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Treatment Techniques

Tongue Diagnosis

An excellent overall general reference book on Traditional Chinese Medicine and meridians is “Between Heaven and Earth” by Harriet Beinfield and Efrem Korngold. It has a brief, but good, section on tongue and pulse diagnostics. It is not that expensive, either, running roughly $16 or less new and about $7 or so used through Amazon.

Another very good one is “The Web That Has No Weaver” by Ted Kaptchuk. It is a bit more expensive at around $21 new and $10 used. Of the two, I would recommend “Between Heaven and Earth” as the better choice for your question.

On the other hand, if you ever get a chance to pick up a used copy of the first edition of “The Web That Has No Weaver,” it is WELL worth adding to your reference library because it is hugely superior to the revised, second edition. Very large sections of, shall we say, “diagnostic” information was left out of the revised version. I have copies of both editions myself and there is no comparison between them.

At any rate, here is a brief synopsis of what “Between Heaven and Earth” says about the tongue.

“The tongue is characterized by its color, texture, moisture, size, and shape. A healthy tongue fits comfortably in the mouth and is smooth, moist, bright, pink, and firm, with a thin white fur that covers the upper surface.

Changes in the body of the tongue generally reflect long-term dysfunction of the viscera, whereas changes in the fur reflect short-term disturbances of digestion, fluid balance, and heat regulation.

In acute conditions such as a cold or flu, the tongue may be red at the tip with a yellow or white fur that is thicker than normal. The red tip indicates Heat and possibly fever, and the thickened fur indicates an Adverse Climate such as Cold or Dampness.

An enlarged, pale, and flabby tongue with greasy or cheesy white fur is associated with deficiency and Dampness or excess Moisture. This is characteristic of illnesses such as chronic bronchitis, colitis, nephritis, or a weak and enlarged heart. The thick, wet quality of the fur is a sign of excess Moisture manifested as phlegm in bronchitis, loose, watery stool in colitis, and edema of the feet and hands in heart disease or nephritis.”

There are six “tongue zones” corresponding to Kidney (back center), Spleen (very center), Lung (between the spleen zone and the tip), Heart (very center tip of the tongue), Liver (left and right side edges of the tongue).

The liver zone says “organs and functions in lateral areas of the body between diaphragm and navel including diaphragm, liver, gallbladder, spleen, hepatic and splenic flexures of large intestine; digestion, elimination, detoxification, catabolic metabolism, coordination.”

There is another page or two of additional information in the book but I wanted to at least give you an idea of what is covered.

Now, so you know, the coverage in the book just barely scratches the surface on tongue diagnostics. There are very detailed books available that cover nothing but tongue diagnosis. None of them, however, are cheap, running from the mid $40 range to over $100. But what a skilled Traditional Chinese Medicine practitioner can tell from just looking at someone’s tongue is absolutely amazing at times. Unfortunately, no one becomes skilled at it with just a weekend seminar, or even several weekend seminars. To become truly skilled requires years of practice. Which is why, even though I have had some training in it myself, I don’t do anything with it. I am not proficient enough in it, nor do I ever intend to become proficient enough in it. As appropriate, I will refer clients to someone who is.

Personally, I think there are so many very fine nuances to tongue diagnosis that I wouldn’t even attempt more than a cursory exam myself. I would always seek out a TCM practitioner instead. Another reason is that a good TCM person would not limit themselves to just looking at the tongue. They would add in things like pulse diagnosis as well to get a more complete picture, which is just as fascinating a subject as the tongue.


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