May I See Your Tongue, Please?

by Johanna Utter, L.Ac., FABORM

May I See Your Tongue, Please?, Johanna Utter, L.Ac., FABORM in Davis, CA

"May I see your tongue, please?"

Have you ever wondered what I’m looking for when I ask to see your tongue? In Chinese medicine, the tongue is thought to be like a map showing the health of the body, similar to foot or hand reflexology charts where different areas correspond with different parts of the body. When looking at the tongue, It’s best to view it in natural light, if possible. I need to look at it relatively quickly, because the tongue body will start to become more reddish-purple the longer that it is stuck out.

So, what exactly am I looking for? I am assessing the color, size, and shape of the tongue body, as well as the color, thickness, and distribution of the tongue coating. A normal tongue is pink (or light red), with a thin, white coating.

What does it mean if your tongue doesn’t look like that? Some variations indicate a condition affecting your whole body, while others may just be associated with a particular are of the chart.

For example, the tip corresponds with the chest (Heart and Lungs), the center part with the middle of the abdomen (Stomach and Spleen), the back corresponds with the lower abdomen (Kidneys and Intestines), and the sides correspond with the Liver and Gall Bladder. All of these organ names refer to the understanding of functions of organs and channels within Chinese medicine, not necessarily their Western anatomical counterparts.

Tongue body colors might be: pink or light red (normal), pale (deficiency), red (heat), or purplish (stagnation). A red tip is often associated with poor sleep, although it may also be due to heat damage to the Lungs from an illness or smoking. Sometimes there are raised red or purplish dots, which shows that there is more longstanding Heat or Stagnation.

Tongue coating that is thick usually indicates Dampness, often caused by a weak digestive system. A yellow coating indicates Heat, a “map” or “geographic” coating or no coating can mean a lack of fluids in a particular part of the body. A gray or black coating that is not due to a medication, such as Pepto Bismol, indicates a more serious problem.

Tongue shape: thin can mean a lack of fluids, swollen can be excess Dampness, toothmarks can either be from Dampness or a deficiency. Shaking indicates Wind, but can also show up with anxiety. Some cracks are congenital, but generally cracks indicate a more chronic lack of fluid.

Some practitioners also look for sublingual veins (swollen veins on the underside of the tongue.) The more prominent the veins, the more longstanding the stagnation.

The tongue is just one part of the diagnostic process. I put together my observation of all the different parts of the tongue: body color and shape/size, coating, and sublingual veins, along with what I observe about a person's overall physique, what I feel in the pulse, and their responses to my questions to form a diagnosis. Although Chinese medicine uses some very basic tools of assessment, they are based in thousands of years of empirical evidence.

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