Tongue Diagnosis – Traditional Chinese Medicine and Acupuncture

you hello and welcome to traditional Chinese medicine tongue diagnosis my name is Cristina capo thanasis I'm a licensed acupuncturist here in the state of Hawaii and I am a diplomat of Oriental Medicine under the national certification Commission for acupuncture and Oriental Medicine I am also the executive director of the Hawaii Oriental medicine and acupuncture Association today I am excited to share with you a an episode on tongue diagnosis and hopefully you can follow along today if you have a second to grab a mirror and we'll look together at your tongue and see what it's telling us about your body tongue diagnosis is an important part of traditional Chinese medicine traditional Chinese medicine is a complete system of medicine that includes diagnostic diagnostic techniques like tongue and pulse diagnosis and treatment methods like acupuncture herbal medicine and other remedies today we're going to look specifically at tongue diagnosis and what it can tell about the body Chinese medicine looks at two main parts of the tongue we focus on the body of the tongue or the skin and we focus on the coding of the tongue some people have a thin or thick coating on top of the tongue and some people scrape their tongue in the morning that is the coding that we're looking at the body of the tongue can tell us things about the Chi in the body Chi a rough translation into English would be the energy that flows through our body it is not connected with the nervous system cardiovascular system or lymphatic system it is it is a separate system flowing through meridians in the body and it can tell us about the quality deficiencies of the blood in the body so if we look at the coating of the tongue it's looking more at the strength or weakness of the digestive system and the different pathogens and how much they are affecting the body when we put those together we can get a complete look at the nutritional state of the body and the metabolic state of the body the process of taking the tongue diagnosis is relatively quick all you have to do is stick out your tongue for a few seconds and let us take a look when you do stick out your tongue we like the two we ask that you are very relaxed when you stick it out and we get a full clear picture from tip to back so we just look at it for a few seconds up on the top and underneath to get a good look at what's going on so we would like you to open your mouth wide sort of like saying ah and stick your tongue out like so well we don't want you to do is open your mouth too long and look at your tongue for too long that changes the colour of the tongue if you hold your tongue out too long it can get turned a little bit purple after a while or red if you use too much force to stick your tongue out it can change the appearance of the tongue too so we don't want to make a skinny kind of tongue does that make sense okay good some of the qualities that we look at we take the qualities and we look at them one at a time so if you can look at this first slide the different qualities that we look at on the tongue are the the tongue colour so we are looking if it's too red too pale we're looking at the size of the tongue is it too small and thin is it too enlarged filling up the cavity of the mouth or just right in between we can also look at the coating thickness how thin non-existent or thick it is and we look at the colour of the coating how yellow or white and sometimes tinge of grey or brown we also look for the moisture of the how dry it is or how wet sometimes there's much saliva on the tongue and we also look underneath the tongue some of the special signs we look for that not everybody has but some abnormal signs we look for scalloped edges we look for red dots distributed anywhere on the tongue and we look for different purple bumps and patches these can tell us several different things about the tongue so basically we look at a couple aspects of the coating the thickness and the color we look at the body of the tongue for the color and we look at the size of the tongue and we pay attention for any special patches dots scallops going on we also want to pay attention in this next slide or you can see a map of the tongue where these special signs on and/or the coding is located sometimes they can be concentrated in different areas of the tongue which indicate different organs have been affected so at the tip of the tongue is represented by the heart and the lungs the center of the tongue represents the crooks of the digestive system the spleen and the stomach on the sides we have liver and gallbladder and in the back we have kidney and bladder so different signs and symptoms can show up in different areas of the tongue which can also give us clues as to how your body is functioning first of all if you have your mirror handy we will start and classify your tongue very simply in terms of those different aspects the picture you see here is a normal tongue a normal tongue is pink with a thin white coating and no abnormal special signs so if we keep this in the middle of the screen for most of these slides you'll be able to compare the the different signs as they are abnormal compared to the the normal tongue let's get started okay first we look at the tongue color so how red pink or pale is your tongue if you can look at the slide on the left this tongue is a little bit too red that tongues can get can be all different shades of red cherry red dark deep red and this one is quite a nice bright red in the middle again we have our perfectly pink tongue on the right hand side we have a pale tongue can you notice how this is a little bit wider than the pink and definitely lighter than the red and at the bottom of the screen we have a tongue that's has a tinge of purple so we have to see if your tongue is pink is it red is it pale and it can have a tinge of purple either by itself it can be pink with purple it can be darker red with purple or it can be pale with attention purple do you can you see what yours is okay let's go on to the next one the next sign we're looking for is the size of the tongue again in the middle we have a nice perfectly sized pink tongue with thin white coating on the left if we look at this red tongue again the red tongue is quite thin it's quite thin this way and it's small in size this way so this is a too small of a tongue you may ask some people's tongue may be genetically different than other peoples we say that this is their constitution some people may run hot some people may run cold you're right but we can see what their constitution is or what their body type is by the size of the tongue accompanied by all the other aspects on the right side we can see that this tongue is quite enlarged when they open their mouth it fills up the whole cavity of the mouth these people may also feel that their tongue is enlarged they they may feel that it's bigger when they start seeing symptoms of illness or disease so we can check next on our list is your tongue too small is it perfectly in the middle or is it enlarged next we can look at the tongue coating thickness on the left-hand side of the screen this