How to Read Your Tongue: Shape (Including a Quivering Tongue), Size, Color and Coat
Tongue Shape
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.
Tongue Size
The size of the tongue can indicate if there is a deficiency in blood or fluids in the body, which can be seen in insomnia, anxiety, and headaches.
Tongue Color
The color of the tongue indicates if there is heat, a deficiency of yang, or stasis and stagnation in the body, which can indicate pain, menstrual cramps or irritability.
- Pale: often points to Blood or Qi deficiency, with tiredness or a pale complexion.
- Red: suggests heat, which may show up as feeling warm, thirst or restless sleep.
- Purple or dusky: suggests stagnation, often seen with pain or painful periods.
Tongue Coating
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.
Cracked Tongue and Qi Deficiency Tongue in Chinese Medicine: What Cracks and Scallops Mean
A Case Study Using Tongue Diagnosis for a 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, part of our Chinese herbal medicine in NYC, 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.
Tongue diagnosis is part of every visit for traditional Chinese medicine in NYC at Sage Wellness. To learn how the whole system fits together, read what is Traditional Chinese Medicine.
Frequently Asked Questions
What does a cracked tongue mean in Chinese medicine?
Cracks usually point to dryness or a lack of Blood or yin. A crack down the center is often linked to the Stomach and digestion, while many small cracks suggest dryness more generally.
What does a scalloped tongue mean?
Scalloped edges, or teeth marks on the sides, usually point to Spleen Qi deficiency, often with fatigue, bloating or loose stools.
What does a healthy tongue look like?
A healthy tongue is pink, moist, a normal size with no teeth marks, and has a thin white coating.
When is the best time to look at my tongue?
In the morning in natural light, before eating, drinking coffee or brushing your tongue, since all of these can change its color and coat.
SAGE WELLNESS · FINANCIAL DISTRICT, NYC
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