In traditional Chinese medicine, the tongue is considered a window into human health. Its shape and color reveal signs of illness, and tongue diagnosis has been a classic technique in traditional Chinese medicine for thousands of years.
Tongue shape: A large, scalloped tongue indicates kidney deficiency and poor metabolism; a thin, red tongue indicates yin deficiency with heat.
"Fair and chubby, so cute!" This phrase is often used to describe a child's health and cuteness, but it's not so healthy when used to describe a tongue. A swollen, white tongue is a common tongue appearance, hence the name "white jade tongue." Because the white jade tongue is so "fat," its edges often rub against the teeth, leaving teeth marks.
People with a large, swollen tongue often drool excessively, are sensitive to cold, have cold hands and feet, and lack energy. These are signs of kidney deficiency, which manifests as poor kidney function and chronic kidney disease.
Who is prone to this tongue appearance? Professor Liu Jianfeng, a researcher at the China Academy of Chinese Medical Sciences, said that he once treated a woman in her thirties who complained of frequent dizziness, even nearly fainting several times, but no problems could be found in her diagnosis. Professor Liu asked her to stick out her tongue, and sure enough, it was swollen with very obvious teeth marks. After questioning her, he learned that she was a senior executive at a company, frequently traveled for work, slept only a few nights a month at home, had extremely irregular eating habits, and often stayed up late.
Professor Liu said that patients like this are very common, mostly between 30 and 40 years old, with busy work schedules, irregular lifestyles, staying up late, drinking alcohol, and difficulty eliminating waste from their bodies. They should strengthen their spleen and eliminate dampness, and regularly eat foods such as Poria cocos, yam, jujubes, and hawthorn. In addition, Yang Li said that besides a swollen tongue, there is also a thin, reddish tongue, which is common in the elderly. This may indicate kidney yin deficiency or yin deficiency with heat, and can be improved by taking Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) under the guidance of a doctor.
Tongue coating: Thick, white, greasy – indicates poor spleen and stomach function and a tendency to diarrhea; thick, yellow, greasy – indicates damp-heat and suggests limiting alcohol consumption.
"A pale red tongue with a thin white coating, of moderate size, balanced and symmetrical—this should be a normal and healthy tongue," Professor Liu Jianfeng describes. What constitutes a normal thin white coating? Simply put, it should be visible through the coating, meaning the tongue itself should be faintly visible underneath. If it's not visible and is "covered up," then it's a thick coating. How do you judge the size? Look for teeth marks.
Clinically, a common tongue appearance is a thick, greasy white coating, meaning a thick layer of white coating on the tongue that cannot be wiped off or scraped off, and is covered with a layer of oily mucus. This tongue appearance often indicates poor spleen and stomach function, indigestion, and frequent problems such as diarrhea and stomach pain. "Especially after the Grain in Ear solar term, when the temperature is high and the humidity is heavy, a thick, greasy white tongue coating is particularly easy to appear," Yang Li reminded.
Another common type is a thick, yellow tongue coating. A thick, yellow, and greasy tongue coating indicates damp heat in the body, and this tongue appearance is often seen in people who drink alcohol.
Professor Liu Jianfeng also mentioned a man in his fifties, 175cm tall and weighing nearly 200 pounds, who complained of "a poor appetite and a constant feeling of bloating." Professor Liu examined his tongue, which had a thick, yellow, and greasy coating. He asked if the patient frequently experienced a bitter taste in his mouth, dry mouth, and poor sleep, to which the patient nodded repeatedly. It was later learned that this patient loved to drink alcohol, almost daily, and disliked exercise. Professor Liu prescribed medication for him for a week, and at the follow-up examination, the patient said, "My appetite feels much better."
A yellow tongue coating may also indicate a heat syndrome, such as a wind-heat cold, especially in the height of summer when the air conditioner is on and the temperature difference between indoors and outdoors is large, making it easy to catch a cold and develop a fever. In this case, you can use some heat-clearing and exterior-releasing medicines, such as Yinqiao Powder, honeysuckle, and forsythia. For dietary therapy, you can eat some mint and cucumber.
