Using Tongue to Diagnose Internal Health

Using Tongue to Diagnose Internal Health

Written by Dr. M. Ling, 8 February 2013

Our tongues say a lot about us, including our health.  Traditional Chinese Medicine (TCM) has developed a unique, effective diagnostic approach using inspection of the tongue.  In this way, TCM offers keys to harmonious health through understanding what we see about our tongue.

Figure 1-tongueFor thousands of years, various areas of the tongue are believed to correspond to different organs and their meridian systems (left image). The tongue gives clear clues as to the health of different organ systems and the body-mind-spirit as a whole.  It is also the changes in the body and coating of the tongue that are important in TCM.

Changes in the tongue happen when changes occur first in the diet, emotions, lifestyle and state of health.

This week’s health tip is to encourage people to examine their tongue as a way to inspect their personal health.  Figure 1 (left top image) and the accompanying chart of nine common syndromes with possible symptoms are a very simple guide to assist in this exploration.


What to look for in your tongue?  First, it’s important to know what a “normal” tongue looks like – whole tongue is uniform pink in colour with thin white coating and slightly rounded shape.

As you look at your tongue then, check the following regularly, note their location on the tongue, as well as any changes over time:

* Colour of the tongue body, including red prickles or black dots
* Coating on the tongue surface
* Colour, thickness, dryness or moistness of the coating
* Shape of the tongue
* Fissures/cracks in the tongue
* Movement of the tongue

1.  If there are sensations of a burning tongue, or pain due to canker sores in the mouth, or you are often irritable, look for a crimson red tongue or tongue tip with reddish prickles.  This suggests overabundance of pathogenic heat in the body, which could be due to eating too much spicy food, (particularly red/green chilis, tabasco sauce), or deep-fried, greasy food, fast foods, and/or highly stressed, unexpressed emotions.

In this case, excess heat-fire must be cleared.  If it is not, over an extended period of time, excess heat in the body burns the Yin aspect of the body – joint fluids, blood plasma, tissues – and cracks or fissures in the tongue eventually appear (usuaully after many years), along with various pains and unwanted symptoms.

2.  If there are black dots on the tongue, or areas of the tongue are darkish-purple, this suggests blood stagnation somewhere in the body and may correspond with cramps, pain, frequent childhood emotional upsets, or a history of severe cramps or pain somewhere in the body.  Activating and removing blood stasis must occur to alleviate the pain.

3.  If the tongue shakes involuntarily, this indicates there is internal wind in the body.  This may correspond in people with severe tinnitus, Parkinson’s, mental illnesses and those with long-term blood or body fluid deficiency, to name a few.  Involuntary shaking of the tongue can also be a warning sign of impending stroke.  Nourishing and moving the blood is a vital treatment principle here.

4.  If you have a thick coating on the surface of your tongue, this suggests turbid dampness and/or phlegm is retained in the body.  If the coating is white, then it is a damp-cold condition.  If the coating is yellow, it is a damp-heat or phlegm-heat disharmony and may be accompanied by bad breath, or stale or bitter taste in the mouth.

One of the meanings of a thick, greasy tongue coating is that there is fumigation of improperly digested food, combined with internal pathogenic factors rising upward to reside on the tongue.  In cases of stomach heat, bad breath is often one of the branch symptoms.

Scraping or brushing the tongue temporarily removes this thick coat and the stale or bitter taste that may accompany it, but unless the root of this turbidity is dealt with, no amount of scraping will permanently resolve it.

5.  If the coating is dry, this indicates systemic whole-body dehydration, and may present along with cracks in the tongue.  Nourishing the Yin fluids and tissues of the body is needed.

There are several ways to treat these imbalances in the body that manifest on the tongue – cupping (all types), acupuncture, herbal medicine, and changes in diet and lifestyle are the main methods used in Traditional Chinese Medicine.

For example, for thick tongue coating, one way to treat this is to balance the pH in the gastrointestinal tract by taking full-spectrum probiotic capsules available at health food stores (acidophilus/bifidus and probiotic yogurt are insufficient), or through other herbal foods and medicines.  For instance, when tongue coating is thick and slightly yellow in colour, daikon (white radish) is an excellent food to eat to eliminate this damp-phlegm-heat.

This is a very brief introduction on how to read your body’s health through inspecting your tongue.

Mouth health is also an important component of dentistry.  A healthier tongue and mouth also means healthier teeth.

In combining the wisdom of a 4000 year-old field of medicine and modern day dental health practices, we can significantly raise awareness about how to improve overall mouth and tongue health.  This is where TCM and dentistry can effectively be used in collaboration together.

Dr. Mee Lain Ling