Question about tongue diagnosis

I always notice that my acupuncturist looks at my tongue when I come in for acupuncture treatments. My acupuncturist (Jennifer Horton) told me before that acupuncturists use tongue diagnosis. I would like to know more about this.

thanks, Tammy

You may have been surprised the first time your acupuncturist asked you to stick out your tongue! In fact, one of the more common questions I get in clinical practice is: “What does the tongue tell you?” Within the confines of Chinese medicine a practitioner can gather quite a bit of information about you and your condition just by a quick exam of the tongue. When we look at the tongue, we are looking at the shape, color, size, coating, and positioning or movement of the tongue, each of which offer a clue to your diagnosis.

Size and shape
The shape and size of the tongue tends to address the status of fluids in the body. For example, a large puffy tongue with scallops or teethmarks suggests that fluids are not being properly metabolized in the body. A very small short tongue may suggest dryness in the body. We are also examining the tongue for cracks. These cracks tell us about the condition of the patient depending on the depth and location.

Color of the tongue
A red tongue indicates that there is heat present in the body, and the redder the tongue the greater the amount of heat present. A tongue that is pale indicates a deficiency of qi and blood or the presence of cold. A purplish color indicates stagnation somewhere in the body. The tongue color may vary on different parts of the tongue. The tongue is like a map of the whole body so any imbalance in the body will manifest on the tongue in that specific location. Heat in the heart or lungs will manifest on the tip of the tongue, showing redness. Any liver imbalance such as blood stagnation or toxins will show on the sides of the tongue. The center of the tongue is associated with the spleen, stomach and digestion.; and the back of the tongue is associated with the kidneys.

Tongue coating
A normal, healthy person will have a thin white coating. We look for a coating that is too thick, too thin, missing, or stripped away in certain areas or a coating that looks like only patches are left. We are also looking at the color of this coating. Some conditions in the body produce a dark gray or even black coating, yellowish, or brown.

A few additional points about tongue diagnosis
It usually takes a while for the tongue to change from ‘normal’ to showing pathology, and also from a pathological state to a normal state.
Tongue diagnosis is more traditionally associated with organ diagnosis, and herbal formula prescriptions whereas pulse diagnosis is more traditionally associated with meridian diagnosis and acupuncture prescriptions.
some people are born with cracks or discoloration or spots.

I find that patients rarely pay much attention to their tongues in this way although some are intrigued by the thought of getting to know more about their bodies just by looking at these details mentioned above. So give it a try if you like. Watch your own tongue, ask friends or relatives to show their tongues off! The more tongues you observe, the more these descriptions will become real to you. Good luck, and let us know how it goes!

Jennifer Horton L.Ac., MSTCM

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