People with a thick, greasy white tongue coating can eat more winter melon and ginger. Yang Li recommends boiling winter melon, Job's tears, yam, and ginger together to make a soup. They can also use Huoxiang Zhengqi Water (藿香正气水). Professor Liu Jianfeng says that if the tongue coating is thick, yellow, and greasy, dietary therapy is not very effective; some traditional Chinese medicine preparations can be used, such as Huanglian Shangqing Wan (黄连上清丸) and Danzhi Xiaoyao Wan (丹栀逍遥丸).
Tongue color: Red tip of the tongue - indicates excessive heart fire and a bad temper; pale white tongue - indicates deficiency of qi and blood.
"My tongue tip hurts so much!" Looking at it, the tip is bright red, a sign of rising internal heat. Professor Liu Jianfeng says this is common in young people, often caused by irregular lifestyles. Besides a red and painful tongue tip, it's often accompanied by irritability and dark yellow urine.
If the tongue is reddish, or even crimson, it indicates blood stasis in the body. Professor Liu Jianfeng mentioned a particularly serious case. A few days ago, a 14-year-old boy suffered a ruptured cerebral vascular malformation and fell into a severe coma, diagnosed as a "vegetative state." He was unable to swallow and needed machines to eat. Western medicine seemed to have no better solutions, so they consulted a traditional Chinese medicine practitioner. When they arrived, they pried open the child's mouth and saw that his tongue had turned bluish, a typical sign of blood stasis, and indeed, systemic blood stasis. They prescribed appropriate medication, and after a period of time, the child was able to swallow again. His mother even shed tears while telling him stories.
Professor Liu cautioned that most people wouldn't have such severe blood stasis, but if an elderly person, especially someone with high cholesterol, has a very dark tongue, it's best to have their coronary arteries checked to see if there's any blockage.
The most effective way to treat a red and painful tongue tip is to promote urination. Professor Liu says corn silk is particularly useful and very simple; just boil it in water and drink the infusion. Alternatively, you can use Imperata cylindrica root and calendula, both of which are available at pharmacies and can also be boiled in water. Additionally, eat more Andrographis paniculata. Besides a red tongue, a pale tongue is also common. Yang Li reminds us that this indicates qi and yin deficiency, and blood and qi deficiency, often seen in women during menstruation. In this case, angelica root stewed with chicken or red date and black-boned chicken soup are both very effective.
Tongue posture: stiff and inflexible – a precursor to stroke ; tongue tremors and drooling – be wary of Parkinson's disease.
In addition to observing the tongue coating and color, it's also important to observe the tongue's posture, that is, its movement. Check if the tongue is stiff, inflexible, or deviated, especially for the elderly. It is said that the tongue is the most flexible part of the human body; a healthy tongue should be able to extend and retract freely, without being crooked or skewed.
If you find your tongue to be stiff, such as frequently biting your tongue while eating or speaking with a lisp, this may be a sign of an impending stroke, especially for people with high blood pressure, high cholesterol, or high blood sugar. It is best to go to the hospital for a check-up as soon as possible.
Professor Liu Jianfeng said he once treated an elderly man around 80 years old who came to the clinic complaining of insomnia. Upon examining his tongue, Professor Liu found it stiff and inflexible, and the patient also had a lisp. After further questioning, he learned that the patient also had a family history of hypertension and hyperlipidemia. Professor Liu advised the patient to have a brain CT scan, which revealed severe blockage of blood vessels in the brain, posing a risk of stroke at any time. Another symptom is tongue tremor, an involuntary shaking motion. If accompanied by drooling, this could be a sign of Parkinson's disease.
If any problems are found with the tongue, you should seek medical attention promptly, especially if you have high blood pressure, high cholesterol, or high blood sugar, or a family history of hypertension. You should also pay attention to eating foods that lower cholesterol, such as black fungus, celery, and hawthorn. You can soak hawthorn in water and add some honey.
