Tongue Diagnosis

tongue diagnosis Tongue diagnosis in Traditional Chinese Medicine (TCM) is an indispensable guide in differentiating syndromes. All the meridians of the viscera connect directly or indirectly with the tongue. And remember, the heart opens to the tongue.

The advantages of the tongue diagnosis are:

  1. The tongue body color almost always reflects the true condition of the patient. The tongue cody and coating are unaffected by short-term events or recent changes.
  2. The tongue appearance monitors the improvement or decline of the patient's condition.
  3. The correspondence of different areas of the tongue to specific organs are in general agreement for a change.
  4. The diagnosis is objective compared with the many variations of the pulse and the pulse taker.
  5. Finally, it's easy and will help you in understanding your own health.

We will observe in detail: color, shape and coating.

  1. Color
    Normal-pale/red and moist
    Pale-indicates deficient Yang and Blood
    Red, deep red indicates a degree of heat
    Purple/blue indicates a statis of blood - reddish from heat and bluish from cold
  2. Shape
    This includes consistency, texture and motility. It reflects deficiency or Excess, the state of the organs, Qi and Blood. We will look at thin, swollen, stiff, flaccid, long, short, cracked, quivering and deviated.
  3. Coating
    The tongue coating is a physiological by-product of the Stomach digestion of food and fluids. In TCM, digestive function depends on Spleen transformation and transportation of food and the Stomach's (origin of fluids) fermenting and ripening the food. In the process, residue reaches the tongue. The moisture, wet or dry, on the tongue shows the state of the Body Fluids. The tongue coating color shows the presence, absence and strength of a pathogenic factor.
    White - cold pattern
    Yellow - full heat
    Grey/black - extreme heat and cold

Tongue Diagnosis, Theory of Oriental Medicine

  1. Tongue diagnosis is an example of Traditional Chinese Medicine (TCM) external observation of internal processes.
  2. To fully understand the tongue diagnosis, knowledge of the Eight Principles: Yin and Yang, Internal and External, Excess and Deficiency; and Hot and Cold are necessary.
  3. The tongue body and coating are affected mostly by short-term events, changing constantly.
  4. A blue tongue and face is normal for a pregnant woman, showing there is activity in the womb.
  5. A normal tongue has a medium white coat and is very red.
  6. The shape is not as important as the coating.
  7. The coating is a physiological by-product of the digestion of food and fluids depending on the Spleen for transportation and the Stomach for ripening the food.
  8. The tongue observation is a very precise indication of the source of the larger problem that the patient has.
  9. The most important aspects of the tongue are the color, shape and coating.
  10. The external factors of food, drugs and self-care can also influence the tongue color and coating.
  11. The centre of the tongue indicates the most about the digestion history of the patient.
  12. To understand the state of the heart, look way back at the root of the tongue for redness.
  13. If the tongue is very pale, it indicates a very high fever is imminent and the coating would be white.
  14. The sides of the tongue are swollen, with crevices and red, indicating frostbite on the extremities.
  15. The tongue is a reddish purple especially around the tip, you question the patient further about his/her cardiac history.

Pulse Diagnosis

pulseAlong with inspecting (conducting a general observation of the patient), auscultation and olfaction (i.e., listening and smelling), and questioning (obtaining information about a patient's medical history and symptoms), pulse diagnosis is considered an essential part of the practice of traditional Chinese medicine. It has been practiced in both China and Japan for centuries, and while it is difficult to master and considered somewhat subjective by physicians in the West, it remains an important diagnostic tool by both TCM practitioners and patients.


While the first use of pulse diagnosis in traditional Chinese medicine remains unknown, one of the earliest references to pulse diagnosis appears in the Huangdi Neijing, also known as The Yellow Emperor's Internal Classic or The Yellow Emperor's Classic of Internal Medicine. A passage in the book notes that, “In diagnosis, observation of the spirit and facial color, and palpation of the pulses, are the two methods that were emphasized by the ancient emperors and revered teachers,” which implies that the practical use of pulse diagnosis existed long before the Huangdi Neijing was written. Other passages in the book provide information on certain types of pulses and their relation to particular diseases.

Another important work that explored the use of pulse diagnosis is the Mai Jing, or Pulse Classic, which is believed to have been written by Wang Shuhe, a Chinese physician who lived in the third century A.D. The Mai Jing expanded on the information contained in the Huangdi Neijing, and included a wide range of applications for pulse diagnosis, along with prognoses and ways to analyze diseases based on the type of pulse a patient demonstrated.

Why Does a Practitioner Take the Patient's Pulse?

In traditional Chinese medicine, pulse diagnosis is used to check a variety of functions. Primary among these are the condition of the patient's blood and qi, an invisible type of life force or energy that travels through the body's acupuncture meridians. Using pulse diagnosis, an acupuncturist can determine areas of the body that may have disruptions or blockages of qi, and may also be able to determine the condition of certain internal organs.

Taking the Pulse

taking pulseOver time, a variety of locations have been used in the process of pulse diagnosis. Originally, pulses were felt at nine locations, three on the head, three on the hands, and three on the legs. Some practitioners still examine the pulse at these locations, along with other pressure points along the body.

In modern times, however, the majority of practitioners perform a simplified version of pulse diagnosis. This simplified version focuses on the radial artery above the wrist, examining three finger positions (cun, guan and chi), and felt at three depths (superficial, intermediate and deep). Both wrists are palpated, one wrist at a time. The results of these readings are used to categorize a patient's pulse.