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<ol>index.jpg</ol>The tongue in Chinese Medicine is the single best indicator of your overall health at any given time. Even modern medicine is beginning to recognise the link between tongue appearance and body health state.
The best time to look at the tongue is after you wake up and have been awake for about 15 minutes but have not consumed any food or drink. Of course, you can look at it anytime but you have to consider things you have just eaten or drunk and looking at it in a natural light is best.
The tongue is divided into sections which reflect the various organs in the body, however its important to note that these organ associations are more energetic than anatomic and more related to function than location, so when I say Liver, really this means the liver, and the cumulative effects of the sympathetic and parasympathetic nervous systems, not just the Liver and the same goes for the other organs. Spleen for instance is in reference to the pancreas and does not actually include any of the known functions of the spleen however since these two organs share a blood supply, disharmony in the pancreas can be physically felt in the spleen area, symptoms like bloating and tenderness...
The sides of the tongue are of the liver and gallbladder, the centre the stomach and spleen. The tip relates to the lungs and heart and the kidneys and bladder are reflected at the tongue's root (see attached diagram).
A healthy tongue will be pink in colour with a THIN white coat.
Cracks in the tongue surface indicate disharmony in the organ which is represented by the area through which the cracks travel. This disharmony could be either heat, cold, dampness or dryness depending on the coating and colour of the tongue body.
The width of the tongue must be taken into account. A wide tongue is indicative of heat, fullness or excess. A thin tongue is indicative of dryness, deficiency and consumption but not necessarily cold (cold is usually considered excess unless it is due to Yang deficiency).
The colour of the tongue body represents the thermal nature of the disharmony and can show stasis or deficiency. A pink tongue is one where blood is sufficient to supply the tongue and is moving freely throughout the body. A purple tongue is indicative of stasis of blood which could be produced by extreme heat or trauma or phlegm. A red tongue indicates heat and this may be heat due to excess of deficiency. Tongues which have odd colours such as green or black must be compared with the five element colours of TCM where each organ pair is ascribed an element. For instance the Liver belongs to the element of wood whose colour is green, therefore a green tinge on the tongue might indicate a liver disharmony. This kind of colouring is rare however but black will show up and this can either indicate a water disharmony (kidneys) or extreme heat or cold.
A pale tongue always indicates deficiency, of either blood or qi (vital energy). You must look to the tongue coating to differentiate this. The sides or only the tip may be pale which is indicative of the specific organ being deficient in one of these areas.
The tongue coating is another major factor. A thin white coat is indicative of healthy stomach yin, and stomach yin is considered to be the most effective gauge of the yin of the whole body since the stomach is called the source of the body's fluids (Yin is about fluids, coolness, female energy like the moon whereas Yang is energetic hot and dry like the sun). A thick coating which is white indicates cold or dampness (dampness will appear greasy but cold is drier). A thick yellow coat indicates heat (or again dampness but this will be greasier than the heat on its own). No coat on the tongue or a coat which is rootless (doesn't seem attached to the tongue) or peeling indicates Yin deficiency. A dry coating indicates yin or blood deficiency and a wet coating with a pale tongue indicates qi or yang deficiency (Yang deficiency is more extreme than qi deficiency but has evidence of cold or greater water retention than qi deficiency).
The tongue shape is the final check, does the tongue have teeth marks on the outer edges (dampness)? Is the tongue flexible (good heart spirit, poor heart spirit will display a stiff or rigid tongue)? Can the tongue extend out of the mouth easily (Yang deficiency will have a short tongue, ie unable to be extended out of the mouth)? Is the tongue quivering or shaking (spleen qi deficiency) and is it deviated to one side (sign of wind stroke, potentially fatal episode about to occur, keep an eye out for this one especially if the patient is complaining of strong headaches and has a thick greasy coat on the tongue! Send to an ER..)?
EXAMPLES:
A thin red tongue with no coat which extends out normally... Yin deficiency with heat.
Same tongue but with a thick yellow coating... Yang excessiveness (commonly called Full Heat or FIRE)
Add to either of these a crack in the middle of the tongue and it becomes Stomach yin deficiency or stomach FIRE...
A pale thin tongue which is dry but has a thin white coat... Blood deficiency, Yin ok.
Same tongue but with no coat... Blood and Yin deficiency.
Same tongue but deviated to one side... Blood and Yin deficiency stirring up wind...
I hope that's enough to wet your appetite for tongue diagnosis... obviously there's lots of terms here which might be new or confusing... If your curious, good, let the questions begin! If it's too much information and seems like a mountain too big to even climb then perhaps you might refer to this post another time and see it differently. Perhaps you could look at your own tongue and ask questions to better understand it...
Do bear in mind however that I've started at the end in the hope it might inspire some of you to go to the beginning. Tongue diagnosis is the LAST thing TCM students learn at the end of their first year after learning the functions and classifications of the organs (Yin organs (zang), Yang organs (fu) and extraordinary fu (neither zang nor fu)) and the classification of disease marked against the theories of Yin, Yang, Cold, Heat, Deficiency, Excessiveness, Internal and External and all of the climactic and internal factors (cold, fire, wind, dampness and dryness) and against the principle building blocks (Vital Substances) of the body (Yin, Yang, Blood, Qi and Body Fluids).