By Maoshing Ni, L.Ac., D.O.M., Ph.D.
Wonder if you're coming down with a cold? Stick out your tongue and say "Ah!" Or at least give it a
glance. Your tongue is one of the easiest ways to check in with your health status. I recently
posted a blog about how to read your face to determine the condition of your health. The tongue is
such an important diagnostic tool for Chinese medicine practitioners that it merits a full article.
How Chinese medicine uses the tongue to interpret your health
The tongue is one of the most important diagnostic areas in ancient medical traditions. What makes the
tongue such a great diagnostic tool? Your tongue, containing water, electrolytes, mucus, and enzymes, is a
very sensitive organ and its appearance changes with many physical changes in the body. In Chinese
medicine, the tongue is a "map" of the internal body. Like the face, the tongue is divided into
five-element zones that correspond to your internal organ networks.
Get in front of the mirror and look at your tongue right now. The tip exhibits the fire element;
behind the tongue tip is the metal element; both right and left sides the wood element; in the
center towards the back is the earth element; and the very back of your tongue is the water element.
Now that you know what element is where, how do you translate what your tongue is telling you?
Signs and symptoms
Here is what you want to see: A normal tongue should be pink, muscular without tooth marking or
discoloration, and have a very thin clear coating that exhibits proper salivary secretions. Monitor
your evolving health level by noticing color, shape, and coating changes in specific zones.
When the color becomes deeper -- going from pale to scarlet to purple -- it means that
there is increasing heat in the body. Heat may mean inflammation, infection, or hyperactivity of the
organ network. When the tongue's color becomes lighter -- from pink to pale to paper white -- it
indicates cold, which can mean anemia, pathogenic cold factor, or low energy and function of the
corresponding organ network. I treat patients with low immune system function, sometimes due to
chemotherapy or chronic fatigue syndrome, and many of them exhibit a pale tongue indicating low
The thickness and color of the coating, or a lack of coating, can indicate different
issues. When the coat of your tongue becomes thick, it is frequently a sign of imbalance in the
digestive system. When the coat turns thick and cruddy, it generally points to decreased immune system
with Candida (yeast infection). When the coat turns yellow, it often signals infection or inflammation
in the body. A peeling coat is usually a sign of damage or weakening to certain systems of the body.
You can further diagnose underlying problems by analyzing the regions of your tongue; these show you
which organ network is affected.
1. Tongue tip
The fire element zone, which corresponds to the heart-small intestine
network, is located at the tip of the tongue. This includes matters of the heart, both emotions and
the physical health. In Chinese medicine, the spirit is said to reside in the heart network. Stress
Anxiety will show up as red color and red dots on the tip of the tongue. Increasing heat signs
means hyperactivity in the heart network due to stress and tension.
2. Sides of your tongue
The sides of your tongue display the wood element. Teeth markings on
the sides of the tongue usually mean stagnant energy in the liver network. You may also notice a
bluish-green or purplish hue or spots in this zone. Dark spots may indicate more serious problems. On
several occasions, I've noticed purple spots in the wood zone in patients that suffer from low energy,
discomfort, distension around the lower ribs, and swelling in the abdomen. I immediately sent each of
them to see a hepatologis -- a liver specialist -- who, unfortunately, confirmed either liver cancer
or cirrhosis in seven out of ten cases.
3. Behind the tongue tip
The band-like area across the tongue and just behind the tip is
the metal element zone, which corresponds to the respiratory and the immune systems. When this area
turns reddish, or when red pin-sized dots occur, it usually means a respiratory infection is on its
way or is settling into the body. Paleness in the metal zone may reflect a weakened immune system. In
rare fungal infections of the lungs, there may appear a brownish black coating over this zone, which
was the case with several of my patients who suffer from lesions in their lungs.
4. Center of the tongue
This area is the earth element zone, and it is related to the
stomach-spleen-pancreas network. Problems of the digestive system most often show up here in the
center of the tongue. G.E.R.D. -- stomach and esophagus acid reflux that keeps many people awake at
night -- may be seen with redness and a yellowish coating in the center of the tongue. Subtle changes
in this area may indicate digestive problems that have not surfaced yet; observe this area and take
prophylactic steps if necessary.
5. Back of your tongue
The back of the tongue reflects many of the body's functions, but is
mainly the domain of the water element, or kidney-bladder network, which includes the hormonal system
and sexual glands. The two large, elevated papilla on the back of the tongue are a normal part of the
taste buds. What you should look for is color and coating. For example, when I see a thick yellow
coating at the back-center of the tongue in my female patients, I know that they are very likely to
get a bladder infection. I tell them to immediately start drinking 8 to 12 glasses of filtered water
a day, take 5,000 mg of vitamin C, and to drink cranberry juice or take its extract -- this regimen
will typically help prevent a bladder infection. More often than not, those who didn't follow this
preventive treatment will call me a few days later with an infection.
Your body alerts you to imbalances in many more ways than just your tongue. Ideally, you should
confirm your findings from your tongue with observations from others, such as the eyes, face, and
nails. I hope this article helps you translate your tongue!