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May 10, 2012
No Two Tongues Are Exactly Alike: What Does Yours Tells You About Your Health?

The tongue has been considered an important assessment organ for thousands of years. It is rich in vascular, or fluid, supplies; contains the taste receptor cells; and is nourished by both the nervous and circulatory systems. Many trained experts with nothing more than your tongue and a good eye, can diagnose many diseases. What does your tongue look like and what does it tell you about your health?

Click for larger image.

The tongue produces saliva, which contains water, electrolytes, mucus, and enzymes. The salivary chemicals can alter the appearance of the tongue in relation to organic imbalances. Taken together, these uniques attributes of the tongue help a trained practitioner make a contributory diagnosis using the tongue.

The first thing you must know, traditional chinese medicine works on the principle good health is achieved by the proper balance of blood, fluids and energy (known as Qi - pronounced chee) flowing through the whole body. Illness results when any of these fall out of balance or proportion with the others.

Chinese medicine also uses the principles of Yin and Yang, two of the body's forms of life energies. Keeping these two in balance is also part of the daily therapeutic principles.

Everyone's life energies ebb and flow back and forth depending on the multitudes of forces which we are bombarded with on a continuous basis. Your diet, exercise, stress levels, work environment, your physical health and even the choices you make each day during the daily circumstances all vary the balance of emotions, health and well-being on a minute by minute basis. Keeping a good balance therefore through your daily environment yields proper health.

How To Utilize Tongue Diagnosis

During a tongue examination, a practitioner looks at factors including coating, shape, and color before examining specific tongue regions. If there is an anomaly in a certain area, the practitioner pays special attention to the related organ system.

No two tongues in this whole world are exactly alike. Your own changes daily also as circumstances arise which dictates a change in your body's perceptions. The size, shape, color, moisture level and the texture will show a continuous change as different events unfold in your life each day.

A perfect tongue is smooth in texture, it fits comfortably in your mouth between your teeth. It is not too thick or too thin, should have a pretty pink color with a thin white transparent coating.

This description means you are in perfect health. All variations from this means you are having some kind of reaction. Reading and understanding these signs is the art of tongue diagnosis.


Color reflects the stability of the internal organs and blood circulation and provides clues about the strength of a patient’s health. A normal color is light or pinkish red with a slight shine. Color often relates to the functioning of internal organs and blood health, as well as immune health.

A practitioner often searches for pale, red or purple shades. Each has a special meaning, especially in relation to coating. A pale tongue reveals excess cold, for example, if there’s also a thick white coating. This could be a sign of anemia or a weakened body. A red tongue might indicate a yin deficiency if the coating is also thin, absent, or peeling.

Body Color
Pink normal or mild disorder

Pale yang, blood a/or qi def
Deficiency Cold
+ thin & dry = blood def
+ wet = qi def
+ swollen = qi def
+ swollen & wet = yang def

Red heat
+ no coating = yin def empty heat
+ yellow coat = excess heat
+ wet = damp heat
+ dry = injured fluids

Dark Red (Scarlet, Cardinal) extreme heat
more severe conditions than red

Purple stagnation
lv qi stagnation is likely
+ pale = cold

Blue severe internal cold
stagnant blood


A normal tongue is smooth with no cracks, and is not too thick or thin. When evaluating shape, a practitioner might also examine the size of the tongue in relation to the opening of the mouth, looking also for teeth marks, ulcerations, and inflammation. These signs might indicate edema or swelling in the body, as well as nervousness. Shape often indicates the health of the body’s fluids and chi flow. For instance, a swollen or puffy tongue points to a spleen chi deficiency and damp heat, while an elongated tongue might indicate heart heat.

Body Shape
cracked if develops during illness indicates chronic and severe, otherwise normal
location of cracks relates to organ pathology
+ red = empty heat consuming fluids
+ pale = blood & qi def
crack runs from center to the tip = ht disorder or congenital ht problems
horizontal cracks = yin def

deviated (crooked) wind

flaccid deficiency heat
+ pale = blood & qi def
+ dark red = yin collapse

long heat in the ht

rigid stroke or early signs of stroke

short (contracted) serious conditions
blood deficiency
ht deficiency
+ pale or purple = cold or yang def
+ swollen = damp or phlegm
+ red = heat consuming the fluids

stiff heat in the ht
ht/sp heat
phlegm obstructing the ht qi
+ normal & pale = wind, stroke

swollen deficiency
+ pale & wet - yang def
+ teethmarks & pale = qi def or excess fluids
+ dark red = excess heat usually ht/sp

thin blood or fluid def
empty heat consuming fluids
+ pale = blood & qi def
+ red = yin def

thorny (strawberry, granular) heat
congealed blood
+ on tip = ht fire
+ on edges = lv/gb fire
+ on center = st a/or intestines heat

trembling (quivering) wind
+ pale = qi def
+ red = heat producing internal wind



A healthy tongue coating is thin and clear, or sometimes pale yellow with a slightly thicker coating at the back of the tongue. A thick coating usually reflects digestive system problems. Different coating instruct the practitioner on potential maladies. For instance, a yellow, thick, or glossy coating reflects damp heat, along with a candida or yeast infection or a decreased immune system. A peeled or absent coating indicates deficient yin and damaged bodily systems.

