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Let Me See Your Tongue

The traditional Chinese medicine diagnosis

By Diane Sheppard, Ph.D., L.Ac.

One of the most commonly used methods of assessing a patient’s condition in Traditional Chinese Medicine (TCM) is tongue diagnosis.  I keep a chart showing different tongues in the lobby of our clinic and patients often ask why it is so important.

In TCM, your tongue is a reflection of what is going on inside your body. The tongue is a copious flow of blood, electrolytes, mucus, and enzymes. It is a very sensitive organ and its appearance changes with physical changes in the body, so much so that in Chinese medicine, the tongue is considered a “map” of the internal body. TCM divides the tongue into five zones that correspond to the five internal organ networks – heart, lungs, spleen/stomach, kidney/bladder/intestine, and liver/gallbladder. These also correspond to the meridians used in acupuncture.

When we ask you to stick out your tongue, what are we looking for? First is color. A healthy tongue is light red with a thin white coat and has a moist luster. Tongues can be bright red, pale or purple and even blue. The tip can be red and the body can have spots or papillae. Next is shape.  Is it thin, thick, wide, short, long, pointed or rounded? Is it flabby or have tooth marks or scalloped edges?  Does it quiver or is it deviated (crooked), or swollen in one area?  Are there any cracks?  Finally, there is the coating.  Is the tongue wet, greasy, dry or lightly moist? The coat can also be thick or thin, white or yellow, can be smooth or look like cottage cheese, or can appear to have no coat.

A practitioner may also lift the tongue to see whether the underside has large or small veins and the color of those veins.

A few of the more commonly seen conditions include a thick, pale tongue that is swollen with scalloped edges, which indicates cold dampness within the body. This tongue is often associated with symptoms like loose stools, bloating, fatigue, cold, and excess worry. If this is what your tongue looks like, you should emphasize warming foods and herbs such as soup, lamb, beef, leeks, nuts, fresh ginger, rosemary, and cinnamon, along with moderate amounts of wild and basmati rice, barley, buckwheat, rye, and amaranth to drain dampness from your system.  Avoid foods that enhance cold in the body such as those eaten straight from the refrigerator, such as ice cream, bananas, cold drinks, grapefruit, watermelon, sour food, and raw vegetables.

A red tongue with a yellow greasy coating is related to damp heat and can show up in irritability, rashes or pimples, easy sweating, thirst, and constipation or smelly stools.  If your tongue looks like this you should avoid spicy, rich and greasy foods, alcohol, sugar, and limit your meat consumption. Instead eat poached or grilled fish, steamed vegetables, turnips, artichokes, salads, seaweed, wild rice, watermelon, cucumber, and asparagus. Drink dandelion and/or detox teas.

Of course, there are many combinations of color, shape and coat, with different appearance on different parts of the same tongue.  TCM practitioners can use these factors to not only diagnose imbalances, but to direct treatment which may include dietary changes, acupuncture and herbs. So that is what we are doing when we ask you to stick out your tongue.

Diane Sheppard is the founding owner of AcQpoint Wellness Center. She is a licensed acupuncturist with a Ph.D. in Oriental Medicine and can be reached at (760) 775.7900. www.AcQPoint.com.

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