two Korean Oriental Medicine doctors. The tongue images were acquired by using computerized tongue diagnosis system, and its color were linearly corrected base on CIE $L^*a^*b^*$ values of 12 color samples. The tongue region was segmented from acquired image and divided into two regions along the vertical direction. In order to estimate color properties of the tongue, a color histogram was calculated for the root region based on the CIE $L^*$ and $a^*$ values, and differences of color histogram values between normal and ED groups were computed based on the Mann-Whitney U test. As results, pixels corresponding to typical colors of the pale tongue and thin tongue coating were significantly more distributed in ED than those in normal group(p<0.05). The tongue color of the root region in ED was revealed to be different from those in healthy subjects.

• Journal of the Institute of Convergence Signal Processing
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• v.16 no.3
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• pp.96-101
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• 2015

A tongue coating evaluation method for WTCI(Winkel Tongue Coating Index) is proposed in this paper, which is used as the diagnostic criteria in the tongue diagnosis. This method uses the color channel analysis and tongue coating extraction from the ultraviolet tongue image. Proposed method analyzes the histogram distribution of the respective color channel for extracting a tongue coating, and performs the verification test from the selected color channel in the tongue coating extraction. Also, Objectivity of the tongue diagnostic criteria is verified by the artificial sample and real-tongue image experiments. In order to evaluate the performance of the proposed Computerized Assistant WTCI Evaluation method, after verifying a measurement accuracy by using the artificial sample images, and applying to the various real-tongue image of subjects. As a result, the proposed WTCI method is very successful.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.1
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• pp.97-103
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• 2009

The status and the property of a tongue are the important indicators to diagnose one's health like physiological and clinicopathological changes of inner organs. However, the tongue diagnosis is affected by examination circumstances like a light source, patient's posture, and doctor's condition. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, classifying tongue coating is inevitable but difficult since the features like color and texture of the tongue coatings and substance have little difference, especially in the neighborhood on the tongue surface. The proposed method has two procedures; the first is to acquire the color table to classify tongue coatings and substance by automatically separating coating regions marked by oriental medical doctors, decomposing the color components of the region into hue, saturation and brightness and obtaining the 2nd order discriminant with statistical data of hue and saturation corresponding to each kind of tongue coatings, and the other is to apply the tongue region in an input image to the color table, resulting in separating the regions of tongue coatings and classifying them automatically. As a result, kinds of tongue coatings and substance were segmented from a face image corresponding to regions marked by oriental medical doctors and the color table for classification took hue and saturation values as inputs and produced the classification of the values into white coating, yellow coating and substance in a digital tongue diagnosis system. The coating regions classified by the proposed method were almost the same to the marked regions. The exactness of classification was 83%, which is the degree of correspondence between what Oriental medical doctors diagnosed and what the proposed method classified. Since the classified regions provide effective information, the proposed method can be used to make an objective and standardized diagnosis and applied to an ubiquitous healthcare system. Therefore, the method will be able to be widely used in Oriental medicine.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.348-360
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• 2015

Objectives From observing the tongue of a patient, one can assess the health status; this method has been frequently used in traditional Korean Medicine (KM) clinics. In particular, KM posits that the color of the tongue is highly related to digestive functions. In this study, the color of tongue and heart rate variability (HRV) were compared between chronic dyspepsia (CD) patients and healthy subjects. Methods Healthy subjects and CD patients with functional dyspepsia (FD), gastroesophageal reflux disease (GERD), or chronic gastritis (CG) were enrolled for the study. Profile view images of the tongue were acquired by using a computerized tongue image acquisition system (CTIS). The color of the tongue body was extracted from the non-coated region on the tongue images. Results Color differences in CIE L*a*b* color space between the three sub-types of CD patients and healthy subjects were analyzed by using multiple linear regression analysis with age and sex as the factors. The variable b* was significantly lower in GERD patients than in the controls (p=0.017). Variable a* was significantly lower in CG than in the controls (p=0.03). No significant difference was seen between FD and controls. In GERD, the tongue body seems to be intense red in color; in CG, pale red. Frequency domain analysis showed that HF was significantly lower in GERD patients than in the controls (p=0.041). Conclusions The color of the tongue body and HF of HRV can be used for diagnosing digestive functions in health care.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.5
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• pp.320-326
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• 2016

Tongue diagnosis is convenient and non-invasive method to examine the body's functional condition, and it has been frequently used in traditional Korean Medicine (KM). The aim of this study was to investigate the difference of the tongue color assessed by computerized tongue image analysis system (CTIS) between the common cold (CC) patients and healthy subjects. A total of 85 participants, including 45 CC patients without organic diseases and 40 healthy subjects, were asked to complete the CC symptom questionnaire. A tongue image was acquired by using CTIS. Color differences in Commission Internationale de l'Eclairage (CIE) L*, a* and b* between the CC patient group and the control group were analyzes by using paired t-test analysis. The variable CIE b* of the tongue body was significantly lower in CC than that in controls (P=0.019). The variable CIE L* of the tongue coating was significantly higher in CC than that in controls (P=0.032). In CC, the color of the tongue body seems to be changed to intense red color. The color of the tongue coating seems to be changed to thick fur. The present study demonstrated that the CTIS can be used as a diagnostic and monitoring tool for the objective and standardized evaluation of common cold in clinics.