What is Tongue Diagnosis in Chinese Medicine?

What is Tongue Diagnosis in Chinese Medicine?

Tongue diagnosis is a very traditional and effective method which has been used to diagnose diseases for over two thousand years. Knowledge of tongue diagnosis is one of the unique treasures of Traditional Chinese Medicine (TCM).

In this article I am going to share with you knowledge about tongue diagnosis. It will be a very interesting topic for you to understand how the tongue is a mirror of the body.

1. Construction of the tongue and how the tongue is related to the body and internal organs

During TCM diagnosis we focus on the body of the tongue, the coating and any particular tastes the patient might experience.

i) The body of the tongue
The body of the tongue is mostly made of muscle. The normal tongue body should be flexible, the colour a fresh red (not too dark, too red or pale), have suitable moisture (not too dry or wet), the shape of the tongue should be suitable to the mouth size (not too puffy or narrow).

The colour of the tongue is linked to the stomach and spleen, a healthy digestion will show a nice fresh redness of the tongue. It is also linked to the circulation from the liver and heart. The shape of the tongue is associated with the functioning of the spleen, kidney and liver.

Different regions of the tongue are related to different parts of the body, internal organs and channels.

  • The tip of the tongue – is related to the heart, lung, chest and upper back
  • The sides of the tongue – is related to the liver, gallbladder, side of the body, outside and inside of the legs, side of the head, face and neck and shoulders
  • Middle of the tongue – is related to the digestion system, stomach, spleen, abdomen area, middle of the back
  • The back of the tongue – is related to the kidneys, urinary bladder, some sexual organs, lower back, lower abdomen, both legs
  • Under the tongue – is related to the kidneys

Because of the relationship between the tongue and the body, your Chinese medicine practitioner can get valuable information about changes in the body and internal organs by observing your tongue.

ii) Coating of the tongue
The tongue coating is the layer over the tongue. A normal healthy coating should be white, thin, and allow the tongue body to be seen through the coating.

Did you know that the coating of your tongue changes according to your health? For certain bodies or certain cases the coating may change every week. It depends on condition of the body’s health.

  • The digestive system (more or less stool retention)
  • The lung (more or less phlegm)
  • The circulation (toxins and blood clots, more or less coating)
  • The period, pregnancy and after labour

Please see below for specific examples of some relationships between the tongue coating and health conditions.

iii) The taste the patient may experience
The normal feel of the tongue is what we experience from food. We should not have a ‘funny’ taste in our mouth with or without food.

Sometimes, people may experience an abnormal taste when there is a disorder of the internal organs.

2. Examples of the relationship between the tongue and body/organ disorders

TCM practitioners check the tongue, not only to find out which internal organs may be abnormal, but also to see the history and constitution of the body in relation to issues that may be arising.

In my clinic I have seen many abnormal tongues, however I will share with you some common tongues I see to give you an idea about how TCM tongue diagnosis works.

Image © Acumedic.com

i) Too red tongue
This indicates that the body has excessive heat. The body may have some of the following symptoms such as, body feels hot, easy to perspire, red face, takes time to fall asleep or vivid dreams, constipation, pungent dark stool, hunger (eats more), very emotional (easy to get anxious) or period comes earlier. Some may have the following disorders, hyperactive thyroid, high blood pressure or menopause.

ii) Pale tongue
This indicates that your body has a lack of digestion, Qi and blood deficiency. You may have some of the following symptoms such as lack of energy, pale face, dizziness (especially upon standing), short of breath, sluggish bowel movement, bloating after eating, scanty period (one or two days), little or no milk production after labour. These people may also have the following disorders: low blood pressure, anemia or infertility/frequent miscarriage.

iii) Purple/dark tongue
This indicates that the liver and heart have a functioning disorder and there maybe a lack of circulation with blood clots (you may have an old injury). Usually you may have the some of the following symptoms such as body aches/pain, joint, neck and shoulder stiffness and pain, chest pain, headaches or period pain with blood clots and brownish bleeding. These people may suffer the following disorders such as endometriosis, polycystic ovaries, migraine, arthritis.

iv) Swollen tongue with teeth marks on the side
This indicates there the body’s spleen is weaker and the body contains excessive fluid. You may have some of the following symptoms such as body heaviness, puffy and heavy limbs, bloating, lack of energy, sluggish bowel movement, easy to gain weight or hard to lose weight, gain weight before period, puffy face and eyes in the morning. These body’s usually have the following disorders such as under-active thyroid, chronic fatigue syndrome, overweight or polycystic ovaries.

v) Narrow tongue with less moisture
This indicates that the body’s has yin weakness (not enough fluid). You may have some of the following symptoms such as insomnia, vivid dreams, hot flushes, constipation, dry skin, thirsty, heart burn or hunger. These people have the following disorders such as hyperactive thyroid, menopause, high blood pressure, depression, anxiety or gastric ulcer.

vi) Thick greasy coating
This indicates that your body has lots of dampness and fluid. You may suffer from the following symptoms such as heavy arms and legs, bloating, lack of energy, stiff joints, weight gain, sluggish bowel movement. These people usually have high cholesterol or fatty liver.

vii) Thick yellow coating especially in the middle of tongue
This indicates that you have lots of food and heat stagnation in your digestive system. You may have some of the following symptoms such as body heat, easy to perspire, body odour and bad breath, yellow urine, constipation, pungent or dark stool, pass lots of wind, bloating, red face, vivid dreams or nightmares or insomnia. These people may also suffer from high blood pressure, high cholesterol, diabetes or liver/gallbladder disease.

viii) Uneven coating
This indicates that your stomach and liver yin are damaged. You may suffer from the following symptoms such as heart burn, stomach pain, not solid sleep, vivid dreams, dry skin, discomfort of the side of body. These people may have the following disorders such as liver and stomach disorders, gastric ulcer.

ix) Sweet taste and greasy feeling to the tongue
This indicates that the spleen is in disorder.

x) Bitter taste
This indicates heart, liver and gallbladder disorder.

xi) Salty taste
This indicates that there is kidney disorder or weakness.

3. What should you do before your tongue diagnosis?

It is best for our practitioners to see your original tongue state (including tongue body and coating). Please pay attention to the following points:

  1. It is best to avoid drinking very hot beverages one hour before your consult.
  2. It is best to avoid eating foods that may change the colour of your tongue, three hours before your consult.
  3. In the morning, when brushing your teeth it is best not to clean the coating off the tongue prior to seeing us.

If you didn’t avoid the last three points, it is best to let our practitioner know during your consult.

Tongue diagnosis in Chinese medicine is an example of how the human body is interconnected, even a small part of the body can give important clues that reflect the whole condition of the body.

So, if you have any chronic health issues that cannot be solved, please visit your experienced Chinese medicine practitioner who will use tongue diagnosis to help solve your internal health issue.

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Dr Ping Wang is the clinic founder and senior practitioner of Ping Ming Health. She has over 30 years of experience in traditional Chinese medicine teaching and practice. Dr Ping especially enjoys sharing her knowledge of Chinese medicine through our popular clinic articles, seminars and clinical training of students and practitioners.

  • melanie

    these articles are very helpful.
    thank you.
    i live in yucatan, mexico….should you know of any chinese medicine
    practitioners in this area i would be very grateful if you would pass on
    their particulars.
    thank you and blessings

    28 November, 2012