tongue has absolutely no coding as you can see it's a little bit shiny shiny because there's no coating slick like the mirror in the middle though the coating is not absolutely visible this we call thin white coating as compared to the one on the left because the left one we call Gwang tae no coding and that shiny shiny appearance of no coating completely smooth on the other hand on the picture on the right you see an extremely thick coating now anything between the middle slide of normal anything thicker than that all the way to the thickness of the slide on the right will all be categorized as too thick not necessarily you have a coating as thick as this person's tongue on the right but anything thicker than the middle one is too thick and we need to say that you have classification of thick tongue coating the one on the left is quite severe people taking pain medications will actually usually have this tone but other than that the disease is usually quite severe by the time the tongue looks like this next it can look at the color of the coating we want white that's quite normal and if it gets thicker you can see an obvious color to the coating so on the left you can see that the coating is white it's very pale in color as opposed to the tongue on the far right which has yellow now you have to be careful when you look at the coating of the tongue because the coating can be dyed if you're sucking on a bright red throat lozenger your tongue coating will be right bright red if you just drank some grape juice your coating will probably purple if you just had chocolate or even black beans you may have a dark brown or black tongue coating if you have not had any chocolate black beans or other dark colored food and you still see a tinge of dark brown or grey this is actually another type of coating it's not as rare it's usually in chronic conditions I did include it here today but in general we will look for today do you have more of a yellow coating or more of a white coating or are you perfectly thin in the middle and white okay did you have time to check okay let's go on to the next slide this is the amount of moisture we have in the tongue hopefully you all have a perfectly healthy tongue like the one in the middle but if you don't you may have a little bit too moist or to drive a tongue this can also give us clues as to what's going on inside the body on the left hand side if you can see this tongue is a little bit shiny from the amount of water left on the tongue some people have so much water on the tongue that it's dripping when they stick their tongue out and on the other side on the right hand side this picture of the tongue the coating is very dry not only is the coating dry but the tongue has cracks in it and the cracks can get more severe than the pictures seen here so we just try to put on the scale from extremely wet to extremely dry which of these polar opposites are you closer to perfectly in the middle a little too wet or a little too dry next we can see if you have any of the special signs on your tongue not everybody does and you might not necessarily have all three if you do but if you have any of them then you'll make a note and we'll come back and see what that means the first picture on the left is a picture of a scalloped tongue do you see the teeth indentations around the edge of the tongue this is one special sign that you may notice some people with light indentation is actually normal but this indentation or this scalloped tongue is quite pronounced and this is telling us especially coupled with the other things we see on that tongue it's telling us that there's something wrong with the body in the middle you can see this tongue has lots of red dots sometimes you can even feel the dots there raised bumps on the tongue usually they're concentrated in the front tip of the tongue but not necessarily they sometimes can be distributed all through the body of the tongue and on the right hand side slide you can see on the tip and around the edges purple spots or purple patches the body of the tongue has discolorations on the sides and on the tip this is the third special sign we can look for when you see these special signs they are usually they usually jump right out at you and it's not hard to miss especially red dots and purple patches and scalloped edges finally we'll look underneath the tongue what are we looking for underneath the tongue we're usually looking for two two characteristics first of all we look for the two veins on either side of the midline we would like the veins to be the length of two-thirds the tongue from the base of the tongue where it connects to the bottom of the mouth to the tip of the tongue we would also like them to be not too thick and not too thin if we look at the picture and left this is a normal tongue veins underneath the tongue they aren't completely they haven't completely disappeared they're not too faint but they're not too large or too long either the other slide on the other hand has quite bulging veins and they are a little bit long on the sides of the tongue you can see a lot of other veins that have also popped out so this is indicating something's wrong with the body the second characteristic we look at underneath the tongue is the color of the tongue sometimes on top of the tongue you may notice that the coating is so thick and so coded coating the entire tongue that it's hard to see the body of the tongue you may be able to see only around the edges but if you look under the tongue at the color you can notice that the tongue on the left is more pink whereas the tongue on the right is more red so hopefully you can see in just a few seconds a snapshot at the bottom of your tongue if you've been looking at your tongue the whole time the things are probably popping out and this doesn't count you have to take a quick couple second snapshot or you have to let your tongue rest for a few minutes before you try again so let's take a quick look at those slides again and we'll see a general trend in heat or cold in the body Chinese medicine diagnoses in terms of yin and yang that simply means is it too much or too little heat in the body too much or too little cold is there excess problems in the body like stagnation or poor circulation dampness something of a water metabolism problem or their deficiency not enough of something in the body so the normal tongue they pass they have everything nice if we look at the next slide we get to the color so where you were you running red or pale nice and pink if you are a little on the red side red is indicating running hot a little bit of heat or too much young or tulu leena in the body on the other hand we have the pale tongue which is more indicative of cold and the purpleness is telling us that there is poor circulation or stagnation in the body that can result from a variety of reasons so red to hot white to cold if we look at the size of the tongue we can see the small tongue and the large tongue these are both indicating deficiencies or weaknesses in the body of different kinds so too small and too large both indicating deficiency well the large and large segments also tell us about dampness or a water