Jivha Pariksha (Tongue Examination) in Ayurveda: An Ancient Diagnostic Tool Revealed

The word ‘Pariksha’ is the method of examination as described in Ayurveda. Roga Pareeksha and Rogi Pareeksha are two factors in carrying out the Pareeksha. Nidana Panchaka directs the examination of Roga (disease), while Rogi Pareeksha includes Trividha Pareeksha (three-fold examination methods), Panchavidha Pareeksha (five-fold examination methods), Astha Sthana Pareeksha (examination of eight sites), Dasha Vidha Pareeksha (ten-fold examination). Ashta Sthana Pariksha includes the examination of Nadi (pulse), Mala (stools), Mutra (urine), Jivha (tongue), Shrotra (ears), Twak (skin), Drik (eyes), and Akruti (physical). Jivha Pariksha aids in the diagnosis of a disease.

Jivha is the organ of taste and is known as tongue in the contemporary science. The tongue is the organ that helps in perceiving the taste, an organ of the digestive system that helps in swallowing the food or facilitates food entry through the process of mastication. Taste perception occurs in the taste buds present over the tongue, palate, and tonsils. Many taste buds are present over the posterior surface of the tongue called circumvallate papillae, and a moderate number of taste buds are present on the anterior surface of the tongue and within the folds respectively.¹

Jivha Pariksha

Jivha is called Rasanendriya as it is an organ of taste. It is formed of Jala Mahabhuta predominantly, Kapha dosha, Rakta, and Mamsa dhatu. Jivha Parikshais one of the Ashta Sthana Pareeksha Vidhi as explained by Yogaratnakara. Examination of the tongue should be done early in the morning before brushing or cleaning the mouth. The factors that are studied in the examination of the tongue are Prakrut Avastha (healthy or physiological state), Vikrut Avastha (pathological state), Varna (colour), Pramana (size), Thala (surface), Chalana (movement), Upalepa (coating).

Features of tongue in Prakrut Avastha (healthy state)

• Shape – Tanu – it should be neither too thin nor too thick oval-shaped.
• Colour – Shyavarakta (pink colour throughout).
• Movement – It should be straight when protruding outside.
• Coating – It should be Nirlipta or Ishatlipta (non-coated or slightly coated).
• It should be Slakshna (moist) in nature.

Features based on the Doshaja Prakriti

• Vataja Prakruti – The tongue of Vataja Prakruti individuals is Ruksha (dry), Sheeta (cold), Khara (rough in texture), Sprushta (cracked), Chala (mobile), Laghu (light), they find it difficult to protrude the tongue as they are anxious.
• Pittaja Prakruti – They protrude the tongue like an arrow during the examination, is Rakta or Shyama Varna (red or reddish brown colored).
• Kaphaja Prakruti – Kapha Prakruti people have large-sized tongues, Pandu (pale-colored), Shlakshna (moist), Lipta (coated), Sheeta (cold), Mrudu (soft).

Features of the tongue in the Vikrut Avastha (pathological state) of dosha

Based on the Trividha Pareeksha Vidhi (three-fold examination methods) – Darshana (Inspection), Sparshana (palpable), and Prashna Pareeksha (Interrogation) the Jivha Pariksha is done for the Vikruti of Tridosha.

• Vata dosha vikruti – Pandu varna (pale colour), coating colour is grey, brown, or black, short, small, thin, dry with fissures are examined on Darshana. Khara (roughness) is felt on palpation and Kashaya Asyata (feeling of astringent taste in the mouth) is an interrogation method.
• Pitta dosha vikruti – Rakta varna (red colour), coating colour is orange, red, yellow, or green, long, pointed, narrow, ulcerated with red edges are the features seen on inspection. Inflamed on palpable and on interrogation method, it is known that there is Katu Asyata (feeling of pungent taste in the mouth).
• Kapha dosha vikruti –Pandu varna (pale colour), whitish coating, thick, swollen, soft with wet edges are the characteristics of tongue in Kapha dosha vikruti seen on inspection. A swollen tongue is felt on palpation examination while Mukha madhuryata (feeling of sweet taste in the mouth) is known on interrogation method of examination.
• Tridoshaja vikruti – Abnormally pinkish colour, the coating is blackish colour, it appears dry, felt like prickly thorn and there is a feeling of mixed tastes in the mouth.

