Welcome to Millwoods Acupuncture Centre

Millwoods Acupuncture Center
102, 2603 Hewes Way
Edmonton AB,   Canada

Phone: (780) 466-8683



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.






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.






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