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Tongue Diagnosis in Traditional Chinese Medicine

Alternative Medicine and Natural Health in NYC

One aspect of Traditional Chinese Medicine patients often find unusual is tongue diagnosis. A thorough intake and examination by an acupuncturist always includes taking a look at the patient’s tongue and it is not uncommon for a patient to ask me exactly what I am looking for when I ask them to stick out their tongue.

Though at first consideration tongue diagnosis may seem unique to Chinese Medicine, it was at one point quite common for Western medical doctors to include a look at the tongue into their full examination. In this Western context, the tongue was seen as a reflection of the state of the digestive system as a whole and it is not uncommon to see tongue indications for herbal medications and homeopathic remedies. As an example, a mapped or “geographical” tongue is a classic indication for Taraxacum, better known to us as the common dandelion.

While in Chinese medicine the tongue is still most closely related to the Stomach, TCM not surprisingly takes a broader, more holistic view of the tongue. Indications about the energetic balance as a whole and of specific organs can all be found on the tongue.

So, what do we look for when we look at the tongue?

First, the shape of the tongue. The tongue can either be thin or swollen. A thin tongue is an indication that the Blood or the Yin aspect is deficient, while a swollen tongue is generally an indication that the Qi or the Yang aspect is deficient. Tongues can also be long, indicating Fire, or short, indicating an internal deficiency. Cracks in the tongue generally indicate a Deficiency Heat caused by a deficiency of Yin.

Second, the color of the tongue body. The normal healthy tongue is pink, but tongues are often red, pale or dusky. A red tongue indicates an internal Heat, while a pale tongue can be due to an internal Cold or to a deficiency of Blood. A blue, dusky or purple tongue indicates Stagnation internally.

Then, the moisture of the tongue. An overly wet tongue indicates excess fluids or stagnation of fluids. A dry tongue indicates Heat of some form, whether it is internal or external. Sometimes the moisture of the tongue can be greasy, slimy or sticky, indicating an accumulation of Phlegm.

And lastly, the tongue coat. If it is thick, the tongue coat generally indicates an external condition. If this thick coat is white, it indicates an External Cold condition, while if it is a thick yellow coat it indicates an External Heat condition. These can often be seen in infectious diseases. Look at your tongue the next time you have a cold, the tongue coat will generally be white and thicker than normal. A lack of coating on the tongue indicates a deficiency, usually of Yin.

The area of the tongue affected by any of the above characteristics can be an indication of which organ is affected. For example, redness on the sides of the tongue, an area associated with the Liver and Gallbladder, can indicate Heat in the Liver and Gallbladder.