Advice Needed - Tongue Pictures Attached

You seem to know quite a bit about TCM already, so why don&#39t you include what you have tried both acupuncture and herbal wise previously and what the results were and why you did or didn&#39t keep going with that particular line of treatment. That way we can think outside of the box for you instead of everyone giving you a bunch of ideas you have already tried.

Your tongue looks near normal really, a little swollen and a crack in the st/sp area and a thin white coat, so you have some digestive issues but they don&#39t appear, from the tongue anyhow, to be deeply integrated into your system. What&#39s your diet like? What were your last three meals exactly? Do you drink much alcohol?

I did send you the address for a practitioner in Maryland, if you didn&#39t get it please contact me directly by clicking on my name and then clicking on the "contact me" button. Then I&#39ll send it again. Without knowing the herbs you were on and/or seeing your personally it is really hard to comment on your case. You definitely have some weakness in the digestive system and in the kidneys as well.

One question about the sweating - is it primarily the hands and/or feet and more at night - or is it spontaneous sweating during the day or excessive with minimal activity?

Do you sleep well? If not, do you have more trouble going to sleep or staying asleep?

How do you feel temperature wise generally - warmer or cooler? And how is your general energy level overall?

Well you&#39ve got a few things going on which are hard to completely diagnose over the internet, but I&#39ll give you a general idea. You have signs of empty heat/yin deficiency (the red tip of the tongue, insomnia, heat). Usually with this as the only pattern you would be constipated. As you are also having loose stools there is either more auto-immune type activity (i.e. celiac, crohn&#39s, etc.) or a conjoined spleen deficiency - or a bit of both. Herbally the classic treatment for yin deficiency is Liu Wei Di Huang Wan - but with loose stools already it may be too hard on your system and you would either combine it with Bao He Wan or try treating the stomach/spleen first and then working on the yin aspects. To deal with the spleen aspects I would consider starting with something like Shu Gan Wan which is helpful for GERD, reflux, emotional constraint, etc. perhaps combined with Jia Wei Xiao Yao Wan to clear some of the heat. In theory, again much easier if I were to see you personally, you could do something like 5 tablets of Shu Gan Wan with 5 tablets of Jia Wei Xiao Yao Wan 3 times a day before meals and then after about 2 weeks if it&#39s working you could drop that to twice a day and starting taking 7 tablets of Liu Wei Di Huang Wan with 5 tablets of Bao He Wan in the evenings before you -want- to go to sleep along with those. After about 2-3 months the stomach should be greatly improved (if that&#39s the right combination for you at this time) - then the yin deficiency could take 3-6 months of a low dose like I described to improve.

There are lots of other options you could do including using formulas like Wu Mei Wan which can help IBS, colitis type symptoms along with parasitic infestations. But we generally start with the most obvious and most harmonizing line of action and then start branching out from there if we don&#39t get the results we would want.