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Look at your tongue,
check your health
If you have
visited a TCM doctor, you may remember that he listened your
description about your trouble, asked you some questions, then
looked at your tongue and felt your pulse. Then, you may
surprise that he started to give you herbal prescription or
start acupuncture.
It is quite beyond your experience when you visited your family
doctor, who may not ask many questions and he is so eager to
send you to various lab tests or X-ray or MRI or something else.
You need to wait until next time, or next of next time to get
formal treatment (unless you have pain or fever, then he will
give you pain killer or aspirin-like drugs).
It is true that for most of TCM doctor, his
diagnosis for your health is based on your feelings, your tongue
and your pulse he felt. It is so simple.
Our tongue is very important for TCM doctor
to make a diagnosis, as well as our face, palm, ear, arm, leg,
foot, etc. – all based and support the idea that “any part of
the body contains the information of the whole body”. This idea
is proven true during thousands of years of clinic practice by
Chinese. For this reason, we can focus massage on the feet to
solve healthy problem, so called reflexology; and we can focus
work on an ear to reach the same aim, so called ear acupressure
(auricular acupressure/acupuncture); and even focus on a eye to
perform acupuncture: eye acupuncture. This is our body.
Your doctor can tell your health condition
by looking at your tongue and you can too. Here we introduce the
main idea how to look at your tongue to check your health
condition by yourself. So many times, we do not feel anything
wrong while it has been shown up on our tongue. In another
words, the illness signal comes up on the tongue (and on the
pulse… ) far away before we feel it.
The best time to see a tongue is in the
morning, under natural light, before brush your teeth. Of course
it is not possible to keep your TCM doctor at your home, but you
should know that you should not brush your tongue or drink hot
water before you come to your doctor, since they will change
your shape and color of your tongue. If you want to show your
TCM doctor true information, you should pay attention to my
warning.
1.
Normal tongue
First, we need to know what is a “normal”
tongue.
A normal tongue should look not too big or
small, not too thick nor thin, not too red in color nor pale,
not too wet nor dry. The tongue covering is thin and white in
color and cover most part of the tongue. The tongue is stable,
not shaking when pull out. There should have no teeth index on
the edge of the tongue. Well, how it looks like for such
“normal” tongue? Here you are: see the figure 1a. 1b. and 1c.
I include more tongue pictures here showing
normal or relatively normal tongues with the aim to let you have
a broad idea what a normal tongue feels like. You may have no
chance to see so many tongue if you are not a TCM doctor.
Normal
tongue looks similar each other. Abnormal tongues are many and
they are largely variable. Here we introduce some of the tongue
pictures we collected from our clinic works. They are not all of
the abnormal tongues we can see in clinic. If your tongue is
different from the “normal” tongue, but is none of the abnormal
tongue here, visit your TCM doctor in your town.
2. Water retention tongue (fig. 2)
Fig.
2a.
Look at this tongue. You may have noticed
that it is big, with teeth index around its edge. It looks puffy
as there is water in it to make it “puffy”. Yes, this tongue
suggests that the patient has water retention (relatively or
absolutely) in the body.
The water retention does not mean it is
urine retention in the urine bladder, or swelling only. It
actually suggests lots of possibility: the water might be in any
part of the body. If the excess water is in stomach, one feels
bloating in the upper stomach, feels palpitation, or nausea. If
the water accumulated in brain, one feels drowsy, lazy and heavy
head, slow reaction, poor memory… If it is in ear, one feels
dizzy and ringing in the ear. If it is in joints, one feels dull
pain and swelling in the joints. Cyst is another example for the
water attention in the body. If
the water is in the chest, one feels bloating and oppression in
the chest, and has cough with phlegm…
 Fig.
2b
 Fig.
2c
If you see such tongue and find that the
tongue covering is thick, it may suggest that the water has
condensed into “phlegm”. In Chinese medicine, the phlegm is a
very broad concept. It does not only mean the phlegm that comes
out of your lung when you cough. As the water, the phlegm can be
accumulated in any part of body to block the life energy moving.
The problem caused by the accumulation of phlegm is mush hard to
treat than by water. A fibrosis is an example of the
accumulation of phlegm under the skin.
3.
Yin deficiency
Yin deficiency
tongue looks thin, small, dry and the color is pretty red (Fig.
3a and 3b). Yin is the material part of the body (whereas the
Yang is the motivating and functional part of the body). Without
enough Yin in the body, people feels chronic fatigue; dry mouth;
poor mental ability to study, analyze, or remember things;
shallow sleep; weakness in lower back; reduced sex ability,
night sweet and dry mouth; frequent night urine…
When the Yin is less, the Yang will be
relatively more or extra in the body, to show a kind of, what we
called floating fire. The fire tends to “burn” in mouth to cause
ulcer in tongue as map tongue (part of the tongue is pearled
off, so as looks as a map);
to burn gum to cause bleeding, to burn the lung to cause
cough bleeding; to burn in ear to cause ear ringing; to burn
stomach to cause dry mouth and discomfort in stomach, with
hungry feeling but cannot eat lots; burn in colon to cause
constipation, to burn in skin to cause multiple muscle pain
(MS)…
Such Yin deficiency tongue is commonly seen
in patients with long term and heavy illness, such as in
patients with cancer after chemotherapy, or patients after heavy
bleeding. It is also quite common in patients with multiple
sclerosis.
