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The strong sunlight this summer has enabled me to inspect people’s tongues in good natural light.  I’ve been more involved in discussions with clients about their tongues as a consequence.  Their curiosity has prompted me to explain why I look at tongues, what I’m seeing and what they mean.

What the tongue says

When we look at person, we notice their complexion (dry, pale, spots), we notice the vitality of their hair, liveliness or tiredness of their eyes and so on.  We are making instant judgments about a person’s health, wellbeing and mood from these non-verbal clues.  Similarly these exterior aspects are also reflected on the tongue.  However, the tongue is special because of its immediate connection to the interior of the body.  This gives it a prominent place in Chinese Medicine diagnostics: it tells a practitioner about the state of your blood, fluids, organs (especially your digestion) and disease progression.  This information has been gathered by generations of Chinese Medical physicians over thousands years to produce a window into the body about what is going on. It is another non-verbal clue.

So what I am looking at?

  • The tongue body – the shape, colour and cracks on its surface tell me much about a person’s health.
  • The tongue covering – the coat on a tongue is important too. I look at thickness, colour, texture (dry/greasy) and coverage (are there patches of no cover for example).  Please don’t brush your tongue before your appointment!

What is a normal tongue?

The tongue should be a pale red, without cracks, not too big or small, no teethmarks and with a thin white coat covering the tongue.  When your tongue deviates from the norm, this could be due to disease past or present, your constitution (genetic inheritance) and lifestyle.  This includes your emotional life.

Commonly Seen Tongues

I see a lot of tongues indicating digestive problems.  A consequence of poor eating habits (eating late at night, eating in a hurry, eating while working) and poor diet.  A typical Chinese diagnosis is Stomach Yin Deficiency in these cases. Such people need to avoid fried foods, hot spices, caffeinated drinks and alcohol, which have a drying effect, besides reviewing their eating habits.  The symptoms of this pattern include constipation, dry mouth and throat, and thirst.

When the Chinese Stomach is not functioning correctly there is no coating on the tongue (I say Chinese Stomach as the functions and pathology are broader than our understanding of the stomach organ).  There are some intermediate stages before reaching a full-blown deficiency though.  At the beginning the coat will look as if it is resting on the tongue and not connected and then as this develops a tongue will start to lack a coating in patches.

This is a tongue with a patchy coating.

Another sign of stomach disharmony is a Stomach crack (or cracks) on the tongue. However, Stomach cracks may indicate a constitutional tendency to digestive upsets rather than the actual pathology.

The tongues below illustrate Stomach cracks.

cracked tongue

This final tongue shows an extreme form of Stomach heat developing from the redness of the tongue. As you can see, this is in addition to lacking a coat and cracks.

empty heat tongue

The signs of the tongue must be taken together with all others as part of the initial consultation. The tongue can sometimes contradict other signs and symptoms, so in Chinese Medicine, we must have a number of signs to establish a firm diagnosis.

Obviously, any treatment in this case must include also a change in eating habits. This can be the most difficult aspect of the treatment for people to follow. I offer home care advice about foods that such clients should eat more or less of based on Chinese Medical principles. However, these can be difficult to follow without support and so often I will refer such clients to a nutritionist.