In my practice, along with a full interview and medical assessment, tongue diagnosis is one of the main tools I use to understand my patients’ state of health. Most patients are embarrassed to stick out their tongues or they wonder what I am doing staring it. So I am going to educate you on what I look for by observing the tongue and how the tongue is used as a gateway to your health.
Tongue diagnosis has been used for thousands of years in Traditional Chinese Medicine. In TCM, the tongue is known as an internal organ that you can see from the outside. Therefore, it is a great diagnostic tool to understand the health of the internal organs as well as the overall health of the human body.
In Chinese Medicine, the tongue is divided into different organ systems. Geographically, the center of the tongue is the digestive system or spleen and stomach region. The back of the tongue is the reproductive system or kidney region. The sides of the tongue are the liver and gallbladder region and the upper region and tip of the tongue are the lung and heart organ systems.
In observing the tongue, the first thing I look at is the shape. There are many different shapes that indicate different symptoms. To name a few, a quivering tongue can mean energy deficiency of the spleen or digestive system. A hammer shape tongue can indicate emotional disorders and an enlarged tongue may indicate digestive system issues.
The coat of the tongue tells about the fluid physiology of the body. A thin coat or lack of coat can suggest a lack of fluids in the body, as seen in insomnia, anxiety, and menopause. A thick coat can be seen in such disorders as depression, ovarian cysts, fatigue, fibromyalgia and headaches.
Cracks in the tongue can indicate dryness or blood deficiency. Disorders seen with a cracked tongue are skin or vaginal dryness, shortened menstrual flow, poor memory, insomnia and PMS.
Scallops, which are crevices on the sides of the tongue, can indicate digestive system issues, edema or fatigue.
A Case Study Using Tongue Diagnosis
41-Year-Old Female With Anxiety
This is a case study of a patient that came in with a chief complaint of anxiety. She was consistently worried and cried very easily. Other symptoms were insomnia and a poor memory. She also complained of always being tired. As I observed her tongue, it appeared small and pale with cracks in the center as well as scallops on the side of the tongue.
Her diagnosis in Chinese Medicine was anxiety due to heart blood and spleen qi deficiency. The first thing to notice in this case was the size of the tongue, which was small. This indicated there was not enough blood to fill the tongue. Supportive evidence of blood insufficiency was also seen in the central cracks of the tongue. The paleness of the tongue indicated both a blood and energy deficiency. The scallops indicated extra fluids in the body due to a weak digestive system, which is due to a spleen qi deficiency.
The physiology behind her tongue diagnosis was her spleen, which is one of the main organs in the digestive system. Because the spleen is one of the main organs that nourish energy, fatigue appears when it is weak. When the spleen is deficient it cannot properly produce sufficient blood to the heart and therefore, when the heart is not properly nourished anxiety and insomnia are present. Using my diagnosis I treated her with acupuncture and an herbal prescription called Gui Pi Tang as well as gave her some dietary recommendations to follow.
The outcome was that she felt more willpower and was not constantly worried all the time. She felt more centered and she had a dramatic increase in energy. As a result, her tongue body began to change. It became more pink and enlarged. Her skin tone was not as pale and she had a better overall complexion. This is an example of how tongue diagnosis reflects the overall health of the body and can be used as a diagnostic tool when treating a patient.