The tongue not only allows you to taste the sour, sweet, bitter, and spicy, but it is also a mirror of health. Tongue diagnosis, as a unique and sophisticated diagnostic method, has been revered by physicians for thousands of years.
By observing the subtle changes in various characteristics of the tongue, doctors can gain insights into the health status of the body, and this utility has recently been confirmed by modern science.
Life Times (Search “LT0385” on WeChat to follow) interviewed experts to tell you how the tongue reveals the body’s condition.
Interviewed Expert
Dr. Zhou Jingxin, Deputy Chief Physician of the Nephrology and Endocrinology Department at Dongzhimen Hospital, Beijing University of Chinese Medicine Article Author: Life Times Reporter Ouyang Yunshuang
“Tongue Diagnosis” Has Been Confirmed
A paper published in the journal Technology introduced an artificial intelligence technology. Researchers from Iraq’s Middle Technical University and the University of South Australia utilized this technology to achieve the skill of “tongue diagnosis.”
Researchers trained a machine using 5,260 images to predict tongue color under different lighting conditions and matched abnormal tongue colors with diseases, achieving an accuracy rate of 98%; subsequently, they input 60 images of abnormal tongues into the system, and the diagnostic accuracy reached 96.6%. The researchers then began to perform “visual diagnosis” on real patients—using a camera placed 20 centimeters away from the patient to capture tongue color, the imaging system could display possible diseases and predict their health status in real-time.
Dr. Zhou Jingxin stated that this research result and technology once again prove the wisdom of Traditional Chinese Medicine (TCM).
The history of tongue observation dates back over two thousand years, with the ancient Chinese medical classic Huangdi Neijing detailing the relationship between the tongue and the internal organs. Through continuous practice and summarization by generations of physicians, tongue diagnosis has gradually become an indispensable part of the TCM diagnostic system.
TCM believes that the tongue is the sprout of the heart, the external manifestation of the spleen, and the coating is generated by the stomach qi. The tongue is closely connected to the five internal organs through meridians, thus, changes in the internal organs often reflect on the tongue. Changes in tongue appearance can quickly and intuitively reflect the body’s qi and blood status, yin and yang balance, and the progression or retreat of pathogenic factors.
10 Types of Tongue Appearance That May Indicate Illness
Dr. Zhou Jingxin reminds that if there are changes in the color, shape, or coating of the tongue, it may indicate health issues or even diseases.
Tongue Color
▶Pale Tongue: Commonly seen in patients with deficiency of both qi and blood, or insufficient yang qi, often accompanied by a thin coating or no coating. Insufficient yang qi causes the tongue body to become pale; patients with anemia are also prone to a pale tongue. ▶Red Tongue: Generally indicates excess heat in the body or yin deficiency leading to heat. If there are red spots or prickles on the tongue surface, they represent excessive heart fire, excessive gastrointestinal heat, or liver and gallbladder fire. Clinically, patients with acute stroke often have an abnormally red tongue; Helicobacter pylori infection may present with a slightly red tongue with white spots.▶Purple Tongue: Commonly seen in those with poor blood circulation, such as cold syndrome, heat syndrome, or blood stasis syndrome. A dark purple tongue may be caused by hyperlipidemia, pulmonary heart disease, etc.; cancer patients may also present with a purple tongue that has a thick greasy coating; a bluish-purple tongue suggests vascular, gastrointestinal, or asthma issues. ▶Yellow Tongue: Generally caused by food coloring, such as long-term smoking, drinking tea, and consuming dark-colored foods.
The paper mentions that a yellow tongue may also be seen in patients with body heat, liver and biliary diseases, gastrointestinal issues, and diabetes.
Tongue Coating
▶Thick Coating: May indicate a progression from mild to severe illness, or gastrointestinal stagnation. If the coating is thick and yellow, it often indicates internal heat or food stagnation; a thick white greasy coating often indicates excessive damp phlegm. In cases of cold or systemic infections, infants, the elderly, and immunocompromised individuals may also present with thick coating. ▶Dry Coating: Indicates a dry coating without moisture, commonly seen in patients with high fever, yin fluid deficiency, or vomiting and diarrhea causing fluid loss.▶Greasy Coating: Indicates dampness and turbidity accumulation, with yang qi being restrained. A yellow greasy coating often indicates damp-heat; a white greasy coating often indicates cold dampness.
Tongue Shape
▶Swollen Tongue: A tongue that is swollen and has tooth marks on the edges is often caused by spleen deficiency and excessive dampness or deficiency of yang qi. If the coating is thick and yellow, it may be accompanied by damp-heat.▶Thin Red Tongue: A tongue that is thin and red often indicates yin deficiency heat or malnutrition.▶Cracked Tongue: A tongue with cracks often indicates deficiency of essence and blood or excessive heat damaging fluids. Sudden appearance of cracks may suggest superficial gastritis or malnutrition; if symptoms persist for more than two weeks, medical attention is advised.
What Does a Healthy Tongue Look Like?
According to doctors, a healthy tongue should be: light red in color, moist in texture, and able to move freely, with a thin white and even coating, and moderate dryness and wetness. It is important to note that changes in tongue appearance do not exist in isolation but are related to the patient’s overall symptoms, pulse condition, etc. Tongue diagnosis, as an auxiliary diagnostic method, relies on the experience and skills of the physician. Therefore, tongue diagnosis is a specialized diagnostic skill, and one should not hastily self-diagnose based on tongue appearance. If you notice abnormal tongue appearance, be sure to seek medical attention and have a professional doctor assess it.
Professor Zhao Yan from the School of Traditional Chinese Medicine at Beijing University of Chinese Medicine stated in an interview that the tongue nerves originate from the brain and connect to the tongue, and frequently moving the tongue is beneficial for the body. You can practice the following tongue exercises:
1. In the morning, in front of a mirror, extend and retract the tongue 10 times, then move the tongue left and right outside the mouth 5 times;
2. Sitting with fingers spread on the knees, slightly lean forward. Inhale through the nose, then open the mouth wide, extend the tongue and exhale, while opening the eyes wide and looking straight ahead, repeat 3-5 times;
3. Open the mouth, slowly extend the tongue, hold for 2-3 seconds, and repeat 5 times;
4. Tilt the head back, extend the chin, open the mouth wide, extend the tongue, hold for 2-3 seconds, and repeat 5 times.▲
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