Different diseases and the variation in features of the tongue that are examined on Jivha Pariksha as per Ayurveda

Colour

• Shweta (white) – Kaphakshaya (decrease in Kapha dosha), Ojakshaya (decrease in Oja)
• Shwetabha (pale) – Vatajakshaya (decreased Vata dosha), Pandu (anemia)
• Paridagdha (strawberry colour) – Sannipataja jwara (fever due to vitiation of three dosha), Pittaja vruddhi (increased Pitta dosha)
• Krishna (black) – Vataja vruddhi (increased Vata dosha)
• Peeta (yellow) – Kamala (jaundice), Purana Pandu (chronic anemia)
• Neela (blue) – Kaphaja vruddhi (increased Kapha dosha), Madatyaya asdhya lakshana (incurable stage of Madatyaya)
• Dark red– Rakta vruddhi (increased Rakta dosha)
• Purple – Pitta vruddhi (increased Pitta dosha)

Size

• Hriswa Jivha – Beeja dosha (genetic disorder)
• Deergha Jivha – Beeja dosha (genetic disorder)

 Coating of the tongue

• Lipta Jivha is seen in Sannipataja jwara (fever due to vitiation of three dosha), Amlapitta (hyperacidity), Poorvaroopa of Prameha (premonitory symptom of Diabetes mellitus).

Surface of the tongue

• Atitanu (smooth tongue) – Kaphaja vaishamya (imbalance in Kapha dosha)
• KharaJivha/ kantaka Jivha (fissured tongue) – Tridoshaja vyadhi (diseases of vitiation of three dosha)

Movements of the tongue

• Jivha vepana (tremors in the tongue) – Kampavata
• Stabdha Jivha (immobile tongue) – Jivhastambha

Arishta Lakshana (fatal signs and symptoms) explained in Ayurveda based on the Jivha Pariksha

• Shushka – dry
• Loss of taste
• Stabdha – tongue would be hard and tongue.
• Bhrusham Shyava – bluish black discolouration of the tongue.
• Gurvi – heaviness of the tongue.
• Nischetana – loss of sensation on touch.
• Kantakopachita – tongue covered with thorns / prickly tongue.

Conclusion

The tongue is the mirror of the digestive system. It reflects the condition taking place inside the body. Jivha Pareeksha is one among the Ashta Sthana Pareeksha that helps in understanding the healthy state of a healthy individual, diagnosis, and prognosis of a disease. Based on the components like Varna, Pramana, Thala, Upalepa, and Chalana of the tongue different conditions can be assessed. The features of a healthy state of a person are known through the examination of the tongue. The abnormal characteristics of the tongue direct the diseased conditions. Fatal signs and symptoms told in Ayurveda help to know the fatality of the disease. Thus, Jihwa (tongue) must be examined very carefully, and this is an important tool for the diagnosis and prognosis of a disease.

References

1. JIHWAPAREEKSHA – A TRADITIONAL DIAGNOSTIC METHODOLOGY WITH CONTEMPORARY ADVANCEMENT, International Journal of AYUSH, 2022 (Jan-Feb), Volume 12, Issue 1, p.07-18.
2. TONGUE, ITS EXAMINATION AND CLINICAL IMPLICATION, International Journal of Research in Ayurveda and Pharmacy, 2016 (Mar – Apr), Volume 7, Supplement 2, p.154-155.
3. IMPORTANCE OF JIHWA PARIKSHA AS DIAGNOSTIC TOOL IN PRESENT AND PAST ERA, International Ayurvedic Medical Journal, 2022 (January), p.188 -191.
4. https://www.researchgate.net/publication/339079783_JIVHA_PARIKSHA_A_DIAGNOSTIC_TOOL-REVIEW