TCM Tongue diagnosis

Write By: shahul Published In: Tongue diagnosis Created Date: 2014-10-06 Hits: 134878

Tongue Diagnosis in TCM Acupuncture Theory



One of the most common questions that people ask about acupuncture is: "Why does my acupuncturist look at my tongue?"

Tongue and pulse diagnosis are two of the more important diagnostic tools in Chinese medicine. They are both used to derive a TCM diagnosis for your condition which is used to plan your treatment. Generally the tongue, is much easier to learn and less subjective than pulse diagnosis. It is less meridian specific than the pulse, however, the tongue will show the depth and nature (hot, cold, etc.) of an imbalance and it is less effected by short-term influences such as nervousness. The tongue is also useful as a measurement tool to gauge the progress of a disorder.


Common Tongue Geography and Meridian Correlations

tongue geography
¤ Lower Jiao
The Base of the tongue corresponds to the Kidney, Urinary Bladder, Large Intestine and Small Intestine Meridians.

¤ Middle Jiao
The sides of the tongue correspond to the Liver and Gall Bladder meridians. Some theories place the Gall Bladder on the patients left side and the Liver on the patients right side.

The Middle of the tongue corresponds to the Stomach and Spleen Meridians.

¤ Upper Jiao
The Tip of the tongue corresponds to the Lung and the Heart

How Can the Tongue Change?







Vitality of the tongue

Zang, Fu, Qi, Blood, Body Fluids

Flourishing: bright with energetic movement and moist indicates good Stomach Qi

Withering: dark and dry tongue with sluggish movement indicates exhausted Stomach Qi


Reflects true condition of body

Thermal nature of the disease

More Red: Blood overfills tongue, more heat

Less Red: Qi and blood are insufficient, less heat, more deficiency


Tough or tender

Reflects excess or deficiency

Rough: exuberant antipathogenic Qi and muscle fibers bulge

Tender: Qi and Blood are deficient and cannot fill fibers; Yang deficiency cannot transform body fluids and cold-damp accumulates


Large or Small

Often reflects constitution

Large: overfilling of Blood, damp accumulation

Small: lack of nutrition due to Qi, Blood and Body Fluid Deficiency


Moist, smooth

Body Fluids, heat, stasis

Cracks: malnourishment of Qi, Blood and Body Fluids due to heat or dampness obstructing

Prickles: heat pushes Qi and Blood up where they overfill the tongue causing papillae to thrust out


How the tongue moves

Condition of muscles and sinews

Stiff: lack of nourishment due to internal organ deficiency or phlegm/Blood stasis obstructing Qi and Blood resulting in stiffening of the tongue

Limp: sinews lack nourishment of Qi, Blood and Body Fluids and do not have the strength to move


Abnormal movement

Pathogens or deficiency

Spasm due to internal wind, usually due to hyperactive Liver, internal heat or malnutrition.  Can be trembling, deviated or protruding.


How long the tongue is

Pathogens or Internal Organs

Short: excessive cold causes contraction and spasm; malnutrition causes phlegm to stagnate and obstruct; heat injures Body Fluids; Qi and Blood deficiency due to Spleen and Kidney failure

Long: excess pathogenic heat consumes Qi, Blood and Body Fluids; internal organ failure resulting in the tongue being unable to contract







Pathogenic factors

White: exterior or cold patterns; targets Lung and Large Intestine

Yellow: interior or heat patterns; targets Spleen and Stomach

Gray: interior, heat or cold-damp patterns

Black: interior, extreme heat or extreme cold patterns


Antipathogenic Qi or depth of disease

Thin: impaired Spleen or Stomach cannot evaporate and transform dampness; Kidney and Stomach Yin deficiency cannot send up Body Fluids or damp turbidity is sent up.

Thick: Spleen and Stomach are stagnated by food or phlegm damp and turbid damp steam rises


Condition of Body Fluids

Dry: excessive pathogenic heat injures Body Fluids; internal organ dysfunction leads to Yin deficiency

Wet: water damp attacks body due to Spleen or Kidney Yang deficiency cannot transform Body Fluids


Distinguishes pathogenic factors, fluid metabolism

Damp, phlegm, water or food stagnates and accumulates and the Stomach Qi produces excess turbidity that steams upwards


Location and depth of disease

Even: widespread pathogen, dampness obstructs middle jiao

Uneven: certain body parts or organs are affected, there will be uneven distribution


State ofStomachQi & Yin

Deficient Stomach Qi or Yin results in exuberant rising of turbid dampness or Stomach Yang, burning fluids.


Pathogen severity, condition of Stomach Qi & antipathogens

Rooted: sufficient Stomach Qi that is attached to tongue tightly, difficult to scrape off

Unrooted: insufficient Stomach Qi due to Qi deficiency in the Stomach or Kidney

Ayurvedic_Tongue Diagnosis