Ng Hui Ping, SCHMI Senior Medical Executive/Resident Physician
Many have wondered why do their TCM Physicians always ask them to stick out their tongue? This is known as the “Tongue Diagnosis”, which is one of the four important clinical diagnoses in TCM.
A TCM Physician will usually make an observation (望) of the tongue, listen to breath sounds or note abnormal smell (闻), ask the symptoms (问) and palpate the pulse or diseased areas (切).
Tongue diagnosis, recorded as early as in the Yellow Emperor’s Inner Classic (黄帝内经) published in the period of pre-Qin to Han dynasties, is of great significance in TCM clinical diagnosis. It can present strong visual indicators of one’s overall health balance or unbalance.
The tongue is one of the important organs in the oral cavity. From the physiological point of view, changes in the tongue can be influenced by the changes in blood circulation, nervous system, tongue papillae, and glands.
In the holistic view from TCM perspective, the tongue can reflect the essence (精) and Qi (气) generated from the zang-fu organs (脏腑) through the meridian network (经络), which are energy pathways.
Qi and blood are generated when the internal organs are functioning normally. A light red, moist, flexible tongue with vitality indicates the abundance of Qi and blood. As the tongue is connected to the meridian network and zang organs (Liver, Heart, Spleen, Lungs, and Kidneys), it can also reveal the states of the viscera and bowels (脏腑) – Qi, blood, body fluid, pathogenic factors, the progress of diseases etc.
The nature of the disease, for instance, repletion and deficiency of healthy Qi, can be distinguished from the tongue colour. The disease location (superficial or deep) and the sufficiency of Stomach Qi can be distinguished from the tongue coating. The texture of the tongue tells the pattern of the disease and the degree of body fluid depletion.
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