 Fig.
3a.
 Fig.
3b
4.
Yang deficiency
Yang Qi in the body is just as the Sunshine
on the earth. Without sunshine, there is no life, animals or
plants. The earth is dead. Similarly, without Yang Qi in the
body, the body is dead. The blood is not circulating, the lung
is not breathing,… nothing will function. Because the Yang Qi is
the power of all body function, so if the Yang Qi is in a
deficiency condition, many functions will be affected: the blood
circulation, the water metabolism, the temperature distribution…
so the tongue for a Yang Qi deficiency is also usually a
combination of the Yang Qi deficiency and the associated
results, such as water retention, blood stagnation, unevenly
distributed body temperature… etc..
Fig. 4a, 4b and
4c is a typical Yang Qi deficiency. The tongue looks thin with
purple color tint. The purple tint of the tongue suggests the
Cold.
In practice, most of patients show such
Yang Qi deficiency tongues. In modern life, there are so many
ways to exhaust the Yang Qi in the body. Stressed study in
school starts to exhaust our Yang Qi in the upper part of the
body (the Lung and the Heart). Over eating and alcohol drinking
exhausts our Yang Qi in the middle part of the body (the
Spleen). Excess sex life exhausts the Yang Qi in the lower part
of the body (the Liver and the Kidney). You see, it is the
typical life pattern for people live in the western world.
Yang Qi deficiency is the first step
towards overweight, allergic, and …. Cancer. Once you see your
tongue as such Yang deficiency, consulting with your TCM doctor
to have some correction, even if you feels nothing but little
bit cold in hands or feet only, or only have little running nose
from time to time. They are marks that you have no enough Yang
Qi in the body now.
 Fig.
4a
 Fig.
4b
 Fig.
4c
 Fig.
4d
5.
Fire
Typically, people with Fire in the body
will have change in color in the tongue mostly, rather than
shape. The color of tongue is red, or dark red, representing
“Fire”. Depending on the position of the Fire in the body, in
the upper part of the body or in whole body, the red color can
be find mostly in the tip (top) of the tongue or in whole
tongue, respectively.
Fig. 5a shows red color in the tip of the
tongue. This patient has a common cold with fever and sour
throat. He has dry mouth and little headache. Not every person
with common cold will have such tongue. This is only one type of
common cold, based on the TCM category.
Fig. 5b shows a tongue of a patient with
heavy pain and bloating stomach. He did not have bowel movement
for several days. Now he also has dry mouth and nausea too. The
yellow color of his tongue suggests that the accumulated
water/phlegm in the stomach area has produced Fire in the body
too. Such tongue can be seen mostly with acute infection in the
body, such as acute pneumonia, acute tonsillitis, acute
intestinal obstruction, just as examples.
When you see a tongue as such with a yellow
color, make sure it is not due to the drinking of colored
beverage, such as orange juice or coffee.
 5a
 5b
 5c
6.
Blood stagnation
Blood should circulate in the body
smoothly. If there is any block in any part of the body, we call
it blood stagnation. It is quite common in patient with long
time illness, since many other pathological condition could
contribute to the stagnation of circulation. The tongue
suggesting blood stagnation looks as dark and purple spots on
the tongue and/or bigger veins under the tongue. Usually, you
can also find bigger blood clot in women menstruation blood (if
the stagnation is in the uterus); or sharp pain in the body,
such as coronary heart disease; or various veins in the legs.
 6a
6b.
7.
Other special tongues.
There are many other kinds of tongues that
are mixture of above typical ones. It makes the clinic diagnosis
and following treatment difficult.
I want to specifically mention one kind of
the tongues (Fig. 7a), that I saw quite frequently in my
patients who live in Wetaskiwin area of Alberta,
Canada. I can see such tongue
in patient who comes from other part of Albert, but more in
Wetaskiwin.
Chronic fatigue
with various other complaints is quite common in such patients.
In TCM, we should consider Yang Qi deficiency in these patients.
Some doctors may not agree with me, and they may believe that
such tongue should belong to Yin deficiency. However, my
experience is that with herbs that belong to supply more Yang Qi
works better for those patients for their health condition, as
well as for the change of tongue.
Fig. 7a and 7b come from the same patients.
After treatment with herbal therapy, the tongue changed (Fig.
7b). The multiple small cracks on the edge of the tongue become
less apparent. The color of the tongue is neither so dark red
(less floating fire in the body). Fig. 7c is the tongue of
another patient.
 Fig.
7a
 Fig.
7b
 Fig.
7c
 Fig.
7d
 Fig.
7e
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