Disease Inquiry, Health Guidance, Classic Health Preservation, Traditional Chinese Medicine, No Need to Seek Help When Sick
The tongue is the most functional organ in the human body: it not only allows us to speak with rhythm and tone, but the taste buds covering it also enable us to perceive the sour, sweet, bitter, and spicy flavors of food. But did you know? Diseases can also be reflected through the tongue.
When seeing a doctor, they often ask you to “stick out your tongue for a look.” Traditional Chinese Medicine (TCM) believes that “the tongue is the sprout of the heart,” meaning the tongue is an external manifestation of the heart, and the deficiency or excess of the heart and its changes can often be reflected in the tongue’s quality. The tongue is divided into several different areas: the tip, the middle, the root, and the sides, which represent different organs and viscera.
Specifically, the tip of the tongue represents the heart and lungs, the middle represents the spleen and stomach, the root represents the kidneys, and the sides represent the liver and gallbladder. When a certain area changes, it indicates that the corresponding organ may have issues.
In addition to the different areas of the tongue, the shape, color, coating, and moisture of the tongue also reflect changes in our body. This is particularly evident in the tongue coating: generally, as a disease progresses from mild to severe, the tongue coating will change from thin to thick, indicating that the pathogenic factor has moved from the exterior to the interior; if the tongue coating changes from thick to thin, it indicates improvement in the condition.
Therefore, by observing the tongue, we can understand the whole body. By learning tongue diagnosis, we can timely understand changes in our body. Let’s take a look at some common tongue appearances.
— Normal Tongue: Pale Red Tongue with Thin White Coating —
1
Yang Deficiency Tongue Appearance:
(1) Physical Manifestations: Cold intolerance, preference for hot drinks, lack of energy, excessive sleep, pale lips, hair loss, easy sweating, loose stools, clear and frequent urination.
(2) Causes: Excessive consumption of cold and cool foods, drinking cold beverages, weak constitution, excessive exposure to cold environments.
(3) TCM Herbal Remedy: 20g of Dang Gui (Angelica Sinensis), 30g of Sheng Jiang (Fresh Ginger), 500g of Lamb, 2 bags of Cinnamon Powder, boiled into soup for consumption.
(4) Daily Health Preservation: Cinnamon powder, one bag each time, once a day, taken with warm water.
2
Blood Stasis Tongue Appearance:
(1) Physical Manifestations: Forgetfulness, dry throat, irritability, dry skin, body aches, dark complexion, dark lips, dark circles, dysmenorrhea.
(2) Causes: Poor blood circulation, trauma, emotional stress (liver qi stagnation can easily lead to blood stasis), qi deficiency, cold exposure.
(3) TCM Herbal Remedy: Half a bag each of San Qi Powder (Notoginseng), American Ginseng Powder, and Dan Shen Powder (Salvia Miltiorrhiza), taken with warm water, which promotes qi and blood circulation and alleviates pain.
3
Blood Deficiency Tongue Appearance:
(1) Physical Manifestations: Poor memory, weak thinking ability, poor sleep, easy insomnia, fatigue, cold intolerance, warm hands and feet in hot weather, cold hands and feet in cold weather.
(2) Causes: Blood loss, poor spleen and stomach function leading to inadequate nutrient absorption, excessive worry consuming heart and spleen blood.
(3) TCM Herbal Remedy: 3 bags of American Ginseng Powder, 3 bags of Fu Ling Powder (Poria), 300g of Longan Flesh, mixed and steamed for 4 hours, taken with hot water daily.
4
Yin Deficiency Tongue Appearance:
(1) Physical Manifestations: Dry eyes, dry mouth and throat, heat in palms and soles, dry stools, dizziness, tinnitus, poor sleep, rapid pulse, preference for cold drinks, irritability, and easy anger, soreness in the lower back and knees.
(2) Causes: Insufficient body fluids, staying up late, consuming spicy and excessive hot foods, severe illness.
(3) TCM Herbal Remedy: 9g each of Sheng Di Huang (Rehmannia), Sha Shen (Glehnia), Mai Dong (Ophiopogon), and Gou Qi Zi (Goji Berries), 1 bag of Dieda Shihu Powder (Dendrobium), 1 bag of American Ginseng Powder, 3g of Dang Gui, and a section of Pig Backbone, boiled into soup for consumption, effective within a week.
(4) Daily Health Preservation: 1 bag of American Ginseng Powder, 1 bag of Dieda Shihu Powder, taken once a day with warm water.
5
Water Dampness Tongue Appearance:
(1) Physical Manifestations: Facial (eyelid) swelling, oily skin, prone to acne, diarrhea, heavy and sluggish body, dry and hard stools, irritability, and easy anger.
