“Do you really look at people’s tongues?”
Yes, not always but when I need a clearer picture of what is happening the tongue offers additional information. The tongue is a muscle and by the miracle of evolution, it's the one muscle we can see without it being sheathed by skin. It’s the start of our digestive tract, it reflects the health of the body’s ability to nourish itself plus so much more. Having visual access to one muscle like this gives Chinese medicine practitioners a world of information. So, to take some of the mystery and skepticism away from this ancient diagnostic method here is a simple breakdown of some of the things we look for.
To start, there is a universal way of interpreting what is seen on the tongue. I will not be going over that because there is an incredible amount of detail and reasoning that is difficult to explain to an audience not versed in Traditional Chinese Medicine theory. But my hope is to give examples of what a tongue can show and what we could see.
Body Shape
The tongue's body changes along with our physiology. It reflects the tone of the person’s muscle and can reflect things like dehydration, edema or various deficiencies. An example would be a puffy tongue showing fluid metabolism issues, spleen qi xu, which could look like edema, weight gain, or digestive problems. While a tongue body that is thin and withered can show a lack of nourishment, either by blood, qi, yin, nutrients, etc.
Color
Healthy red, pale, dusky, purple, red, black… all are possible colors of the tongue! The goal is to have a healthy fleshy red tone that borders on pink. Pale shows deficiency, red shows signs of heat, and purple reflects blood stagnation.
Coat
The tongue coat says more than you would expect. It can vary from being thick to nonexistent, yellow to white in color, it could have cracks in it, portions that are peeled off exposing the tongue below it and it can vary in thickness from front to back. A healthy coat is thin, white, and consistent across the entire tongue surface.
Sublingual
The underside of the tongue has sublingual veins. We look here to search for signs of stagnation in the body. The more stagnation the more engorged and blue the sublingual veins will be. We also look at how much of the vein is engorged, from base to tip or just part way? This is a good place to track progress in those with chronic pain due to blood stagnation.
Organ Map
Various locations on the tongue are associated with specific organs. And yes, your tongue does tell us what is going on with those organs when we look at it. Got a red tip? Could be heat in the heart. Have a crack in the center of the tongue? Well, that could reflect something happening with your digestion, perhaps yin xu.
To me what is most important is tracking the process of the tongue over time. Changes will appear which helps me know if we are headed in the right direction. There’s a lot more that we look for, such as bumps, symmetry, indentations, etc. but maybe I’ll cover that another day.
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