• Korean Journal of Oriental Medicine
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• v.14 no.3
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• pp.89-95
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• 2008

A tongue shows physiological and clinicopathological changes of inner organs. Visual inspection of a tongue is not only convenient but also non-invasive. To develop an automat ic tongue diagnosis system for an objective and standardized diagnosis, the separation of the tongue are a from a facial image and the detection of coatings, spots and cracks are inevitable but difficult since the colors of a tongue, lips, and skin in a mouth as well as those of tongue furs and body are similar. The propose d method includes preprocessing with down-sampling and edge enhancement, over-segmentation, detecting positions with a local minimum over shading from the structure of a tongue, and correcting local minima or detecting edge with color difference. The proposed method produces the region of a segmented tongue, and then decomposes the color components of the region into hue, saturation and brightness, resulting in classifying the regions of tongue furs(coatings) into kinds of coatings and substance and segmenting them. Spots are detected by using local maxima and the variation of saturation, and cracks are searched by using local minima and the directivity of dark areas in brightness. The results illustrate the segmented region with effective information, excluding a non-tongue region and also give us accurate discrimination of coatings and the precise detection of spots and cracks. It can be used to make an objective and standardized diagnosis for an u-Healthcare system as well as a home care system.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.47-52
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• 2007

In Oriental medicine, the status of tongue is the important indicator to diagnose one's health, because it represents physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive, therefore, tongue diagnosis is one of the most widely used in Oriental medicine. But tongue diagnosis is affected by examination circumstances a lot. It depends on a light source, degrees of an angle, doctor's condition and so on. So it is not easy to make an objective and standardized tongue diagnosis. As part of way to solve this problem, in this study, we tried to design a discriminant function for white and yellow coating with multi-dimensional color vectors. There were 62 subjects involved in this study, among them 48 subjects diagnosed as white-coated tongue and 14 subjects diagnosed as yellow-coated tongue by oriental doctors. And their tongue images were acquired by a well-made Digital Tongue Diagnosis System. From those acquired tongue images, each coating section were extracted by oriental doctors, and then mean values of multi -dimensional color vectors in each coating section were calculated. By statistical analysis, two significant vectors, R in RGB space and H in HSV space, were found that they were able to describe the difference between white coating section and yellow coating section very well. Using these two values, we designed the discriminant function for coating classification and examined how good it works. As a result, the overall accuracy of coating classification was 98.4%. We can expect that the discriminant function for other coatings can be obtained in a similar way. Furthermore, if an automated segmentation algorithm of tongue coating is combined with these discriminant functions, an automated tongue coating diagnosis can be accomplished.

• Korean Journal of Oriental Medicine
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• v.13 no.3
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• pp.119-124
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• 2007

Introduction: In Oriental medicine, the status of tongue is the important indicator to diagnose one's health, because it represents physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive, so tongue diagnosis is most widely used in Oriental medicine. By the way, since tongue diagnosis is affected by examination circumstances a lot, its performance depends on a light source, degrees of an angle, a medical doctor's condition etc. Therefore, it is not easy to make an objective and standardized tongue diagnosis. In order to solve this problem, in this study, we tried to design a discriminant function for thick and thin coating with color vectors of preprocessed image. Method: 52 subjects, who were diagnosed as white-coated tongue, were involved. Among them, 45 subjects diagnosed as thin coating and 7 subjects diagnosed as thick coating by oriental medical doctors, and then their tongue images were obtained from a digital tongue diagnosis system. Using those acquired tongue images, we implemented two steps: Preprocessing and image analyzing. The preprocessing part of this method includes histogram equalization and histogram stretching at each color component, especially, intensity and saturation. It makes the difference between tongue substance and tongue coating was more visible, so that we can separate tongue coating easily. Next part, we analyzed the characteristic of color values and found the threshold to divide tongue area into coating area. Then, from tongue coating image, it is possible to extract the variables that were important to classify thick and thin coating. Result : By statistical analysis, two significant vectors, associated with G, were found, which were able to describe the difference between thick and thin coating very well. Using these two variables, we designed the discriminant function for coating classification and examined its performance. As a result, the overall accuracy of thick and thin coating classification was 92.3%. Discussion : From the result, we can expect that the discriminant function is applicable to other coatings in a similar way. Also, it can be used to make an objective and standardized diagnosis.