a sticky condition in the body of poor water metabolism if we look at the next slide we can look at the thickness of the coating this is telling us about the strength or weakness of the digestive system on the left hand side the tongue with absolutely no coding that's quite glassy is showing us extreme digestive weakness like I mentioned the people that are taking the pain pills that's very hard on the stomach lining and other parts of the digestive system on the other hand the right-hand side picture is showing us a lot of accumulation of a dampness this idea of food and fluids that we put in the body not digesting properly and it creates a sticky condition where the body isn't cleaned out properly and we need to flush out or transform the dampness so digestive deficiency versus excess dampness in the body next if we look at the tongue coating color we can see again the idea of heat and cold in the body so the more white the coating and the thicker the more usually the more cold you have in the body the more yellow the coating usually the more heat you have in the body and if you saw that tinge of brown gray and you know that your tongue has not been dyed from eating any dark-colored foods then you may have more of a chronic condition chronic conditions tend to have a slight coating of that brown gray on the top the moisture level can also indicate the level of heat or cold in the body the more heat you can easily imagine burning off the fluids in the body so if we look at the right hand slide of that dry coating with cracking in the tongue it usually indicates some kind of heat in the body whereas if we have a very moist watery coating on the tongue or lots of saliva this is usually an issue of cold and or too much dampness in the body for the special signs if you notice any of those on your tongue the first one the scalloped edges or the indentation is telling us that there is digestive or Qi deficiency in the body the middle one with the red dots is telling us heat too much heat in the body if it's on the center tip it's usually concentrated in heart and lung area and we can tell these people usually have some insomnia the coating on the right hand side is actually not what we're looking for for the special sign but if you can see those purple spots on the sides and the tip this is telling us there is stagnation located in the heart or lungs and on the sides in the liver or gallbladder if we look underneath the tongue we can also tell what's going on in the body the left being the normal and the right side showing a little bit too much heat from the color red again and then we can also tell that these bulging veins have too much stagnation in the body so poor circulation accumulation of excess that needs to be flushed out of the body now if we put all of those signs together and try to come up with a correct diagnosis we check this one for our first example deficiency heat tongue so we see that the heat signs are several first of all we look at the color it's quite red red indicating heat we look at the size of the tongue the tongue is too small so it's deficiency this can tell us oh can we have that slide back this can tell us that the deficiency heat means that there is not enough fluids and blood in the body deficient of good fluid and blood sort of like a rough translation of dehydration creating heat we can also see many little red dots spread out all over the tongue this is enforcing the idea that there's too much heat in the body if we look at the coating it's extremely thin it's not shiny thin like the guang tie the absolutely no tongue coating but it is very thin if it were thick we may think that it's more associated with excess damp heat but this one is extremely thin so that's another sign that's showing us this is deficiency heat underneath their veins might be quite thin or non-existent again signifying the deficiency in the body this person may suffer from night sweats they may feel irritable they may have insomnia they may feel flesh without having a fever and they may have constipation or firm stools these signs these are all signs of in deficiency with heat so this is one way that we can put all of the signs together and come up with a correct diagnosis if we look at one more example we can see this deficiency cold dampness together for our spleen Qi deficiency diagnosis in this we first look at the color of the tongue it's actually pretty pink not too pale if we look at the size of the tongue it's not too large not too small possibly starting to get a little bit enlarged if we look at the coating it's white color but it's much too thick the thickness is telling us dampness in the body and the white is telling us cold in the body so cold dampness is usually created by a weak digestive system if the digestive system is weak it cannot properly digest the food and liquid that we intake and therefore we create over time a sticky condition in the body this is further reinforced by the scalloped edge that you see around the tongue this scalloped edge is indicating some kind of Qi deficiency digestive deficiency and possibly blood deficiency but this town is not pale enough for blood deficiency we also may notice that if the tongue were a little bit more enlarged and on the pale side we may diagnosed him with kidney Yong deficiency because as the digestive system is weakened it draws on the kidney warmth to continue digesting the food and after a certain period of time the kidneys will also start to become weak when this happens this tongue will continue to enlarge and pale become pale and then we'll have kidney Yong deficiency the current tongue that you see will probably have different symptoms like chronic loose stools they may have fatigue they may have a lowered immune system always catching colds so these are some that's some of the signs of the spleen Qi deficiency we hope that you can put together some of the signs that you've seen today and come up with a diagnosis for fun for yourself of course this is not to replace your traditional Chinese medicine practitioners diagnosis but it's always nice to know when you go into your practitioner what exactly are they looking for what are they looking at why do they want to see my tongue people always think it's a little strange when I say let me take your pulse I can tell about your organs let me look at your tongue I can tell what's going on in the body if you just understand a little bit about what we're looking for and while we're looking at it then you will be able to communicate more effectively with your practitioner and you will be able to monitor your progress and in the future you will be able to hopefully help yourself understand how different foods affect you how does lack of sleep affect you staying up all night you can notice in the morning that your tongue may be a little more red if you eat too much oily foods or too much cheesy kind of foods you may notice that your tongue coating is quite thick this is all fun to monitor and observe and see how your body changes the more sensitive you can become to your body the healthier become I hope you can stay tuned for next time thank you so much today for watching and Mahalo Oh