Tongue Coat
thin normal
exterior condition, wind-cold

thick excess damp/phlegm
food stagnation

dry heat consuming yin
excess yang or fire
deficiency fluids

moist normal or mild imbalance

wet excess fluids from yang def

sticky (greasy, creamy) dampness or phlegm
retention of food

Coat Coloration
white internal or external cold
if coat looks like cottage cheese = ST heat
+ thin coat & body aches = exterior wind-cold
+ thin coat & thorny = wind-heat

yellow internal or external heat
effected by coffee, tea a/or smoke intake

gray hot or cold internal condition
retention of phlegm heat
+ dry = heat consuming body fluids
+ moist = damp cold

black severe condition involving hot or cold
+ pale = excessive cold from yang def
+ dry & possible thorny = consumption of body fluids

Coat Rooting
moss appears firmly implanted
strong st/sp qi

moss appears to float on the surface
st/sp qi def
peeled sp qi def
deficient yin or fluids


Traditional Chinese Medicine usually distinguish the tongue in three major areas, called Upper Jao (tip of the tongue); Middle Jao (center of the tongue) and Lower Jao (back of the tongue). A further division is as follows (see image left):

  • Green Areas: sides of the tongue. Liver and detoxification system. Changes can indicate high toxicity levels. Darkening can reveal pain and discomfort.
  • Red and Grey Areas: tip of the tongue. Heart and functions of nervous and immune system. Can indicate colds, the flu, sleep issues, and issues in the mental state.
  • Yellow Area: center or the tongue. Spleen. Changes can reveal digestive or absorption issues.
  • Orange Area: back of the tongue. Kidney. Signs can indicate problems in the urinary, reproductive, and elimination systems, as well as adrenal issues or back issues.

Tongue Appearance
Accompanying Symptoms
What It Means
What You Can Do
Too thick with scalloped edges
Lethargy, feeling of heaviness in limbs, lack of motivation
flow of fluids in body off-balanced
Cut down on dairy products and sugar.Eat more of the following: beef and chicken(proteins)
fruits such as coconut, figs grapes, cherries and dates
vegetables such as shitake mushrooms, potatoes, squash and sweet potatoes
lentils and rice for grains
the herb ginseng
Tongue appears too wet
excessive perspiration and phlegm
inbalance of fluids such as too much phlegm or water in the body
Eat more foods which will help you dry the excess fluids:
barley and rye for grains
proteins such as aduki beans, kidney beans, mackerel and sardines
vegetables include corn, mushrooms, celery, onions, turnips, pumpkin, lettuce, radishes, watercress and seaweed
lemons and plums for fruits
herbs to include pepper, garlic and horseradish
Tongue is too thin and very dry
insomnia, dry skin, constipation and stress
dehydrated, body feels over-taxed
Reduce caffeinated products, get more rest. Increase your intake of water. Eat more root vegetables, asparagus and seafood.
Blue/purple areas on tongue
stress, sedentary lifestyle
Liver problems, your blood and energy are not flowing properly
Get moving and stretching everyday. Eat more foods that help promote the movement of qi. Crab for protein
onions, chili peppers, radishes, scallions and carrots for vegetables
herbs and spices include mint, safflower oil, basil, cloves, garlic, cayenne, coriander, marjoram and dill
Tongue too pale/ orange color
fatigue, frequent illness
blood deficiencies, anemia
Eat foods that build your blood and maximize its function: lamb, red meats, sardines, oysters, eggs, kidney beans and liver
add grapes, apricots, dates and figs
green leafy vegetables and spinach
Tongue is swollen and pale
you always feel cold, back aches and knee discomfort
excess of yang
Eat more warming food to increase your yang:
proteins like lamb, lobster and shrimp
raspberries for fruit
walnuts and pistachios
herbs and spices such as basil, chives, dill, garlic, cinnamon, ginger and cloves
no coating or a yellowish coating on tongue
Recent illness, smoking
too much heat in the body, possible infection, too much coffee, not enough rest. A tongue with no coat or a yellowish coat designates a yin deficiency.
Stop smoking. Cut back on caffeine. Eliminate artificial sugar substitutes. Eat cooling foods that nourish your yin:
vegetables like spinach, asparagus and lettuce
fruits like bananas, grapefruit, lemons and watermelon
protein from seafood and egg whites

Marco Torres
is a research specialist, writer and consumer advocate for healthy lifestyles. He holds degrees in Public Health and Environmental Science and is a professional speaker on topics such as disease prevention, environmental toxins and health policy.



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