The tongue has been considered an important assessment organ for thousands of years. It is rich in vascular, or fluid, supplies; contains the taste receptor cells; and is nourished by both the nervous and circulatory systems. Many trained experts with nothing more than your tongue and a good eye, can diagnose many diseases. What does your tongue look like and what does it tell you about your health?
The tongue produces saliva, which contains water, electrolytes, mucus, and enzymes. The salivary chemicals can alter the appearance of the tongue in relation to organic imbalances. Taken together, these uniques attributes of the tongue help a trained practitioner make a contributory diagnosis using the tongue.
The first thing you must know, traditional chinese medicine works on the principle good health is achieved by the proper balance of blood, fluids and energy (known as Qi - pronounced chee) flowing through the whole body. Illness results when any of these fall out of balance or proportion with the others.
Chinese medicine also uses the principles of Yin and Yang, two of the body's forms of life energies. Keeping these two in balance is also part of the daily therapeutic principles.
Everyone's life energies ebb and flow back and forth depending on the multitudes of forces which we are bombarded with on a continuous basis. Your diet, exercise, stress levels, work environment, your physical health and even the choices you make each day during the daily circumstances all vary the balance of emotions, health and well-being on a minute by minute basis. Keeping a good balance therefore through your daily environment yields proper health.
How To Utilize Tongue Diagnosis
During a tongue examination, a practitioner looks at factors including coating, shape, and color before examining specific tongue regions. If there is an anomaly in a certain area, the practitioner pays special attention to the related organ system.
No two tongues in this whole world are exactly alike. Your own changes daily also as circumstances arise which dictates a change in your body's perceptions. The size, shape, color, moisture level and the texture will show a continuous change as different events unfold in your life each day.During a tongue examination, a practitioner looks at factors including coating, shape, and color before examining specific tongue regions. If there is an anomaly in a certain area, the practitioner pays special attention to the related organ system.
A perfect tongue is smooth in texture, it fits comfortably in your mouth between your teeth. It is not too thick or too thin, should have a pretty pink color with a thin white transparent coating.
This description means you are in perfect health. All variations from this means you are having some kind of reaction. Reading and understanding these signs is the art of tongue diagnosis.
TONGUE COLOR
Color reflects the stability of the internal organs and blood circulation and provides clues about the strength of a patient’s health. A normal color is light or pinkish red with a slight shine. Color often relates to the functioning of internal organs and blood health, as well as immune health.
A practitioner often searches for pale, red or purple shades. Each has a special meaning, especially in relation to coating. A pale tongue reveals excess cold, for example, if there’s also a thick white coating. This could be a sign of anemia or a weakened body. A red tongue might indicate a yin deficiency if the coating is also thin, absent, or peeling.
Body Color
|
Indications
|
| Pink | normal or mild disorder |
| Pale | yang, blood a/or qi def Deficiency Cold + thin & dry = blood def + wet = qi def + swollen = qi def + swollen & wet = yang def |
| Red | heat + no coating = yin def empty heat + yellow coat = excess heat + wet = damp heat + dry = injured fluids |
| Dark Red (Scarlet, Cardinal) | extreme heat more severe conditions than red |
| Purple | stagnation lv qi stagnation is likely + pale = cold |
| Blue | severe internal cold stagnant blood |
TONGUE SHAPE
A normal tongue is smooth with no cracks, and is not too thick or thin. When evaluating shape, a practitioner might also examine the size of the tongue in relation to the opening of the mouth, looking also for teeth marks, ulcerations, and inflammation. These signs might indicate edema or swelling in the body, as well as nervousness. Shape often indicates the health of the body’s fluids and chi flow. For instance, a swollen or puffy tongue points to a spleen chi deficiency and damp heat, while an elongated tongue might indicate heart heat.
Body Shape
|
Indications
|
| cracked | if develops during illness indicates chronic and severe, otherwise normal location of cracks relates to organ pathology + red = empty heat consuming fluids + pale = blood & qi def crack runs from center to the tip = ht disorder or congenital ht problems horizontal cracks = yin def |
| deviated (crooked) | wind |
| flaccid | deficiency heat + pale = blood & qi def + dark red = yin collapse |
| long | heat in the ht |
| rigid | stroke or early signs of stroke |
| short (contracted) | serious conditions blood deficiency ht deficiency + pale or purple = cold or yang def + swollen = damp or phlegm + red = heat consuming the fluids |
| stiff | heat in the ht ht/sp heat phlegm obstructing the ht qi + normal & pale = wind, stroke |
| swollen | deficiency + pale & wet - yang def + teethmarks & pale = qi def or excess fluids + dark red = excess heat usually ht/sp |
| thin | blood or fluid def empty heat consuming fluids + pale = blood & qi def + red = yin def |
| thorny (strawberry, granular) | heat congealed blood + on tip = ht fire + on edges = lv/gb fire + on center = st a/or intestines heat |
| trembling(quivering) | wind + pale = qi def + red = heat producing internal wind |
TONGUE COATING
A healthy tongue coating is thin and clear, or sometimes pale yellow with a slightly thicker coating at the back of the tongue. A thick coating usually reflects digestive system problems. Different coating instruct the practitioner on potential maladies. For instance, a yellow, thick, or glossy coating reflects damp heat, along with a candida or yeast infection or a decreased immune system. A peeled or absent coating indicates deficient yin and damaged bodily systems.
