TCM Tongue Diagnosis (舌診)

TCM Tongue Diagnosis (舌診)

The tongue, often described as the "mirror of the body," reveals a wealth of information about our health and well-being. Unlike other muscles, the tongue remains uncovered by skin, offering a unique window into our internal landscape.

In traditional Chinese medicine, the tongue is divided into sections that correspond to the body's meridians and organ systems. This holistic approach allows practitioners to form a comprehensive picture of the body's internal balance, detecting imbalances and monitoring treatment progress.

The body of the tongue provides clues about the body's Qi flow and blood quality, while the coating indicates the strength of the digestive system and the presence of pathogens. By analyzing both aspects, practitioners can assess a patient's nutritional and metabolic status, gaining a comprehensive understanding of their health.

To illustrate, the tongue map below highlights specific areas corresponding to internal organs:

👅 Tip of the tongue: Reflects the Heart and Lung functions.
👅 Center of the tongue: Corresponds to the Stomach and Spleen.
👅 Sides of the tongue: Represent the Liver and Gallbladder.
👅 Back of the tongue: Reflects the Kidney, Bladder, and Intestines.

From a Western perspective, the tongue serves as a diagnostic tool for various bodily functions. It offers clues about digestion, lymphatic function, blood quality, neurological health, presence of pathogens, and underlying health conditions.

When a practitioner of Traditional Chinese Medicine examines the tongue, they meticulously assess its length, size, shape, color, saliva production, and the condition of its fur coat. These observations provide valuable insights into the body's overall health.

A healthy tongue should appear pink, with a thin white coating, minimal saliva, and free from cracks, swelling, or sores. To examine your own tongue, it's best to do so upon waking, before brushing your teeth or consuming anything.

Unfortunately, in the modern day, with aging and increased exposure to emotional stress and processed foods, finding a perfectly normal tongue becomes rare. Nonetheless, grasping the characteristics of a healthy tongue can empower individuals to effectively monitor their own health.

So what are the abnormal tongues and how can you differentiate them?

Diagnosis by Observation: Tongue Body Shape
The shape of the tongue's body can reveal a wealth of information about the body's internal balance.

  • Pale, thin shape: This presentation often indicates Blood Deficiency, suggesting a lack of nourishment and vitality within the body.
  • Red, no coat, thin shape: An indication of Yin Deficiency, suggesting an imbalance in the cooling, nourishing aspects of the body's energy.
  • Swollen body: Typically associated with Damp or Phlegm accumulation, pointing to issues with fluid metabolism and circulation.
  • Partially swollen: Indicates Heat, suggesting an excess of Yang energy within the body.
  • Stiff: May indicate the presence of Interior Wind or Blood Stagnation, pointing to potential circulation issues or energetic blockages.
  • Flaccid: Suggests Body Fluid Deficiency, indicating insufficient moisture and lubrication within the body.
  • Long: Often associated with Heat, suggesting an excess of energy and activity within the body.
  • Short, pale: Indicates Severe Yang Deficiency, suggesting a profound lack of warmth and vitality.
  • Short, red, without coat: Suggests Severe Yin Deficiency, indicating a depletion of the body's cooling, nourishing energies.
  • Cracked: May indicate Heat or Yin Deficiency, suggesting imbalances in the body's energetic and moisture levels.
  • Trembling: Suggests Spleen Qi Deficiency, pointing to issues with digestion and energy metabolism.
  • Deviated: Indicates the presence of Interior Wind, suggesting energetic imbalances and instability.
  • Teethmark: Often associated with Spleen Qi Deficiency, indicating issues with digestion and nutrient absorption.

Diagnosis by Observation: Tongue Coat
The coating on the tongue provides further insights into the body's internal balance and health.

  • Thick coat: May indicate the presence of Exterior or Interior pathogenic factors, suggesting an invasion of harmful energies or imbalances within the body.
  • Coat without root: Suggests Stomach Qi Deficiency, indicating issues with digestion and energy metabolism.
  • Sparse: Typically associated with Stomach Yin Deficiency, indicating a lack of nourishment and moisture within the digestive system.
  • No coat: Indicates Stomach and/or Kidney Yin Deficiency, suggesting a depletion of the body's cooling, nourishing energies.
  • White coat: Suggests Cold, indicating an excess of Yin energy and a lack of warmth and vitality within the body.
  • Yellow coat: Indicates Full Heat, suggesting an excess of Yang energy and activity within the body.
  • Greyish, black, wet: Suggests Extreme Cold, indicating profound stagnation and depletion of vital energies.
  • Greyish, black, dry: Suggests Extreme Heat, indicating excess heat and inflammation within the body.
  • Moist tongue: May indicate Yang Deficiency, suggesting a lack of warmth and vitality within the body.
  • Dry tongue: Suggests Heat or Yin Deficiency, indicating imbalances in moisture levels and energetic flow.
  • Greasy: Typically associated with Damp and/or Phlegm accumulation, suggesting issues with fluid metabolism and circulation. 

1. Tongue Coating Color


  • White Coating: This often indicates internal coldness, suggesting an imbalance in the body's energetic equilibrium.
  • Yellow Coating: Conversely, a yellow coating typically signifies an excess of heat within the body, pointing towards potential imbalances or pathogenic factors.


2. Tongue Body Characteristics

  • Thin Tongue: Often signifies a deficiency of bodily fluids, reflecting potential imbalances in hydration and nourishment.
  • Swollen Tongue: Indicates fluid retention and may suggest underlying issues related to circulation or fluid metabolism.
  • Dry Tongue: Suggests an excess of yang energy within the body, potentially indicating internal heat or energetic imbalances.
  • Moist Tongue: Indicates deficient yang energy, reflecting potential deficiencies in warmth and vitality.
  • Teethmarks: Signify excess Yin and insufficient Qi, offering insights into the body's energetic balance.
  • Cracks: Suggest a deficiency of Yin and an excess of Qi, pointing towards potential imbalances in moisture and energetic flow.

3. Tongue Coating Thickness

  • Lack of Coating: Could signal deficiencies or imbalances within the body's internal environment, offering insights into areas of potential concern.
  • Greasy Coating: Indicates excessive dampness transforming into phlegm, reflecting potential challenges in fluid metabolism and circulation.

4. Tongue Body Color

  • Pale Tongue: Indicates a deficiency of blood within the body, reflecting potential challenges in nourishment and circulation.
  • Dark Red Tongue: Suggests potential blood-related illnesses, such as blood stagnation, offering insights into potential imbalances within the body's circulatory system.

We just went over TCM tongue diagnosis! We hope this information is useful to your study and daily practice!

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