(2) Causes: Qi deficiency, lack of exercise, consumption of cold drinks, leading to water dampness retention in the body.
(3) TCM Herbal Remedy: 10g each of Red Bean and Job’s Tears, 1 bag of Fu Ling Powder, 1 bag of Dan Shen Powder, boiled in water for 30 minutes, used as tea to dispel summer dampness, suitable for summer. In winter, for cold dampness, it is advisable to use green Sichuan Pepper to boil water for foot baths.
(4) Daily Health Preservation: 1 bag each of Fu Ling Powder, Pine Pollen, and Dan Shen Powder, taken once a day with warm water.
——
We mainly observe three aspects of the tongue:
First, observe the spirit:
The spirit is observed from the brightness of the tongue, looking at its light and dark, which reflects the strength of the spirit and the overall vitality and energy of the person.
Next, observe the tongue coating:
The evenness and cleanliness of the tongue coating reflect the strength of the middle qi, with the coating primarily reflecting the qi of the spleen and stomach.
Finally, observe the tongue body:
The thickness, redness, and hardness of the tongue reflect the distribution and condition of qi and blood throughout the body. In fact, it is observed from the three aspects of spirit, qi, and form.
Additionally, avoid food and drinks that may stain the tongue before tongue diagnosis to ensure accuracy.
Tongue Diagnosis Essentials
(1) Tongue Color① Pale Tongue: The tongue color is lighter than normal, indicating deficiency or cold conditions, often seen in blood deficiency, representing weak yang qi and insufficient qi and blood. A pale and plump tongue indicates deficiency cold; a plump tongue with teeth marks indicates qi deficiency or yang deficiency.TCM Herbal Remedy: Huang Qi Powder (Astragalus), Cinnamon Powder, Dang Gui, etc.② Red Tongue: The tongue color is deeper than normal, appearing bright red, indicating heat conditions, often associated with internal heat. A red tip indicates heart fire; red sides indicate liver and gallbladder heat; a dry red tongue indicates heat injuring body fluids or yin deficiency with excess fire.TCM Herbal Remedy: Tian Dong (Asparagus), Mai Dong, Dieda Shihu Powder, American Ginseng Powder.③ Dark Red Tongue: The tongue color is deep red, indicating excess heat, often associated with pathogenic heat deeply entering the nutrient level, blood level, or excess fire due to yin deficiency.The darker the red or dark tongue, the heavier the heat pathogen.TCM Herbal Remedy: Huang Lian (Coptis), Mai Dong, American Ginseng Powder.④ Stasis Spots Tongue: The tongue has bluish-purple spots or patches, often indicating internal blood stasis.TCM Herbal Remedy: San Qi Powder, Dan Shen Powder, Hawthorn Powder, etc.⑤ Bluish-Purple Tongue: The entire tongue appears bluish-purple, indicating either extreme heat or cold conditions. A deep, dry, dark red tongue indicates extreme heat, while a pale yellowish-purple or bluish-purple tongue that is moist indicates yin cold conditions.TCM Herbal Remedy: Dieda Shihu Powder, Cinnamon Powder, Mai Dong, etc.(2) Tongue Shape: Observe the age and condition of the tongue, its thickness, and the presence of prickles or cracks.① Age Condition: “Old” refers to a rough tongue texture, firm color, often associated with excess or heat conditions, while “young” refers to a delicate tongue texture, soft color, often associated with deficiency or deficiency cold conditions.TCM Herbal Remedy: Dieda Shihu Powder, Cinnamon Powder, Huang Qi Powder, Huang Lian, etc.② Thickness: “Thick” refers to a swollen tongue, often related to water dampness retention. A pale and swollen tongue with teeth marks often indicates spleen deficiency or kidney yang deficiency with water dampness retention; a red and swollen tongue often indicates internal damp-heat or excessive heat toxicity. “Thin” refers to a small and thin tongue, often indicating deficiency conditions. A pale and thin tongue often indicates insufficient qi and blood; a red and thin tongue often indicates internal heat due to yin deficiency.TCM Herbal Remedy: Fu Ling Powder, Huang Qi Powder, American Ginseng Powder, Shan Yao (Chinese Yam), Job’s Tears, Dang Gui, etc.③ Prickles: Enlarged and hypertrophied tongue papillae, protruding like thorns, often indicate excessive heat pathogens. The more severe the heat, the larger and more numerous the prickles. Clinically, prickles are often seen on the tip and sides of the tongue, with prickles on the tip often indicating excessive liver and gallbladder heat.TCM Herbal Remedy: Dan Shen Powder, Hawthorn Powder, Jue Ming Zi (Cassia Seed).④ Cracks: The tongue has various longitudinal or transverse cracks or wrinkles, often due to mucosal atrophy. Cracked tongues can be seen in some normal individuals. A red and cracked tongue often indicates excessive heat; a pale and cracked tongue often indicates insufficient qi and yin.TCM Herbal Remedy: American Ginseng Powder, Dieda Shihu Powder, Mai Dong.