  1. I have some white coating on my tongue in the back. With a bit of scattered teeth marks in a diagnosis way to the left of my tongue and in the back where the white coating is there's bumps also on the left and a bit of scattered diagnolly what does that mean

  2. Hi lovely acupuncture human ,, what is it that under my tong in the base there are on the right and left 2 little dark red little balls I do. Acupuncture for 0 years Oman my own body. But never diagnosed my tuna I have learn ed. Ear acupuncture and body acupuncture but never until now known much and didn’t care about the tung. What. Could it be
    ? Thz for your lovely intellectual video Chris….

  3. Acupuncturist Christine Kapothanasis masters Tongue Diagnosis in theTCM and Acupuncture.Her argument is very exact and  storgly persuasive.

  4. your shares are wonderful-manythxs-keep posting so we keep learning pls-you have alot to share-we have alot to know-

  5. This was an exceptional video.  I went to an acupuncture school today and they observed the pulse, looked at my tongue but didn't really explain anything about it.  This has educated me as to what I do need to change to obtain optimal health.  Excellent instruction and pictures.  Thank you

  6. thank you v much Dr.Christina
    you hive a great video n the way you explained its a unique style , once again thanks.Thanks for freshening of my knowledge

  7. thank you v much Dr.Christina Kapothanasis
    you hve uploaded a great video n the way you explained its a unique style , once again thanks.

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