Tongue: Why do acupuncturists look at my tongue?

Why do acupuncturists look at their patients’ tongue?

One of the more unusual experiences for a person visiting an acupuncturist is the request, ‘would you please stick out your tongue’! The practitioner then proceeds to peer intently at the protruding appendage, perhaps nodding sagely to themselves, or even drawing a diagram of the said tongue complete with coloured in areas and detailed hieroglyphic notes that may or may not be deciphered as, ‘thin white coating’, ‘swollen with teeth marks’, or, God forbid, ‘black, thick, greasy coating with yellow at the sides’! So what does it all mean?


I suppose the first thing to say is that older members of the public may even remember their own GP making a similar request to see their tongue in the past (perhaps some GP’s still employ this technique today). Observation of the tongue was a common western medical diagnostic tool up until the first world war and the practice certainly continued among some doctors well beyond that time.

In Chinese Medicine tongue diagnosis has been an important tool in assessing the health of the patient for around two thousand years. Bearing in mind that historically the more able and scientifically minded members of a society tend to be the ones who practise medicine, that is two thousand years of empirical research! Chinese medical diagnosis is rooted in the detailed observation of the patients signs and symptoms and the tongue is one of the most important sources of medical information.

The Chinese Medical practitioner is primarily trying to assess the relative state of a patients chi (loosely translated as energy). It is not simply the quantity of a patients chi which is of interest but also the quality of the chi, how easily it flows through the body and where blockages are located. The practitioner will also be asking if the chi is being obstructed or depleted by an external pathogen such as heat, cold, damp or phlegm and if so which organ in the body is the pathogen affecting? All of these questions, and many others, can be answered from a detailed observation of the tongue.

tongue areasDifferent areas of the tongue relate to different internal organs such as the heart, lungs, stomach and liver etc. The colour of the tongue is also important indicating the presence of heat or cold or perhaps a blood deficiency. The colour of the tongue coating may be indicative of a poor diet which could be affecting the stomach or the spleen, Cracks on the tongue surface may point to the long standing presence of heat which may be adversely affecting the heart or the lungs.

These are just some of the diagnostic medical indications which the practitioner can discover from a detailed examination of the tongue. This information is then assessed in conjunction with an investigation of the pulses (which also give an indication of the state of the chi in the organs of the body), coupled with the medical information gleaned from questioning the patient about their health.

This exhaustive Chinese medical diagnosis endeavours to give the practitioner a full and comprehensive picture of the patients health and it is from this detailed information that the practitioner then prepares the most effective treatment plan in order to help return the patient back to full health. Observation of the tongue is a vital diagnostic tool in this process.

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