(3) Tongue State: Observe whether the tongue body has tremors, is tilted, weak, or stiff.① Tremors: The tongue body trembles involuntarily, often indicating both qi and blood deficiency or internal liver wind.② Tilted: The tongue body is tilted to one side, often indicating a stroke or a precursor to a stroke.③ Weak: The tongue body is weak and lacks strength, often due to both qi and blood deficiency leading to insufficient nourishment of the muscles.④ Stiff: The tongue body is not flexible, difficult to bend, or even unable to move, often indicating high fever injuring body fluids, excessive heat, or a sign of stroke.TCM Herbal Remedy: TCM includes Huang Qi Powder, Tian Ma Powder, American Ginseng Powder, Chrysanthemum, Dang Gui, Gou Teng (Uncaria), Ling Yang Jiao (Antelope Horn).(4) Tongue Coating:The tongue coating is the manifestation of the stomach’s vital energy.1. Coating Color: There are white, yellow, gray, and black coatings.① White coating is the most common in clinical practice, while other colors can be considered transformations from white coating. White coating generally belongs to the lungs, indicating exterior conditions or cold conditions, but in clinical practice, white coating can also be seen in internal conditions or heat conditions. For example, thin white and moist indicates wind-cold; thin white and dry indicates wind-heat; cold dampness in internal conditions can show thick and greasy white coating.TCM Herbal Remedy: Fu Ling Powder, Job’s Tears, etc.② Yellow coating can be light yellow, tender yellow, deep yellow, or scorched yellow. Generally, the deeper the yellow coating, the heavier the heat pathogen. Light yellow indicates mild heat; tender yellow indicates moderate heat; deep yellow indicates severe heat; scorched yellow indicates heat accumulation; yellow and dry indicates heat injuring body fluids; yellow and greasy indicates damp-heat.TCM Herbal Remedy: Dieda Shihu Powder, Xuan Shen (Scrophularia), Mai Dong, Huang Lian, etc.③ Gray-black coating often indicates heat conditions, but can also indicate cold dampness or deficiency cold conditions. A gray-black and dry coating indicates excessive heat injuring body fluids; a gray-black and moist coating often indicates yang deficiency with excessive cold. Gray-black coating is often seen in more severe stages of illness.TCM Herbal Remedy: Dieda Shihu Powder, Cinnamon Powder, etc.2. Thickness: There are thin coating, thick coating, sparse coating, and no coating.Thin coating often indicates the early stage of disease, with the pathogenic factor still on the surface, indicating a lighter condition; thick coating often indicates a stronger pathogenic factor that has already penetrated internally; or indicates gastrointestinal stagnation; or phlegm dampness. The thicker the coating, the stronger the pathogenic factor, and the more severe the condition. However, the formation of tongue coating reflects the presence of stomach qi; even if the coating is thick, it indicates that stomach qi is still present, while sparse coating often indicates insufficient righteous qi, and no coating indicates severe deficiency of stomach qi, lacking the ability to generate. Irregular shedding of tongue coating, with smooth areas without coating, is called “flowered peeling coating,” often indicating insufficient qi and yin of the stomach; if accompanied by greasy coating, it indicates that phlegm dampness has not transformed and the righteous qi has been injured.TCM Herbal Remedy: Fu Ling Powder, American Ginseng Powder, Dieda Shihu Powder, etc.3. Moisture and Dryness: Reflects the condition of body fluids.Normal tongue coating is neither dry nor wet; a dry tongue without coating indicates that body fluids have been exhausted, with external diseases often being due to dry heat injuring body fluids, while internal diseases often indicate yin deficiency with insufficient body fluids; a moist tongue coating indicates that body fluids have not been injured, while excessive moisture on the tongue surface that drips when the tongue is extended indicates the presence of dampness retention in the body.TCM Herbal Remedy: American Ginseng Powder, Dieda Shihu Powder, Fu Ling Powder, etc.4. Greasy Coating: The coating is dense and fine, resembling a layer of murky, smooth mucus covering the tongue surface, difficult to wipe off, often indicating excessive phlegm dampness.TCM Herbal Remedy: Fu Ling Powder, Job’s Tears, etc.5. Putrid Coating: The coating is loose and resembles tofu dregs, piled on the tongue surface, easy to wipe off. Putrid coating often indicates the transformation of food stagnation in the stomach into putrid matter.TCM Herbal Remedy: Sheng Di (Rehmannia), Huang Lian, etc.
Note: This article is for reference only; specific treatment and medication should follow medical advice! This public account is used for academic exchange only.
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