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What Can You Tell By Looking at My Tongue?  Tongue Diagnosis in Chinese Medicine

When you think about diagnosing health conditions, the first thing that probably comes to mind is a blood test, an X-ray, or maybe a physical exam. But in Traditional Chinese Medicine (TCM), there’s an ancient and incredibly insightful tool that’s been used for thousands of years to assess your overall health: your tongue. It may sound surprising, but your tongue can reveal a lot about what’s going on inside your body.

Look at the tongue in the picture above. At first glance, I see a tongue that looks rather pale, the sides of the tongue are congested, and the middle towards the tip is a bit puffy. The coating is thin and white, which looks pretty good.  Without knowing anything more, I would wonder if this person is under stress, tired or worn out, is feeling malnourished or is struggling with digestive issues or issues with her lungs.

Want to be learn how to read a tongue too?

 

Why the Tongue?

In TCM, the tongue is like a mirror to your internal state, offering a clear view of the balance or imbalance in your body’s systems. The reason for this is simple: the tongue is closely connected to the organs through the network of meridians (the pathways of energy or Qi in TCM). The tongue’s appearance — its color, shape, coating, and moisture level — can provide insights into your health.

 

What We Look for in Tongue Diagnosis

When a TCM practitioner examines your tongue, they are looking for specific characteristics that give clues about the state of your body. Here’s a breakdown of the key features we focus on:

Tongue Color

The color of your tongue can tell us a lot about your internal environment

• Pale Tongue: Often indicates a deficiency in Qi or blood. It can suggest fatigue, poor digestion, or low energy.
• Red Tongue: This can indicate heat or inflammation in the body. It might be linked to conditions like infections, fever, or excess heat in the heart or liver. Redness on the tip can indicate a cold (Lungs) or anxiety (Heart).  If it is red in the middle, we think of heat in the digestive system.
• Purple Tongue: This usually points to stagnation of blood or Qi due to emotional stress or physical blockages.  Purple tends to indicate there is some kind of pain or Cold somewhere in the body.

Tongue Coating

The coating on the surface of the tongue gives us a closer look at your digestive health. A
healthy tongue coating is thin and white.

• Thick or Yellow Coating: Thickness indicates dampness, usually coming from the digestion.  Over time, dampness can create heat, leading to a yellow thick coating.  Those with reflux, gas, or GI problem will often see a thick yellow coating in the center of the tongue.
• Thin or No Coating: This may indicate a deficiency of Qi or fluids. If your tongue is red and lacks a coating, it may suggest a yin deficiency or dehydration.  As people age they can deplete their yin, it is common to see tongues with very little coatings in the elderly.

Tongue Shape and Size

The shape and size of the tongue can help diagnose conditions related to Qi and blood,
and even emotional well-being.

• Swollen Tongue: A tongue that’s swollen or puffy can indicate a deficiency of Qi, particularly in the spleen, or the presence of dampness or fluid retention in the body.
• Thin Tongue: A thin tongue may suggest a deficiency of blood or Yin.
• Cracks or Teeth Marks: Cracks in the tongue can be indicative of a deficiency of Yin Fluids (hydration). Teeth marks around the edges often indicate the body is not metabolizing fluids very well, usually showing a weakness in the digestive system, particularly the Spleen Qi.
• Congestion on the Sides: A tongue that has tension on the sides or ends up with a pointed shape is a strong indicator of stress, or Liver Qi stagnation.

Tongue Moisture

The level of moisture on your tongue reflects your body’s fluid balance.

• Dry Tongue: A dry tongue can indicate dehydration, or a deficiency in body fluids, often related to a lack of Yin.
• Excessively Wet Tongue: If your tongue is overly moist, it could be a sign of excessive fluid retention, dampness, or even a condition where the body’s fluids are stagnating, often linked to the Spleen or Kidney function.
• Cracks and Fissures: Cracks or fissures on the tongue may reveal deeper imbalances. A crack in the middle of the tongue, for instance, can be a sign of digestive weakness, especially in the Stomach or Spleen, while cracks at the tip could indicate Heart-related issues.

Tips for Understanding Your Own Tongue: A Quick Guide to Tongue Diagnosis

What is a healthy tongue?  Pale red with a thin white coating.  Look at a childs tongue, they often show vibrant health!

Now, how about yours?  Here’s a guide to help you understand what your tongue might be telling you.

First, Examine Your Tongue’s Color

• Pale: Indicates a deficiency in Qi (energy) or blood, often linked to fatigue or digestive issues.
• Red: Suggests heat or inflammation, commonly associated with fever, irritability, or infection.
• Purple: Points to blood or Qi stagnation, or Cold.  Often, we see pale purple tongues in people with great fatigue who easily chill.

Next, Check the Tongue Coating

• Thin, White Coating: A healthy digestive system with no excess.
• Thick or Yellow Coating: Indicates dampness, heat or excess, often related to digestive issues.
• No Coating: Suggests Yin deficiency, often accompanied by dryness or easily overheating.
• Dry Coating: Typically points to dehydration or Yin deficiency.

Observe the Shape of Your Tongue

• Swollen or Puffy, Toothmarks: Points to Qi deficiency or dampness, often seen with sluggish digestion or water retention.
• Thin, Narrow: Indicates a lack of blood or Yin, seen in chronic stress or exhaustion.
• Cracks or Fissures: Can indicate excessive heat drying up your fluids.  The location of the cracks will give you more info.

Track Changes Over Time

Your tongue changes with diet, stress, and illness. Pay attention to patterns—such as a thicker coating after rich meals or a redder tongue during stress—so you can better understand how your body responds.  It is fascinating to understand the messages our bodies give us, taking time to look at your tongue can give you deeper insight into your health on a day-by-day basis.

While tongue diagnosis offers valuable insights into your health, it’s just one part of a larger picture. If you notice significant changes or persistent imbalances, consider coming in for an appointment and ask your provider for support.

 

Julie