Your tongue tells the story of whether your internal organs, the energetic pathways to which they correspond, blood, and fluids are healthy or harboring pathogens. Acupuncturists look at their patients’ tongues to get a good idea of whether there are excesses or deficiencies in strength of the qi, blood, and other body fluids. Along with a pulse and overall visual diagnosis, and discussing symptoms with the patient, we acupuncturists can formulate which organ system(s) need to be balanced through needling or addressed through other accessory techniques.
I often describe the top of the tongue as a "road map" for the internal organ systems in your body - in this sense, discoloration in one area can indicate deficiency in a specific area of the body. For example, redness near the tip can mean heart issues or inflammation. A thick, white coating near the back can indicate sluggish digestion and toxins in the colon.
In a tongue diagnosis, the size, shape, color, coating (texture), and movement are observed to understand what’s happening in the body. Signs of good health are a pale red tongue with a thin and white coating that is moist, but not too wet.
Here are some common symptoms and their meanings:
Size and shape
- Large and puffy or scalloped: dampness, excess fluids
- Small and short: dryness, deficiency in fluids
- Red: excess heat
- Pale: deficiency in qi and blood
- Purple: stagnant qi and/or blood
- Thick: excess heat
- Yellow and thick: damp heat
- Dry and yellow: excess heat
- Peeled or absent: deficient yin
During the course of acupuncture treatments, the characteristics of your tongue should change week to week. For this reason, tongue diagnosis serves as a great barometer for how treatment is progressing. Given time, a consistent treatment schedule, and amendments in diet and lifestyle, your tongue should progress in appearance to reflect your good health.