• 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.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.45 no.6
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• pp.123-131
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• 2008

In Oriental medicine, the status of a tongue is the important indicator to diagnose the condition of one's health like the physiological and the clinicopathological changes of internal organs in a body. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is affected by examination circumstances like a light source, patient's posture, and doctor's condition a lot. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, segmenting a tongue region from a facial image captured and classifying tongue coating are inevitable but difficult since the colors of a tongue, lips, and skin in a mouth are similar. The proposed method includes preprocessing, over-segmenting, detecting the edge with a local minimum over a shading area from the structure of a tongue, correcting local minima or detecting the edge with the greatest color difference, selecting one edge to correspond to a tongue shape, and smoothing edges, where preprocessing consists of down-sampling to reduce computation time, histogram equalization, and edge enhancement, which produces the region of a segmented tongue. Finally, the systematic procedure separated only a tongue region from a face image with a tongue, which was obtained from a digital tongue diagnosis system. Oriental medical doctors' evaluation for the results illustrated that the segmented region excluding a non-tongue region provides important information for the accurate diagnosis. The proposed method can be used for an objective and standardized diagnosis and for an u-Healthcare system.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.1
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• pp.262-266
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• 2008

We plan to make the standardization of the pattern identifications for stroke and differentiate them by tongue diagnosis. We make a case report form which has questionnaires for tongue diagnosis in stroke patients. And we collected cases from the multi center network which consists of twelve university hospitals and one local hospital. The cases confirmed by diagnosis of medical specialists and residents are 321 cases. They are divided into Qi Defficiency 30.84%, Dampness& Phlegm 25.55%, Fire & Heat 22.43%, Eum Defficiency 18.69% and Blood Stasis 2.49%. We analyzed the markers which classified into the color of tongue body, the color of fur, the quality of fur, the dryness of tongue, the shape of tongue. To make a stroke pattern identification standard, we must try variable ways.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.134-144
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• 2006

Tongue diagnosis is an important diagnostic method in traditional Oriental medicine. It has been especially accepted that quantitative analysis of tongue images allows the accurate diagnosis of the exterior-interior and cold-heat patterns of a patient. However, to ensure stable and reliable results, the color reproduction of such images must first be error-tree. Moreover, tongue diagnosis is much influenced by the surrounding illumination and subjective color recognition, so it has to be performed objectively and quantitatively using a digital diagnostic machine. In this study, 457 tongue images of outpatients were collected using the Digital Tongue Inspection System. Through statistical analysis, the result shows that the heat and cold patterns can be distinguished clearly based on the hue value of the tongue images. The average hue value (1.00) of the tongue's image in the cold pattern is higher than that in the heat pattern (0.99).

• The Journal of the Society of Korean Medicine Diagnostics
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• v.19 no.1
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• pp.1-10
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• 2015

Objectives The purpose of this study was to survey the status of clinical use of a computerized tongue diagnosis system (CTDS) Methods We searched domestic/international articles using the CTDS from online medical databases including OASIS, NDSL and pubmed. We selected articles on clinical application or reliability of CTDS but excluded articles on mechanical design or software programming for developing a new CTDS. Finally we found 15 articles and classified the articles according to the study purpose. Results Out of the 15 articles, 8 were focused on the clinical application including halitosis, cold/heat syndrome, lung cancer, xerostomia etc. Other 5 articles were aimed at evaluating and improving reliability of CTDS. The other 2 articles were studied for development of differential diagnostic criteria on tongue coating thickness. Conclusion We found out that until now the researches on clinical application of CTDS mainly had been performed for producing a variety of CTDSs. Considering the importance of the tongue color in the traditional Korean medicine, we suggest that at first standard operating procedure for CTDS be developed and researches to develop differential diagnostic criteria on tongue body/coating color be performed and then explore its applications.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.16 no.4
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• pp.125-131
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• 2016

Tongue image segmentation is critical for automation of the tongue diagnosis system. However, most image segmentation methods for tongue diagnosis systems in oriental medicine have been proposed as user-based manual types or semi-automatic types. This study proposed a new method for tongue image segmentation, which is the most important image processing stage for complete automation of the tongue diagnosis system in oriental medicine. The proposed method improved the conventional snake algorithm, by making improvement on the internal energy function so that, as the points move outward reversely, the snake energy function is minimized, by using the image characteristics of tongue images. To calculate external energy, hierarchical spatial filtering is applied to ensure resistance against noise. Also, The proposed method was tested by using sample images and actual images, and showed more robustness against the background noise than the conventional snake algorithm. And, when one selected point was moved by the improved snake algorithm, energy values at the starting, middle, and end points were analyzed, and showed robustness that does not fall in the local minima.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1437-1442
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• 2005

Tongue Diagnosis is the important traditional oriental medical diagnosis method that observes not only the general physiological state but also some kinds of disease. However, manual tongue diagnosis is much influenced by surrounding illumination. Therefore, Digital Tongue Inspection System(DigiTis) is needed for the quantification of objective tongue information, In this research, Tongue images of 98 malignant Neoplasm patients and 34 normal persons were collected by Digital Tongue Inspection System. Statistical analysis of tongue images and patient data indicates that cancer group has more blue-purple components in tongue body(舌質) and yellow components in tongue coating than normal group. Also, there are a lot of rose-pink components in the cancer group of second stage and blue-purple components in the cancer group of third or fourth stage. Our study shows that tongue image is a useful index for distinction between disease and health. Furthermore we need more extended research through the additional sampling and various disease.