Tongue Diagnosis in Traditional Chinese Medicine

"Tongue diagnosis" is a practice long used in traditional Chinese medicine (a system of alternative medicine that originated in China). According to the principles of TCM, analyzing the appearance of an individual's tongue can provide a greater understanding of his or her overall health.

Once a tongue diagnosis is completed and other aspects of the patient's health are evaluated, the practitioner may recommend treatment with such therapies as acupuncture, acupressure, herbal medicine, food therapy, and massage.

Girl Sticking Out Tongue
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How a Tongue Exam Can Assess Health

In TCM, it's thought that different areas of the tongue reflect the health of five corresponding organ systems: liver, lung, spleen, heart, and kidney.

TCM is based on the theory that all of the body's organs mutually support each other and that – in order to achieve optimal health – an individual's organs must be in balance.

Although it's been used in TCM for many years, tongue diagnosis and its validity as a medical assessment tool haven't been thoroughly explored in scientific studies.

Still, preliminary research suggests that tongue diagnosis shows promise as a means of evaluating certain measures of health in patients with conditions like rheumatoid arthritis and breast cancer.

Tongue diagnosis should not be used as a substitute for standard medical care or to diagnose potential health problems.

Factors of a Tongue Assessment

During tongue diagnosis, TCM practitioners usually examine the tongue coating, shape, and color. Tongue diagnosis also involves examining specific areas on the tongue. Here's a look at how these issues are addressed in a typical tongue diagnosis.


A light red color indicates that an individual's vital energy (also known as "qi") is strong. Changes in tongue color, meanwhile, are said to signal chronic illness.

For example, pale coloring in the tongue is thought to indicate an issue with the pancreas and/or digestive function, while purple coloring is said to arise from blockages in the flow of Qi.


Normal tongue shape is neither too thick nor too thin; the tongue body is smooth with no cracks. In general, changes in tongue shape are thought to reflect chronic illness affecting the blood, bodily fluids, or qi.

Changes in tongue shape may include a swollen or puffy tongue (said to be another indicator of problems with the pancreas and/or digestive function), cracks in the tongue (a possible sign of imbalance in the heart organ, an issue associated with insomnia and memory troubles), and curling at the sides of the tongue (thought to indicate liver qi stagnation).


Although the tongue coating is usually thin and white, a pale yellow and slightly thicker coating at the back of the tongue may also be normal.

In addition to reflecting the health of the spleen and stomach, tongue coating also provides an indication of acute illness (such as colds). For instance, a peeled or absent tongue coating may result from kidney yin deficiency, an issue associated with conditions like low back pain and tinnitus.


Here are some key points to keep in mind if you're thinking of undergoing a tongue diagnosis.

  • Some disorders don't show up on the tongue. It should also be noted that TCM practitioners do not rely on tongue diagnosis alone in evaluating a patient's health.
  • In most cases, the tongue is examined for no longer than 15 seconds at a time. Extending the tongue for longer may cause changes in tongue shape and color (two crucial elements of tongue diagnosis).
  • Before receiving a tongue diagnosis, you should avoid food and beverages that might discolor your tongue (including coffee, beets, and foods made with artificial food coloring). Consumption of vitamin C may also affect your tongue coloring.
  • If you use a tongue brush as part of your oral hygiene routine, discontinue use of the brush for at least a full day prior to your tongue diagnosis.

If you have any symptoms or health issues that are concerning you, it's important to see your primary care provider. Avoiding or delaying standard care can have serious consequences.

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  1. Lo LC, Cheng TL, Chiang JY, Damdinsuren N. Breast cancer index: a perspective on tongue diagnosis in traditional chinese medicineJ Tradit Complement Med. 2013;3(3):194‐203. doi:10.4103/2225-4110.114901

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