Observe the sublingual collaterals to understand the flow of qi and blood, and the clinical application of the sublingual collaterals

There is a most convenient "window" that can help us judge the degree of congestion in the body, and that is the "sublingual veins", which are called "sublingual collaterals" in traditional Chinese medicine. So how do you check the sublingual veins?

1. Methods for checking sublingual collaterals:

Ask the patient to sit quietly facing the light and lift the tongue about 45 degrees toward the palate, but do not use too much force. Make sure the tongue remains naturally relaxed to avoid creating an illusion. The "sublingual collateral vessels" can be revealed externally. Observe the changes in the color and shape of the "sublingual veins" with your eyes or with the help of a magnifying glass

. First, check the large longitudinal collateral vessels under the tongue located on both sides of the frenulum of the tongue. Generally, there is one branch on each side, but there may be two or more branches. Observe the changes in their color and shape, thickness, length, whether they are bulging, curved, tight and thin, etc. Then check the color changes, shape and thickness of the surrounding small collaterals to see if there are any bulging nodules. At the same time, refer to the changes in the fatness, color and quality of the sublingual muscles for a comprehensive observation.

2. Criteria for judging normal and abnormal.

(A) Normal sublingual vein color and shape.

1. There are three types of large collateral vessels under the tongue: (1) single branch, (2) double branch, and (3) multiple branch. The length of the tongue is divided into two parts longitudinally. The part less than 1/2 is short, and the part longer than 1/2 is long. Thickness: The diameter of large collateral vessels is within about 2 mm. Those exceeding this are considered thick, and those less than this are considered thin. The root is slightly raised and the upper end is flat. A normal pulse is neither thick, long, raging nor thin, short, and tight. Its color is mostly dark red with a bluish tint. Normal colors include bluish purple, light purple, purple-red, light red, etc.

2. The small sublingual collaterals (i.e., branches around the large collaterals) are mostly pink, dense reticular small collaterals, and some normal ones are not visible on the outside.

(ii) Abnormal "sublingual collaterals" and their main symptoms.

The changes in color and shape of the "sublingual veins" can be used to distinguish them from the normal "sublingual veins", and then a judgment can be made by referring to the clinical pulse symptoms.

1. If the "sublingual collaterals" are bluish purple, the pulse shape is thick, long and swollen or thin, short and tight, and the small collaterals are bluish purple or dark red and swollen or have nodules, they are all symptoms of qi stagnation and blood stasis or phlegm and yin stasis (common in diseases such as accumulation of symptoms, ascites, heart pain, phlegm-blocked blood stasis and shortness of breath, coughing up blood, vomiting and bleeding from the nose, abdominal distension and pain, gynecological menstrual disorders, blood stasis and dysmenorrhea, and phlegm nodules).

2. The "sublingual collaterals" are light purple or blue, and the pulse shape is thick, long and swollen, or thin, short and tight. The small collaterals are light purple or dark red, dilated or have small nodules. They are all symptoms of cold stagnation or yang deficiency, qi deficiency and blood stasis (common in chest pain, heart pain, hemiplegia due to stroke, numbness of limbs, edema, ascites, cold pain in the abdomen, and gynecological diseases such as irregular menstruation, dysmenorrhea, and amenorrhea).

3. "Sublingual collateral veins" are purple-red in color, and the pulse shape may be thick, long and swollen or thin, short and tight. Small collateral vessels that are dark red or light blue and swollen or have small nodules are symptoms of heat-stagnation and blood stasis or dampness-obstruction and blood stasis (common in febrile diseases where heat enters the blood, surgical carbuncles, blood stasis and corruption, jaundice caused by dampness and heat, edema and swelling caused by mutual obstruction of dampness and blood stasis, abdominal distension and pain, blood stasis headache, irregular menstruation, dysmenorrhea, metrorrhagia, arthralgia, etc.).

4. If the "sublingual collaterals" are light red or light blue, the pulse is thin and short, and the small collaterals are mostly unchanged, it is a symptom of qi deficiency and blood weakness, deficiency of both yin and yang, or accompanied by blood stasis. The pulse must be tight or dilated (common in chronic wasting diseases, qi deficiency and blood deficiency, consumptive fatigue, indigestion, long-term diarrhea and dysentery, dull pain in the abdomen, gynecological uterine cold and infertility, irregular menstruation, dysmenorrhea, amenorrhea, metrorrhagia, leucorrhea, etc.).