What is tongue diagnosis?
Ever wonder why your TCM practitioner asks you to “stick your tongue out”?
TCM uses 4 assessment categories, also called Four Pillars, to diagnosis patients — Looking, Listening, Palpation, and Asking. Tongue diagnosis falls into the looking category. Each of these categories helps the practitioner to build a overall view to the patients health status.
Tongue diagnosis is an important diagnostic tool for TCM practitioners. Where the pulse shows the current real-time status of the body because it can change so easily, the tongue takes a while to change and thus gives us a view of your overall health. The tongue tends to show the root causes of disharmony in the body and the pulse tells us how that disharmony is impacting different body fluids, Qi/Blood/Yin/Yang, and the Zang Fu organs.
The tongue mirrors the disharmonies happening inside the body. It is separated into sections, and each section corresponds to a different Zang Fu organ system. The tip of the tongue is the Heart, right behind that is the Lungs, the the mass of the body is the Spleen/Stomach, the root is ruled by the the Kidney/Bladder, the intestines are squeezed between the middle and the root, and the sides of the tongue are the Liver/Gallbladder. These areas give us an indication of what Zang Fu are in dysfunction and the characteristics of the tongue tell us what that dysfunction is.
There are several characteristics that we observe when looking at tongues — Shape, Size, Body Color, Texture, Moisture, and Coat/Fur. All of these characteristics tell us a vivid picture of the state of body fluids (is the tongue dry, puffy, thick coat/fur, etc), is there a deficiency (pale or thin) or excess (purple or puffy) of Qi, Blood,Yin or Yang, and temperature regulation issues (yellow coat or red body indicates heat).
So what does a healthy tongue look like? It should have a pale red/pink body. The body should also be soft and flexible which is evenly shaped. It should be moist and bright with a thin white and clear coat.
Tongue diagnosis is foundational to treating disease and disharmony, so make sure that before your appointment you follow theses rules:
DO NOT BRUSH OR SCRAPE YOUR TONGUE! Your practitioner needs to see your tongue in its natural state.
Avoid mouthwash. Many commercial mouth washes can temporarily color your tongue. Even bad breath can be used as a diagnostic tool (sour smell is Liver, bitter can be Heart, etc).
Avoid coffee, tea, or foods (beets, jolly ranchers, etc) that can color the tongue.
Avoid smoking before the appointment as it can also affect the color of the tongue.
If you want to take a peek at your own tongue, check it out in the morning right after waking up. Sunlight or natural lighting is the best lighting for accurate color identification. When you stick it out, make sure to relax your tongue for an accurate look at the body size and shape. If you stick it straight out forcefully the shape is changed. Check out your periodically to see if you notice are any changes!
Note: Tongue and pulse diagnosis is the cornerstone of Chinese Medicine and practitioners spend 4+ years learning how to accurately uses these tools to help their patients. It helps us make an accurate diagnosis when paired with your symptoms, as well as let us know where to insert the needles and which modality would be best to use (moxa, cupping, e-stim, etc). If you have any concerns about your tongue or pulse, make sure to reach out to your practitioner or your doctor.
Interested in learning how Acupuncture & Chinese Medicine can help you take control of your health? Schedule your appointment today!