TCM Tongue Diagnosis - Understanding Your Health from Your Tongue

Have you ever been in acupuncture therapy, and the practitioner asked you to stick out your tongue? It may sound ridiculous to you, especially during your first visit, but there's nothing to be afraid of. 

In TCM - Traditional Chinese Medicine, tongue diagnosis is a complete science. And this guide includes all the nuts and bolts regarding TCM tongue diagnosis so you can be more confident in your next visit to a TCM practitioner. Let's get into it with no more delay. 

What Does Traditional Chinese Medicine Say About Your Tongue? 

Traditional Chinese Medicine is all about building up balance, harmony, and strength in your body. Or simply put, it balances the yin and yang energies, removes Qi stagnation, and prevents diseases in your body naturally.

The tongue is a gateway to the internal health of your body's organs and systems. Since the tongue mirrors the body's internal health, TCM practitioners highly emphasize the tongue examination to evaluate the patient's overall well-being. 

What is a TCM Tongue Diagnosis? 

To uproot any disease thoroughly, we must understand the root cause. Therefore, tongue diagnosis is one of the useful visual tools in TCM that confirms the cause, severity, and longevity of ailments. 

The underlying concepts of TCM help inspect the tongue's color, shape, size, cracks, coating type, and moisture amount to diagnose the nature of the illness. Typically, a healthy tongue that’s pink or pale red with clear saliva and a thin white coating, without any cracks or swelling, reflects a fit as a fiddle body. If there are any imbalances in the body, they may be reflected in the tongue, allowing for the identification of an illness through tongue diagnosis.

For example, a red tongue with no white coating and visible cracks represent Yin Deficiency. Or if the tongue is pale with little or no white coating, the patient has a blood deficiency called anemia.

6 Aspects of Inspecting a Patient’s Tongue

Your tongue is a mini-map that reveals your body’s inside secrets. Here’s how you can learn to interpret these secrets. 

1. Tongue Color

In TCM, a normal tongue is pink. However, any color other than pink may indicate an abnormality in the body. For example, there are three common abnormalities associated with color.

1. Red tongue: if your tongue looks red, it explains the excessive heat, migraine, fever, and inflammation in the body. 
2. Pale tongue: A pale tongue is a symptom of cold, anemia, fatigue, etc. 
3. Purple tongue: A purple or dark tongue spells out body ache and poor blood circulation. 

2. Tongue Size

A healthy tongue is neither too thick nor too thin; it’s supple. Two anomalies regarding size are below.

1. Small tongue: if your tongue is thin and smaller than normal, it could be due to Qi scarcity, anemia, fatigue, or dizziness. 
2. Swollen tongue: a deficient spleen, too much internal dampness, and poor GI health cause the tongue to be swollen with tooth marks along the edges.

3. Tongue Shape

The shape is often analogous to your internal system's excess or deficient conditions. 

1. Puffy tongue: a puffy or scalloped tongue expresses the nutritional imbalance in the body.
2. Thin tongue: Similarly, the dehydration in your body leads to thinning of your tongue.

4. Tongue Moisture

The moisture is related to the state of your body’s fluids.

1. Dry tongue:  means an imbalance of internal body heat.
2. Damp tongue: means damp stagnation and cold issues. 

5. Tongue Papule

Papules are usually small, red, or white in appearance. However, the inflamed or enlarged papules signal damp-heat in the liver, irregular periods, fever, and menstrual cramps.

6. Tongue Coat

The coating stands for the representation of GI health. A healthy tongue has a thin white coating. But if there is any change in color or thickness, it will surely indicate a problem in your digestive tract.

7. Tongue Veins

Healthy and normal veins under the tongue are typically thin, clear, and barely visible. In TCM, they are known as the sublingual veins. If the sublingual veins are swollen, discolored, or have visible blood stasis, it may indicate an imbalance in the body's energy and blood circulation. 

How to Read a TCM Tongue Diagnosis Chart?

Certain areas of your tongue can reveal a lot about the state of your organs. To help you understand this, TCM practitioners use a tongue diagnosis chart, also referred to as a tongue health chart. There are potentially two mapping methods for a tongue diagnosis chart in TCM. 

1. Triple Burner

In this mapping method, the tongue is divided into the following three areas:

1. Lower Burner: the base of the tongue, representing the kidney, small intestine, large intestine, and bladder.
2. Middle Burner: the middle area corresponds to the health of the stomach and spleen. 
3. Upper Burner: refers to the tongue tip that speaks for your heart and lungs.

