What's Tongue Diagnosis in TCM and Why?


Observing and interpreting the signs offered by the tongue is one of the more important diagnostic tools in Chinese medicine. The tongue, like other body parts such as the hands, feet and ears, is a hologram of the body. As such, the tongue can reveal the depth and nature of any imbalances and can also be used to gauge the process of recovery. In Chinese medicine, the tongue is divided into five-element zones that correspond to your internal organ networks. 

1. Tongue tip
The fire element zone, which corresponds to the heart-small intestine network, is located at the tip of the tongue. This includes matters of the heart, both emotions and the physical health. In Chinese medicine, the spirit is said to reside in the heart network. Stress and anxiety will show up as red color and red dots on the tip of the tongue. Increasing heat signs means hyperactivity in the heart network due to stress and tension. 

2. Sides of your tongue
The sides of your tongue display the wood element. Teeth markings on the sides of the tongue usually mean stagnant energy in the liver network. You may also notice a bluish-green or purplish hue or spots in this zone. Dark spots may indicate more serious problems. On several occasions, we've noticed purple spots in the wood zone in patients that suffer from low energy, discomfort, distension around the lower ribs, and swelling in the abdomen.  

3. Behind the tongue tip
The band-like area across the tongue and just behind the tip is the metal element zone, which corresponds to the respiratory and the immune systems. When this area turns reddish, or when red pin-sized dots occur, it usually means a respiratory infection is on its way or is settling into the body. Paleness in the metal zone may reflect a weakened immune system. In rare fungal infections of the lungs, there may appear a brownish black coating over this zone, which was the case with several of my patients who suffer from lesions in their lungs. 

4. Center of the tongue
This area is the earth element zone, and it is related to the stomach-spleen-pancreas network. Problems of the digestive system most often show up here in the center of the tongue. G.E.R.D. -- stomach and esophagus acid reflux that keeps many people awake at night -- may be seen with redness and a yellowish coating in the center of the tongue. Subtle changes in this area may indicate digestive problems that have not surfaced yet; observe this area and take prophylactic steps if necessary. 

5. Back of your tongue
The back of the tongue reflects many of the body's functions, but is mainly the domain of the water element, or kidney-bladder network, which includes the hormonal system and sexual glands. The two large, elevated papilla on the back of the tongue are a normal part of the taste buds. What you should look for is color and coating. For example, when we see a thick yellow coating at the back-center of the tongue in the female patients, we know that they are very likely to get a bladder infection. We tell them to immediately start drinking 8 to 12 glasses of filtered water a day, take 5,000 mg of vitamin C, and to drink cranberry juice or take its extract -- this regimen will typically help prevent a bladder infection.



In TCM, the tongue has many relationships and connections in the body, both to the meridians and internal organs. It is therefore very useful and important during inspection for confirming TCM diagnosis. It can present strong visual indicators of a person's overall harmony or disharmony. The top value of tongue diagnosis is to help identify syndromes and determine treatment. 

For your free consultation, please send the picture of your tongue by email OrientalAcupuncture@outlook.com or Jarry@OrientalAcupuncture.ca
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