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Tongue in Chinese Medicine

Every morning when I wake up, before I eat or brush my teeth, I look at my tongue in the mirror. I suggest that you include this ritual into your morning routine as well! I'm serious. This is in line with the philosophy of being one's own doctor. In this blog I will explain the significance of the tongue in diagnosing internal patterns according to the Chinese medicine theories.

In Chinese medicine we have different ways of diagnosing the patterns. We listen to the story and complaint, we palpate different body parts, we feel the radial pulses on both sides in 3 positions and 3 depths, and finally we look at the tongue. This is how we decide what treatment principle to chose.

The Chinese medicine diagnosis is different from the Western medicine one. Usually the pattern is due to an imbalance in the body and the treatment principle addresses the imbalance. In addition the diagnosis might involve specific organs. Which are viewed differently than the organs in Western medicine. For example if someone has too much liver heat, that does not mean that their actual liver has a hot temperature! The treatment principle in this case is to cool the liver, either by using specific acupuncture points that clear heat or using cooling herbs.

How do we diagnose by looking at the tongue in Chinese Medicine? The tongue is one the internal organs that sticks out and we can look at it. We can see the health of the rest of the digestive tract by looking at the shape and color of the tongue. We also look at the coating, if there is any movement or deviation, we look at the veins under the tongue and lastly every part of the tongue corresponds to different organs. Since Chinese medicine is a holographic system, the tongue represents the body in whole.

I will try to mention some simple examples here but also pointing out that you can find lengthy books on this subject and it takes years of looking at tongues to master this diagnosis technique.

The first thing you look at is the general quality of your tongue. The tongue is a muscle. Is it flaccid or strong? Is it thin or swollen? Is it quivering or deviating to one side? Is it short or long? Like any muscle each one of these qualities gives you an idea of the general state of your energy. If you are tired, your tongue might be flaccid or swollen with teeth marks. If your nervous system is shaky, sleep deprived, or recovering from alcohol consumption, your tongue might exhibit little tremors that indicate the presence of Wind in your system.

Next you can look at the color of your tongue. This shows the general state of your blood. The normal color is pale red. If your tongue is red or has red dots, that indicates heat. If it is dusky red that means blood stasis. If it’s too pale or with an orange hue, that might mean that you need more blood nourishing food. You might be iron deficient or a vegetarian who is not eating enough protein .

Third element is the coating on the tongue. The normal coating is a thin white one. If your tongue has a thick white coat that means there is phlegm in your system. This phlegm can be either substantial, if you have nasal congestion or phlegmy cough, or it can be unsubstantial. When our energy is not moving the fluids of the body properly it creates stagnation. This can affect one’s focus, and make one feel heavy. The resulting stagnation can cause anxiety, panic attacks, palpitations, and in extreme cases seizures.

If the coating of the tongue is thick and yellow it means there is also heat involved with the phlegm. Sometimes people who are smokers have this presentation. If there is no coating, or "peeled tongue", there is serious deficiency in the stomach and digestive tracts. I had a client who found out she had celiac disorder. Once she started eating a gluten free diet her tongue, previously peeled, grew a thin white coat.

The veins under the tongue are closely related with the hormonal state and menstruation in women. They sometimes become large before menstruating and disappear after the periods. If they are always engorged and dark that indicates stagnation in the blood in both men and women.

Lastly, different parts of the tongue correspond to different organs. The tip of the tongue is the heart. So if the tip of the tongue is red, that means heart fire, which can present as anxiety or insomnia. Usually people with heart fire talk a lot or can have bitter taste and breath. The area behind the heart belongs to the lungs, each side corresponds to the liver and gallbladder. The middle of the tongue is the center of the body, the digestive tracts and pancreas. The back of the tongue corresponds to the kidneys and reproductive organs.

Any area of the tongue that is puffy that means stagnation in that organ function. If it has red dots or the color of it is more red, that indicates heat. If there are cracks it means deficiency in that particular organ function.

When you look at your tongue every morning you start to notice subtle changes that can help you modify your diet, activities and sleep to help keep you balanced. For example if you have a thick white coating on your tongue and some kind of phlegm or congestion, try cutting down dairy, eggs, ice cream, smoothies and raw food. Have more cooked food and add ginger and spices to your food. If the tip of your tongue is red, it’s time you go to bed early and have a good sleep routine. If you have indentations around your tongue and your tongue is puffy, you might be over worked, need to have a few weeks of eating well and resting. If the veins under your tongue are bulging out and dark, pay attention to your periods: are they regular, is there any PMS and how is the flow. You might need to see an acupuncturist for hormonal balance.

When I was in school I started having teeth marks on the edges of my tongue and soon afterwards I noticed most people in school had that! The tired digestion due to too much thinking, in our case studying. Last night I ate some ricotta and a cream puff. This morning I noticed a slight glossy white coat on my tongue. This change is very subtle but I know that ginger tea is going to be on my list today and I will cut down dairy!

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