Tongue Diagnosis in Traditional Chinese Medicine (TCM)
diagnosis is an important part of the Chinese medical assessment. During an examination, the overall tongue coating, shape,
and color is taken into account.
The tongue reflects the health of the internal organs and blood circulation. Changes in the
tongue color usually reflect chronic illness. As your health changes, the condition of your tongue will change as well.
normal tongue is pink in color, medium thickness, has no cracks, ulcers, or teeth marks and has a light white coat on it.
of Tongue: Tongue color varies widely from person to person, but is a good indicator of the overall nature of what is going
on in the body. A red tongue indicates that there is heat present in the body, and the redder the tongue, the
greater amount of heat present. A tongue that is pale indicates a deficiency of qi and blood or the presence of cold.
A purple tongue tells your practitioner that there is stagnation somewhere in the body.
Pale: Excess cold, especially
if thick white coating. Spleen qi deficiency, especially if thin white coating. Blood deficiency, especially if
dull, pale face and lips.
Red: Excess heat, especially if there is a
thick yellow tongue coating. Yin deficiency, especially if tongue body is thin and coating is thin, absent or peeled.
Purple: Stagnant qi or Stagnant blood if dark purple tongue body and/or red
spots on the tongue.
A Red Tipped Tongue: The tip of the tongue is related
to the heart and fire element. When the tip of the tongue is red, it is an indication that emotional distress is causing an
imbalance. Today’s fast paced lifestyle has created an epidemic of stress and anxiety. It is very common to see red
tipped tongues in our culture. In addition to a red tipped tongue, other symptoms of a heart imbalance can include insomnia
or frequent nightmares, restlessness, agitation, mouth ulcers, heat sensation in the chest, palpitations with anxiety, dry
mouth and a rapid pulse.
Each area of the tongue is connected to specific internal organs.
Sides of the tongue: Liver Tip of the tongue: Heart Center of the tongue: Spleen
Back of the tongue: Kidney
Shape and Size of Tongue: The shape
and size of the tongue tends to address the status of fluids in the body. For example, a very large, puffy, or scalloped
tongue suggests that fluids are not being properly metabolized in the body. In contrast, a very small, short tongue may indicate
dryness, a deficiency of fluids, or deficiency in general. In addition to shape and size, any movement of the tongue
can indicate a deficiency of energy or the presence of an internal wind pathogen.
Swollen or puffy: Spleen qi deficiency,
especially if teeth marks on the sides or Damp heat. Thin: Blood deficiency or Fluid deficiency. Trembling:
Spleen qi deficiency.
Elongated: Heart heat. Sides curled up: Liver
qi stagnation or, if the sides are swollen and red, it may indicate Liver Fire. Cracks: Excess heat or yin deficiency
or Heart imbalance, especially if there is a crack down the middle of the tongue to the tip.
Tongue Coating: A coating
on the tongue can also give your practitioner information about your health. The thickness of a coating is an indicator
of the severity of the condition being treated. A thin coating, one in which you can see the tongue through the coating,
indicates that any pathogen present is mild or on the exterior. A thick coating that obscures the tongue tells your
practitioner that the condition is deeper and more serious.
The condition of the coating also speaks to the condition
of fluids in the body. A moist or wet coating indicates poor fluid metabolism, and a dry coating indicates depleted
fluids. A coating that is peeled off, either completely or partially, indicates some kind of heat or damage to the Stomach,
possibly a depletion of Stomach Yin, or damage to Stomach Qi.
Tongue coatings also vary in color. In general,
a thin white coating is normal, but can also appear in diseases associated with cold conditions. A yellow or brown coat
indicates heat, and a gray or black coat indicates an extreme condition. It’s also important to note that foods
such as red wine, orange juice, and coffee can alter the appearance of the coating. Needless to say, food dyes can dramatically
alter the color of the tongue. In more than one instance, I have had a young patient stick out their tongue, only to
see a bright blue, green, or pink coating!
Thick: Excess Yellow, thick, glossy:
Damp Heat Dry, yellow: Excess heat
Peeled or absent:
The condition of your tongue will change as your health changes, but in general those
changes appear on the tongue slowly. One exception is during a cold or flu when the patient has a high fever, a very
red tongue will appear fairly quickly.
As with any assessment method, acupuncturists never rely
on tongue diagnosis alone, but use it to provide a complete picture of a person's health.
Tongue diagnosis can be
a subtle art. To try it yourself, observe the variations of your tongue's shape, color, size, and coating and compare
it to that of friends or family members. After you have looked at a few tongues, you will see that they differ widely, and
with a little study can tell you a lot about the overall health of a person!
Dennis Landes, M.Ac.O.M.
Copyright © 2009 Dennis Landes. All Rights Reserved