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What is Chinese Medicine Tongue Diagnosis & How Does It Work?

Sep 26,2023 | YILING

Is Chinese Medicine Tongue Diagnosis Reliable? How is the tongue linked to our body and how does it reflect certain ailments? As an ancient and magical diagnostic method, tongue diagnosis in Traditional Chinese Medicine (TCM) has been proven effective.


What is Chinese Medicine Tongue Diagnosis?

In TCM, specific areas of the tongue are believed to correspond to certain internal organs and reflect pathological changes in those organs. When these organs undergo changes, the tongue's appearance and coating will inevitably show systematic signs. This is rooted in the holistic perspective of TCM. According to TCM, the human body is an interconnected entity, with various components structurally inseparable and functionally interdependent, impacting each other in terms of pathology.


TCM tongue diagnosis primarily observes tongue coating and tongue appearance.


Tongue appearance, also known as tongue body, refers to the muscle and vascular tissue of the tongue. A normal tongue is moderately flat, moves freely, and is soft and flexible. It appears a light shade of red, moist, neither thick nor thin, neither aged nor tender, and is of moderate size, without abnormal shapes.


Tongue coating refers to the thin layer on the back of a normal tongue. It is thin, white, and evenly distributed, slightly thicker towards the middle and root of the tongue. Looking closely, you can see faint hair-like structures resembling delicate young grass.


What Can Tongue Diagnosis in TCM Reveal?

The outermost layer of tongue cells naturally renews every few days, making it valued in TCM due to its strong "timeliness."


In TCM, observations of tongue coating involve thickness, thinness, dryness, moisture, greasiness, and stickiness. Different shades of coating color, such as yellow, white, black, and gray, are also observed. Based on these changes, practitioners can determine whether the pathological factors are on the surface or inside, whether the illness is cold or hot. In a healthy individual, the tongue coating is thin and white, revealing subtle hair-like structures, much like tender shoots just emerging from the ground.


The tongue coating grows constantly, but factors like eating cause it to naturally shed. As a result, the coating retains a normal thickness and structure. Moreover, because the mouth contains an appropriate amount of saliva, the tongue coating remains moist. These are all signs of a healthy tongue. When the coating grows excessively and sheds minimally, causing the coating to thicken, it indicates a pathological condition.


Specifically, according to TCM diagnosis, a normal and healthy tongue should exhibit the following eight conditions:

  1. Normal size
  2. Pale red tongue body color
  3. No tooth marks on the tongue edges
  4. Flat tongue surface without swellings or depressions
  5. Thin and white tongue coating
  6. No cracks on the tongue surface
  7. Normal moisture on the tongue
  8. No red spots, bruises, or spots on the tongue


However, it's important to note that external factors can influence the assessment of tongue health. Changes in time, season, internal and external environments, and other conditions can lead to variations in tongue appearance, such as:

  1. Slightly thicker tongue coating in summer or thin white coating with a hint of yellow; thin white coating with a slight dryness in autumn.
  2. Early in the morning upon waking, the tongue color may appear slightly dull, and the root of the tongue coating may be slightly thick and greasy.
  3. After eating, the tongue coating becomes thinner. After consuming hot and spicy food, the tongue color might turn red.
  4. Children often have a tender or red tongue body and less tongue coating. In the elderly, vitality declines, organ functions weaken, blood and qi circulation slows down, and the tongue mucosa's keratinization increases, resulting in a darker tongue color.


In Conclusion

It's important to understand that Chinese medicine tongue diagnosis is just one part of the observation, similar to pulse diagnosis being part of palpation. These methods collect information rather than serve as standalone diagnostic tools.


The fundamental principle of TCM diagnosis is "holistic examination, integration of the four diagnostic methods, and combination of disease and pattern." TCM practitioners use information gathered from visual, auditory, olfactory, and palpation methods to conduct comprehensive analysis, reasoning, and judgment in order to achieve accurate diagnosis.