When the body experiences issues, the color of the tongue can develop in two directions: one is towards white, progressing from a lighter pale white tongue to a dry white tongue.
The other direction is towards red, from a red tongue to a deeper crimson, followed by red-purple and blue-purple.
Tongue Quality Turning White
In Traditional Chinese Medicine (TCM), a tongue color leaning towards white generally indicates the presence of cold or deficiency of Qi and blood in the body. The deeper the white color, the heavier the cold and the more deficient the Qi and blood.
In TCM, cold is divided into external cold and internal cold.
What is external cold?
For example, in winter, when it is very cold outside, if one wears little clothing, it is easy to catch a chill, and the tongue quality will turn white. This is due to external cold invading the body, classified as external cold.
What is internal cold?
Internal cold refers to excessive cold within the body. For instance, in summer, when it is very hot outside, while others dress lightly, if you still wear a thin jacket or shirt and feel cold from the wind, this indicates insufficient kidney Yang, leading to internal cold.
Thus, excessive external cold or insufficient Yang energy within the body can both lead to cold, resulting in a white tongue quality.
Case of Qi and Blood Deficiency
A white tongue quality may also indicate Qi and blood deficiency, suggesting the body needs blood tonification, which is common among women.
I once treated a female patient in her thirties who experienced amenorrhea, sometimes not having her period for several months. Initially, she used Western medicine progesterone, which had an effect while she was taking it; however, once she stopped, there was no response. Concerned about potential harm to her body, she was hesitant to continue, and later sought to regulate her body.
In TCM, treatment for amenorrhea often involves using herbs that invigorate blood and promote menstruation, but upon examining her tongue, I immediately realized that her amenorrhea could not simply be treated by promoting menstruation.
She had a typical pale white tongue with a very thin coating, indicating a deficiency of both Qi and blood. A body with both Qi and blood deficiency is like a river that is about to dry up; at this point, digging the riverbed to clear it is of no use. Therefore, promoting menstruation would not be effective; the most important thing is to nourish. Once Qi and blood are sufficiently nourished, there will be enough water in the river to clear the riverbed and resolve the amenorrhea issue.
——Case Sharing
TCM believes that the spleen and stomach are the source of Qi and blood production, so I first needed to nourish her spleen and stomach. After a period of nourishment, when her Qi and blood were sufficiently restored, I began using herbs to promote menstruation, and her period returned. Gradually, her menstrual cycle normalized.
Tongue Quality Turning Red
A tongue color shifting towards red generally indicates the presence of heat in the body. Heat-induced red tongue quality can also be classified into external heat and internal heat.
What is external heat?
Generally, when the weather is very hot or one suddenly enters a very hot environment, far exceeding the body’s normal tolerance, it can create a warm-heat evil, causing the tongue quality to turn red.
Warm-heat evil can lead to warm-heat diseases, which are often infectious and present symptoms leaning towards heat signs, such as dry stools, sore throat, and fever. Therefore, patients with warm-heat diseases will have a red tongue quality.
What is internal heat?
This refers to heat originating from within the body, which can also cause the tongue appearance to turn red. TCM believes that Yin deficiency can generate heat. Yang represents fire, while water represents Yin. Within the human body, body fluids and blood are considered Yin, primarily used to nourish our body. We all know that for a car engine, having lubricating oil results in less heat generated during operation; however, once the lubricating oil is gone, the machine will run dry and generate more heat.
Internal heat in the body is produced in a similar manner. When Yin is deficient, meaning body fluids and blood are insufficient, it is easy to generate false heat, and the greater the internal heat, the redder the tongue quality will be.
▲Accumulated food leading to internal heat is generally accompanied by a thick tongue coating.
(Note: Children may experience internal heat due to excessive eating, leading to food accumulation and internal heat. Careful observation will reveal symptoms of food accumulation; at this time, digestion must be addressed to reduce heat, as herbal teas and fruits may not resolve this type of internal heat.)
▲A relatively healthy tongue appearance
Therefore, the transition of tongue quality color from white to red generally indicates a change in the body from cold to heat. Whether due to internal or external factors, this will be reflected in the tongue appearance.
By observing the color of the tongue quality, one can determine the state of the body. If external heat is excessive, we can clear the heat; if internal Yin is insufficient, we can nourish the body with Chinese medicine to reduce false heat, restoring the tongue quality to its normal color.
Warm Reminder
TCM emphasizes the four diagnostic methods, with tongue diagnosis being an important part. Regularly observing one’s tongue quality can serve as a reference for health maintenance. If any issues are detected, timely medical consultation is necessary for a more accurate diagnosis.
Observing tongue quality is just one part of tongue diagnosis. For more information on children’s tongue diagnosis, please refer to the article “Understanding Children’s Tongue Coating with Illustrations!”
Author’s Biography:
This article is excerpted from the book “Great National Medicine—How Chinese People Should Use Medicine” co-authored by renowned TCM physician Dr. Pei Xueyi and Dr. Pei Sheng, who comes from a family of TCM practitioners with over 30 years of clinical experience. Please indicate the source when reprinting.
Looking for quick answers?
Want to find previous articles?
Want to know about care for cough, fever, diarrhea, etc.?
Scan the QR code below to enter “Search in the Account”
Input keywords to search.
When a bunch of articles appear, remember to use the filter options available in the column.
Recommended Reading:
The Two Major Characteristics of Food Often Overlooked by Many Parents!
Has your child eaten too much? How to judge?
Sorry, you are not suitable for TCM!
TCM Parenting Wisdom | Protecting Children’s Health with WisdomUsing green, effective, professional, and simple TCM parenting methodsto help you solve various parenting challenges encountered daily.
Long press the QR code, scan the QR code in the image to follow us!Welcome to cooperate, contact WeChat: inin191