What is Chinese Tongue Diagnosis?

When you come to see me for Acupuncture, I usually ask to see your tongue. Why? Because Chinese tongue diagnosis helps make acupuncture more effective. 

Here are some of the reasons. . .

What can I tell from looking at your tongue?

When I look at your tongue I am look at different things. I ask to see your tongue for a couple of seconds, 2 or 3 times. I look at your tongue’s body colour, shape, coating and markings. I also ask to see under your tongue and look at the very tip of your tongue. In Chinese Medicine all of these things relate to different aspects of your health. 

Tongue Body Colour
In Chinese medicine, the tongue body colour reflects the state of your vital energy, also called Qi (Chee). This indicates the overall state your blood, your organ health and also your circulation. Optimally, in a healthy tongue, this is dark pink / light red.

If the tongue is purple it signifies Blood Stagnation or clotting. When pale it can indicate a Blood Deficiency imbalance, or in some instances the presence of Cold. If the tongue is bright red this tells me that there is Heat present – either Excess Heat or Deficient Heat. These are the names of two different patterns of disharmony that can be treated with acupuncture.  

Tongue Body Shape
The shape of your tongue lets me know about substances Acupuncturists refer to as Xue (Blood), Qi (Energy) and Jin Ye (Fluid). Ideally your tongue should fit in your mouth without pressing against your teeth and creating tooth marks around the edges. 

When I see tooth marking around the edge of your tongue it suggests a digestive imbalance that is causing you to have a puffy or swollen tongue.  Other examples are a thin tongue, which can indicate a fluid and blood deficiencies, and a quivering tongue, which can relate to digestive problems or imbalances affecting your Liver energy. 

Tongue Coating and Markings
A healthy tongue has a thin white tongue coating. 
Presence of a thick coating can be a sign you have or are getting a cold. It can also indicate different kinds of digestive energetic imbalance. 

A white covering on the surface of your tongue (especially if the coating is thick and seems like it could be scrapped off) or maybe the coat is greasy or sticky, indicates energy patterns termed Damp or Phlegm. When the coating is thick and yellow, I know to use acu-points that treat the energy pattern called Damp-Heat. 

So, now you know a bit more what your tongue coatings tell me, let me explain a little bit about what the markings on your tongue can tell me. 

Cracks on your tongue often indicate an internal Heat imbalance Acupuncturists refer to as Yin Deficiency. I sometimes see red dots on your tongue and this signifies the energy pattern of Empty Heat – this often accompanies a Yin Deficiency pattern.

I understand all these energy patterns and imbalances may seem a little confusing. And, you might be thinking “but how do they actually tell Lucy how to treat me using acupuncture?”  Read on and I explain how I map the energy imbalances I see to specific areas of your tongue, and by doing this I know the best way to treat you. 

Specific Areas of the Tongue

In Chinese medicine certain areas of the tongue relate to different organs and areas of your body. The markings and coatings that I observe in particular areas often guide acupuncture treatment and which acu-points to place needles. 

The following image provides a good overview of how specific areas correspond to each of the organ systems in Chinese medicine – 

Image of tongue with Chinese tongue diagnosis markings
Image of tongue and areas corresponding to energetic organs

When your tongue coating, colour and markings are somewhat mapped over these specific areas, it allows me to build a picture of your internal health; i.e. your tongue tells me what the balance of the Qi, Blood and fluid is in different energy systems which effect your health.  

An example of this mapping is Spleen Qi Deficiency – an energy pattern I frequently see in clinic that presents with sluggish digestion, tiredness and stomach bloating. Another example is Heart Yin Deficiency – which can have symptoms of anxiety, poor concentration, insomnia or palpitations. 

So, there is more to looking at your tongue than you may initially think. It not only informs my Acupuncture diagnosis, but let’s me know how best to treat you; it lets me know where to place needles and also whether Moxibustion or Chinese cupping will be beneficial for your health. 

9 Things to know about Chinese tongue diagnosis – 

1. Your tongue is unique; everybody’s tongue print is as individual as their fingerprint

2. Tongue diagnosis is used in other medical systems such as Ayurveda and even by the historical Greek physicians Galen and Hippocrates

3. I only look at your tongue – no touching or poking! 

4. Brushing your tongue can alter the natural tongue coating – it is important to let me know if you brush your tongue as part of your dental care routine

5. It is normal for me to ask 3-4 times to see your tongue because when you extend your tongue for prolonged periods the body colour and shape can change

6. Certain food & drink and smoking can discolour your tongue – tell me if you have eaten or drank anything that may have done this 

7. Some features on your tongue change from week to week but many features do not change or change very slowly

8. In Chinese Medicine particular tastes relate to organs and elements; bitter relates to Fire and the Heart, salty to Water and the Kidneys, Sweet to Earth and the Spleen (often thought of as the Pancreas) and Pungent to Metal and the Lung. 

9. Tongue diagnosis is never used alone. An acupuncturist always incorporates a combination of Pulse Diagnosis, questioning and when required, physical examination. 

If you have any symptoms or concerns about the appearance of your tongue, it is important to see your doctor.

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