What Acupuncturists observe in a tongue

Observing the tongue and taking the pulse are two of the most common diagnostic techniques in Chinese medicine.

Why look at the tongue?

Chinese medicine uses diagnostic approaches, like the tongue and the pulse, because they reflect the imbalances that are causing your health problem.

What are we looking for in the tongue?

When I am looking at the tongue, I am looking at the the color of the tongue, the size and shape of the tongue body, and the coating on top of the tongue.

If the tongue is very red, or very pale that can show there is heat, or qi deficiency. If the tongue body is purplish, it can show stagnation, a lack of circulation in the body’s channels.   If the tongue coating is very thick and white, it can be dampness.  But if the tongue coating is yellow and sticky, that can signal intense heat.  If the tongue is very red and there is very little tongue coating, then the heat has damaged the fluids in the body.

The size of the tongue can differ as well.  A common tongue sign is called toothmarked, where the sides of the tongue almost look like they have teeth marks in them.  The tongue body can also be cracked, which can show too little yin.

Eczema: A clinical example of the holistic diagnosis

The information from the tongue is not taken in isolation, but rather combined with other techniques, such as the pulse, asking questions, and in the case of eczema, observing the skin.

When it comes to eczema, looking at the skin is very important.  If the skin is very red, irritated, dry, and itchy, then it is probably caused by heat.  We then look at the tongue.  If the tongue is red with a sticky yellow coating, then it is certainly excess heat causing the eczema.  The herbs and acupuncture are focused clearing heat.

But if the tongue is pale and large, with a thick white coat, then it may be heat mixed with qi deficiency, or lack of energy. The herbs and acupuncture would have to also address the underlying lack of energy.

Read more on Acupuncture for Eczema

• Chinese herbs for Winter Eczema: A Success Story
• TCM Treatment for Dyshidrotic Eczema
• Personalized Acupuncture and Herbs for Eczema

Photo: Mike Burns