Tongue Coat
|
Indications
|
| thin | normal exterior condition, wind-cold |
| thick | excess damp/phlegm food stagnation |
| dry | heat consuming yin excess yang or fire deficiency fluids |
| moist | normal or mild imbalance |
| wet | excess fluids from yang def dampness |
| sticky (greasy, creamy) | dampness or phlegm retention of food |
Coat Coloration
|
Indications
|
| white | internal or external cold if coat looks like cottage cheese = ST heat + thin coat & body aches = exterior wind-cold + thin coat & thorny = wind-heat |
| yellow | internal or external heat effected by coffee, tea a/or smoke intake |
| gray | hot or cold internal condition retention of phlegm heat + dry = heat consuming body fluids + moist = damp cold |
| black | severe condition involving hot or cold + pale = excessive cold from yang def + dry & possible thorny = consumption of body fluids |
Coat Rooting
|
Indications
|
| rooted moss appears firmly implanted | strong st/sp qi |
| rootless moss appears to float on the surface | st/sp qi def |
| peeled | sp qi def deficient yin or fluids |
TONGUE REGIONS
Traditional Chinese Medicine usually distinguish the tongue in three major areas, called Upper Jao (tip of the tongue); Middle Jao (center of the tongue) and Lower Jao (back of the tongue). A further division is as follows (see image left):
- Green Areas: sides of the tongue. Liver and detoxification system. Changes can indicate high toxicity levels. Darkening can reveal pain and discomfort.
- Red and Grey Areas: tip of the tongue. Heart and functions of nervous and immune system. Can indicate colds, the flu, sleep issues, and issues in the mental state.
- Yellow Area: center or the tongue. Spleen. Changes can reveal digestive or absorption issues.
- Orange Area: back of the tongue. Kidney. Signs can indicate problems in the urinary, reproductive, and elimination systems, as well as adrenal issues or back issues.
| Tongue Appearance | Accompanying Symptoms | What It Means | What You Can Do |
|---|---|---|---|
| Too thick with scalloped edges | Lethargy, feeling of heaviness in limbs, lack of motivation | flow of fluids in body off-balanced | Cut down on dairy products and sugar.Eat more of the following: beef and chicken(proteins) fruits such as coconut, figs grapes, cherries and dates vegetables such as shitake mushrooms, potatoes, squash and sweet potatoes lentils and rice for grains the herb ginseng |
| Tongue appears too wet | excessive perspiration and phlegm | inbalance of fluids such as too much phlegm or water in the body | Eat more foods which will help you dry the excess fluids: barley and rye for grains proteins such as aduki beans, kidney beans, mackerel and sardines vegetables include corn, mushrooms, celery, onions, turnips, pumpkin, lettuce, radishes, watercress and seaweed lemons and plums for fruits herbs to include pepper, garlic and horseradish |
| Tongue is too thin and very dry | insomnia, dry skin, constipation and stress | dehydrated, body feels over-taxed | Reduce caffeinated products, get more rest. Increase your intake of water. Eat more root vegetables, asparagus and seafood. |
| Blue/purple areas on tongue | stress, sedentary lifestyle | Liver problems, your blood and energy are not flowing properly | Get moving and stretching everyday. Eat more foods that help promote the movement of qi. Crab for protein onions, chili peppers, radishes, scallions and carrots for vegetables herbs and spices include mint, safflower oil, basil, cloves, garlic, cayenne, coriander, marjoram and dill |
| Tongue too pale/ orange color | fatigue, frequent illness | blood deficiencies, anemia | Eat foods that build your blood and maximize its function: lamb, red meats, sardines, oysters, eggs, kidney beans and liver add grapes, apricots, dates and figs green leafy vegetables and spinach |
| Tongue is swollen and pale | you always feel cold, back aches and knee discomfort | excess of yang | Eat more warming food to increase your yang: proteins like lamb, lobster and shrimp raspberries for fruit walnuts and pistachios herbs and spices such as basil, chives, dill, garlic, cinnamon, ginger and cloves |
| no coating or a yellowish coating on tongue | Recent illness, smoking | too much heat in the body, possible infection, too much coffee, not enough rest. A tongue with no coat or a yellowish coat designates a yin deficiency. | Stop smoking. Cut back on caffeine. Eliminate artificial sugar substitutes. Eat cooling foods that nourish your yin: vegetables like spinach, asparagus and lettuce fruits like bananas, grapefruit, lemons and watermelon protein from seafood and egg whites |
Marco Torres is a research specialist, writer and consumer advocate for healthy lifestyles. He holds degrees in Public Health and Environmental Science and is a professional speaker on topics such as disease prevention, environmental toxins and health policy.