2. Zang-fu Organ

The Zang-fu mapping method is a bit different from the above. Here’s how zang-fu works to read the tongue’s regions. 

1. The tongue tip stands for the heart, and the remaining area between the tip and center, accounts for the lungs.
2. The tongue center correlates with the spleen and stomach.
3. The tongue base shows the wellness of the kidneys, bladder, and intestines.
4. The right side represents the liver, and the left side exhibits the gallbladder. 

What Does a Cracked / Fissured Tongue Mean in Chinese Medicine? 

The cracked or fissured tongue is also known as the scrotal or plicated tongue. Similar to other irregularities, stress, illness, poor diet, and lifestyle is the root cause of cracked or fissured tongue. The location and pattern of the cracks provide insights into the organs’ state and the severity of the sickness.

In rare cases where the condition is severe and causes discomfort or infections, fissured tongue surgery may be needed to smooth out the tongue's surface by removing or reshaping tissue. For most people with a fissured tongue, improving oral hygiene can help alleviate symptoms and prevent complications. This includes regular brushing, flossing, and tongue scraping to remove bacteria and debris.

1. Types of Cracked Tongues

In TCM, longer, greater in number, and deeper cracks estimate the excess or deficiency of heat, blood, and other body fluids. Here are a few ways to read a cracked tongue.

• Short horizontal cracks: this pattern of cracks indicates stomach dryness due to insufficiency of blood or Yin.
• Crack Down the Center to Tip: the crack from the center to the tip of the tongue reveals cardiovascular problems and chest tightness.
• Crack in the Center: the crack in the center likely hints at the lack of stomach fluids and improper digestive system function. 
• Vertical Crack in the Center: if a long crack occurs along the midline of your tongue this can indicate that your spine must be stressed.  

2. Syndromes Corresponding to Fissured Tongue

TCM theory comes up with three primary syndromes considering fissured tongue.

• Spleen Shortfall: a fissured tongue accompanying thick coating with tooth marks shows the lack of spleen in the body.
• Heat Imbalance: a rough, fissured, reddish tongue body indicates a heat imbalance in the system.
• Blood Deficiency: a fissured white tongue is a sign of anemia or blood insufficiency.

What Does White Coating on Your Tongue Mean? 

The white coating or fur signals the internal health of the digestive tract. A healthy tongue 

always shows up with a thin white coating, demonstrating the well-functioning digestive system.

The color variation of the tongue coating is indicative of the tongue's overall health. A  normal tongue coating is typically white and thin. However, a heavy white fur can indicate cold symptoms, a black and gray coating can indicate acute cold or heat, and the yellow coating may  indicate an infection. 

The pathogenic factor is also linked with the thickness of the white coating on the tongue. In TCM, the pathogenic factors include cold, dampness, wind, heat, dryness, and summer heat.

What Does Chinese Medicine Teach Us About a Scalloped Tongue? 

Often, body swelling, dehydration, excessive alcohol consumption, smoking, and systemic inflammation leave tooth marks on the edges of your tongue, resulting in a wavy or scalloped tongue.

In Chinese Medicine, dampness, excessive mucus, nutrient deficiency, and spleen deficiency are some of the major reasons for a scalloped tongue. Moreover, a few severe situations, such as cancer or tuberculosis, are coupled to a scalloped tongue. 

What is the Best Time to Examine Your Tongue?

The ideal time to self-examine or visit a doctor for a tongue checkup is in the morning after you’ve just woken up. Remember, you must not brush your teeth or drink juice or coffee before the examination.

This is because brushing or taking coffee or tea can scrape off the coating, leading to a false analysis, so it must be prohibited before a clinical visit.

How Does Tongue Acupuncture Reading Work? 

Chinese tongue acupuncture treatment is a sophisticated skill that combines medical science and the art of healing. Primarily, the acupuncture reading monitors the stability of Qi, Yin, Yang, blood, etc., in your body to get your health back on track.

Tongue acupuncture therapy is unique to each individual as every patient and every illness is distinct from others. The tongue provides clues about the inner health of organs, and practitioners use this information alongside pulse and other diagnostic methods to improve the reliability of treatment.

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Final Takeaway

TCM tongue diagnosis has been a tried-and-true method for thousands of years. Your tongue can reveal a lot about your internal well-being. However, it's always wise to consult with a professional TCM practitioner or doctor before making any health-related decisions based on self-examination. Taking care of your body is important, so always seek the best care and nutrition possible!