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Does your tongue look like this?

How to use tongue diagnosis to identify body imbalances

Tongue diagnosis is a fundamental diagnostic tool in Traditional Chinese Medicine (TCM) that has been practiced for thousands of years. It offers a unique window into the body’s internal health by examining the tongue’s appearance.

This method, used alongside other diagnostic techniques like pulse diagnosis and observation, helps TCM practitioners understand the state of a person’s organs, blood and Qi (vital energy).

Let’s explore what tongue diagnosis is, how it’s used, and what various tongue markers can indicate about your health.

What is tongue diagnosis?

In TCM, the tongue is considered a reflection of the body’s internal environment. Practitioners believe that different parts of the tongue correspond to different organs and their functions. By observing the colour, shape, coating and texture of the tongue, TCM practitioners can gather important clues about the state of a person’s health. The tongue is seen as a map, with specific regions reflecting the health of specific organs:

  • Tip of the tongue: heart and lungs
  • Centre of the tongue: stomach and digestive system (called spleen in TCM)
  • Sides of the tongue: liver and gallbladder
  • Root of the tongue: kidneys, bladder, intestines and reproductive organs

How tongue diagnosis is used

Tongue diagnosis is one of the non-invasive diagnostic methods used by TCM practitioners. They examine the tongue under natural light, looking at the following characteristics:

  • Colour: indicates the condition of the blood and Qi (vital life energy).
  • Shape: reflects the strength or weakness of organ function.
  • Coating: provides insight into the presence of pathogens and the state of digestion.
  • Moisture: shows the body’s fluid balance.

By combining these observations with information gathered from other diagnostic methods such as checking the pulse, TCM practitioners gain a comprehensive understanding of a person’s health to tailor treatments accordingly. This may include acupuncture, herbal medicine, dietary recommendations and lifestyle changes.

Tongue markings and what they mean

Here are some common tongue markers and what they mean in TCM:

Tongue colour

  • A normal tongue is pale red or pale pink in colour.
  • Pale tongue may indicate Qi deficiency. It often suggests that the body’s energy levels are low and there might be issues with the spleen.
  • Red tongue is usually a sign of heat in the body, which can be due to excess heat or inflammation. The location of the redness indicates which organ is affected. For example, a red tip suggests heart heat, often linked to emotional stress.
  • Purple tongue indicates blood stasis, meaning blood flow is not smooth. This can be associated with pain, poor circulation or severe Qi stagnation.

Tongue shape

  • Swollen tongue with teeth marks on the sides often points to spleen Qi deficiency and damp accumulation in the body. It can be associated with digestive issues and fluid retention.
  • Thin tongue may indicate blood deficiency or Yin deficiency. It suggests that the body lacks sufficient nourishment or fluids.

Tongue cracks

Cracks on the tongue can be a sign of Yin deficiency or heat in the body. Specific patterns of cracks can provide additional insights.

  • A long central crack points to excess heat in the stomach due to stress or overconsumption of alcohol, coffee or spicy foods. This often leads to symptoms such as dry mouth, thirst, a dry tongue and a burning sensation in the stomach. A long central crack may also reveal that the person is a chronic worrier.
  • Midline crack at the tip usually suggests a tendency toward anxiety and, less likely, heart problems.
  • Short cracks across the tongue can indicate a lack of Yin (cooling and nourishing fluids). If they are in the centre, it could mean stomach issues and if near the tip, potential lung issues.

Tongue coating

  • Thick coating usually indicates the presence of dampness or phlegm in the body, suggesting poor digestion and the accumulation of pathogens. This may present as bloating, nausea, diarrhoea, sinus congestion, phlegmy coughs, weight gain and fluid retention.
  • A thin coating is normal, but if it becomes too thin or absent, it suggests Yin deficiency or a depletion of fluids which can lead to dry mouth and throat, night sweats, hot flashes, insomnia, dry skin and fatigue.
  • Yellow coating typically points to heat, especially in the digestive system. The intensity and location of the yellow can indicate the severity and location of the heat. This can lead to problems like acid reflux, bad breath, inflammation, stomach ulcers, constipation and excessive thirst.
  • White coating is usually associated with cold conditions or dampness in the body. It suggests issues with digestion or the respiratory system like indigestion, diarrhoea, poor appetite, persistent coughing, respiratory infections and fatigue.

Tongue moisture

  • Dry tongue indicates a lack of body fluids, which can be due to Yin deficiency, excessive heat or dehydration.
  • Wet tongue suggests an excess of dampness in the body, indicating issues with fluid metabolism and/or adrenal fatigue.

Additional markers

  • Teeth marks (scalloped edges) usually indicate spleen Qi deficiency. This means the digestive system is not transforming and transporting fluids efficiently, leading to dampness accumulation and digestive issues. Bloating, swelling, brain fog, tiredness and sluggish digestion are typical signs of spleen Qi deficiency.
  • Strawberry dots are small, red dots on the tongue and are typically a sign of stagnation leading to heat or inflammation in the body. The location of the dots on the tongue will tell you which organ or area of the body is affected.
  • Geographic tongue: This condition is characterised by irregular, map-like cracks in the tongue’s body, often accompanied by a lack of coating. In TCM, a geographic tongue usually suggests a deficiency Yin that may lead to symptoms of night sweats, vertigo, palpitations and even panic attacks.

What does your tongue show?

Tongue diagnosis is a fascinating and valuable tool that provides a non-invasive method to assess the body’s internal health. By examining the tongue’s colour, shape, coating and moisture, TCM practitioners can gather important information about a person’s organ function, blood flow and overall vitality. This diagnostic method, combined with other TCM practices, helps create a holistic approach to health and well-being. Whether you’re a practitioner or someone interested in alternative medicine, understanding tongue diagnosis can offer deeper insights into the intricate connections within the body.

To learn more about tongue diagnosis, TCM, the energetics of food and pulse diagnosis, CNM’s TCM Short Course is a great introduction to help you restore your body’s natural ability to heal using foods and lifestyle.

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Blog/Article content reflects the author's research and diverse opinions, not necessarily CNM's views. Items may not be regularly updated, so represent the best available understanding at the time of publication.

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