tongue-syndromesA healthy tongue body is pink. In Traditional Chinese Medicine (TCM) the tongue body represents the yin organs, blood and nutritive qi (ying qi). Examples of a tongue that has lost it’s healthy qi (zheng qi) include a tongue that is: pale (qi or blood deficiency); pale sides (liver blood deficiency); red with purple spots (heat with blood stagnation); red center (stomach heat);  blue center, slippery and greasy (damp phlegm accumulation). These are just examples, there are many other patterns.

The tongue shape reflects the overall condition of the yin organs, blood and nutritive qi (ying qi). The shape of the tongue should be suitable to the mouth size (not too puffy or narrow). Examples of tongue shapes include: thin, red and peeled (yin deficiency); swollen (spleen yang deficiency); stiff (liver wind); flaccid (deficiency body fluids); short, pale and wet (interior cold); cracks (yin deficiency); teeth marks (spleen deficiency). These are just examples, there are many other patterns.

Tongue coating reflects the state of yang organs. The tongue coating is the layer over the tongue. A normal healthy coating should be white, thin, and allow the tongue body to be seen through the coating. The moisture of the tongue reflects the condition and transport of body fluids. Normal coating is slightly moist. If fluids become deficient the tongue will dry out. Tongue coating color shows the relative heat and cold of the condition and the severity of the pathogen. The thickness of the coating is relative to the amount of the pathogenic factor present. Increasing thickness means the pathogen is going deeper whereas the change from thick to thin reveals an improvement. Examples of different tongue coatings reflecting weak zheng qi include: yellow (heat); watery (yang deficiency); sticky and clear (phlegm damp retention); foul breath (heat); foamy (wind). These are just examples, there are many other patterns.

As for the tongue movement, when the zheng qi is healthy the tongue moves smoothly in and out. Examples of unhealthy movement include flicking the tongue out quickly (heat signs) and quivering (spleen qi deficiency). There are other movement patterns as well.

Different regions of the tongue are related to different parts of the body, internal organs and channels, for example: The tip of the tongue or “upper jiao” is related to the heart and lungs. The sides of the tongue are related to the liver and gallbladder. Middle of the tongue or “middle jiao” is related to the digestion system, stomach and spleen. The back of the tongue or “lower jiao” is related to the kidneys, urinary bladder and intestines.

When a practitioner of TCM looks at a patient’s tongue he/she is looking at many things such as the tongue body, shape, movement, coating as well as the yin and yang organs reflected on the tongue. Tongue diagnosis in TCM is comprehensive and much information can be gathered from it such as the degree of the pathogenic factor and the state of the organs as well as pregnancy issues.

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