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Updated: Jun 29, 2025

Objectification of Tongue Diagnosis in Traditional Medicine, Data Analysis, and Study Application
Published on: April 14, 2023
Effects of Sitting and Supine Positions on Tongue Color as Measured by Tongue Image Analyzing System and Its Relation
Aya Murakami1, Akira Morita2, Yuki Watanabe3
1Center for Pharmaceutical Education, Faculty of Pharmacy, Yokohama University of Pharmacy, 601 Matano-Cho, Totsuka-Ku, Yokohama 245-0066, Japan.
Abstract:
Tongue diagnosis is one of the important diagnostic methods in Kampo (traditional Japanese) medicine, in which the color and shape of the tongue are used to determine the patient's constitution and systemic symptoms. Tongue diagnosis is performed with the patient in the sitting or supine positions; however, the differences in tongue color in these two different positions have not been analyzed. We developed tongue image analyzing system (TIAS), which can quantify tongue color by capturing tongue images in the sitting and supine positions. We analyzed the effects on tongue color in two different body positions. Tongue color was quantified as Lab from tongue images of 18 patients in two different body positions by taking images with TIAS. The CIEDE 2000 color difference equation (ΔE00) was used to assess the difference in tongue color in two different body positions. Correlations were also determined between ΔE00, physical characteristics, and laboratory test values. The mean and median ΔE00 for 18 patients were 2.85 and 2.34, respectively. Of these patients, 77.8% had a ΔE00 < 4.1. A weak positive correlation was obtained between ΔE00 and systolic blood pressure and fasting plasma glucose. Approximately 80% of patients' tongue color did not change between the sitting and supine positions. This indicates that the diagnostic results of tongue color are trustworthy even if medical professionals perform tongue diagnosis in two different body positions.
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