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How many times when we get up in the morning and look in the mirror, when we go to brush our teeth, have we observed a strange appearance in our tongue. White, yellowish, with red dots,..., the color and texture of the tongue immediately reflects the state of our health. A morning exam can help you discover small alterations in your body or that of your family in time.

The functions of languages

The tongue is made up of seventeen muscles that allow it to carry out all the movements and the multiple activities and functions it performs.

First of all, it is an important part of the digestive system since it allows food to be retained in the mouth, contributing to the chewing process, helping saliva to wrap food and prepare it for its passage to the digestive system. In addition, the pupils spread over the surface of the tongue allow us to appreciate the taste of everything we eat and distinguish one food from another.

And as everyone knows, in addition to all that, the language allows us to speak and communicate with others thanks to the word.

The tongue in traditional medicines

For thousands of years, the traditional medicine of all cultures has considered the observation of the appearance of the tongue as an essential means of diagnosing diseases. We all remember the old rural family doctors, when CT scans were not available or modern diagnostic methods that made us stick out our tongues when we were sick and diagnosed us with "dirty stomach" or poisoning of any kind.

Among traditional medicines, it is undoubtedly Traditional Chinese Medicine (TCM) that has given greater importance to the study and observation of the tongue, developing a very complete diagnostic system that receives the name of She zhen. Currently, Dr. Song Tian Bin has compiled an "Atlas of tongues and tongue coatings in Chinese medicine" where we can find 245 different types of tongues with their associated pathologies.

The mirror of the organism

We can consider the tongue as «The mirror where we can see the general state of the organism». Chinese medicine shows that the appearance of the tongue is a reflection of internal pathological variations. According to the principle of interdependence of all macro and microcosmic phenomena, any change suffered by one part of the system (in this case the human body) will be reflected by all the rest of the parts that compose it. That is why the ancient Chinese sages said: "Everything that happens inside (Li) is revealed outside (Biao)." Traditional Chinese Medicine gives great importance to the close relationships between changes in the environment and the reactions of the organism. The linual examination allows obtaining objective and evident signs of said reactions.

The tongue is one of the most important organs of the mouth, it is linked to the bottom of the oral cavity, the jaw and the hyoid bone, it is a muscle made up of many striated muscles. It has two faces, the back and the mucous part on which three types of papillae can be distinguished: filiform, fungiform and goblet-shaped (the taste buds belong to this last group).

Physically it occupies an important area of splanchnic projection in the cerebral cortex, due to the great variety of tongue movements that must be controlled during the act of speaking.

Energetically, the tongue is closely linked to the energetic physiology of all the organs, which makes it a preferential "reflex zone" to check the state of the organs and their correct functionality.

How do you do a self-diagnosis?

This article does not intend to teach a complete method of diagnosis by observing the tongue, which requires in-depth medical knowledge, but only a series of basic indications so that the reader can better understand their state of health.< /p>

The conditions required to take a correct language exam are the following:


We should use natural light if possible. In the case of using artificial light, neon light is preferable and never directly. We must also avoid being near colored surfaces that can be reflected.

The position: the person being observed should open their mouth slightly and stick out their tongue naturally. A very stretched, tense or curved tongue can modify its appearance and its vascularity, which would lead to errors of appreciation.

The order of observation: generally we begin by observing the tongue coating (appearance and color) and secondly the body of the tongue (color, shape and mobility). It begins at the tip and ends at the root.

Modification of the color by food or medication: it must be taken into account if you have taken any type of food or medication that could have changed the color of the tongue, since this type of coating, called Ran Tai, has no diagnostic significance.

Influence of the season: It is common for the general appearance of the language to change depending on the season. In summer the coating is usually thicker, yellow and pale; in autumn it is finer and drier, while in winter it is usually more humid.

Colour, shape and texture

In the language test, two things must be observed:

The body of the tongue: (She Zhi) on which we will determine three characteristics: color, shape or aspect of the body and mobility.

Colour: can be pale, pale red, red, scarlet, or violet-blue.

Shape: splendid / withered, young / old, thick / large, thin and fine, cracked, prickly, dotted, with dental imprints, double, hemorrhage of the tongue, carbuncle of the tongue, tongue boil, tongue pimples, tongue fungus.

Mobility: hard, limp, shrunken, shaky, protruding, numb, and paralyzed.

Lingual coating: (whitish layer that covers the tongue), from which we will determine its color and texture.

Color: white, yellow, gray and black.

Texture: thick/thin, wet/dry, tofu/buttery, flaky, partial/full, true/false.

Dry with spongy papillae

One of the things that is easiest to observe on the tongue is the amount of water that the body contains, which is made up of 70% water. There are some diseases, such as diarrhea, which can cause significant loss of water in the body. In these cases the language will look like this:

Dry tongue with spongy papillae that will present the classic dry appearance comparable to when three or four liters are missing in our body. This aspect of the tongue should make us suspect the existence of a toxic and infectious disease. The greater or lesser degree of dryness can give us an orientation about the intensity of the condition. The presence of a dry tongue is indicative of a more or less elevated increase in body temperature.

To check if we have a dry tongue, it is enough to pinch a little, with the index finger and the thumb, the skin that is located on the sternum. If after this operation, the skin does not immediately return to its place and remains rough for a while, it most likely means that you are in the presence of dryness.

To remedy the situation, simply drink a lot of water in a few hours.

With whitish coating

Sometimes we find that the layer that covers the tongue (coating) has a whitish appearance and the mouth seems "pasty". This is a frequent situation related to heavy digestion. In some cases the tongue is completely thick and produces a sensation of great dryness in the mouth, with an arid tongue. In general, the coating is made up of cell debris from the superficial layer of the tongue, which accumulates while sleeping. The chewing of food serves to remove the coating, turning the tongue shiny and pink. In other cases, on the contrary, when the tongue is dry, the coating persists even after eating.

The causes of this phenomenon are diverse: for example, an indisposition of the digestive system. When there is acute indigestion or when the individual has digestive problems caused by poor secretion of hydrochloric acid in the stomach, caused by insufficient motility of the digestive tract, the tongue appears white, pasty and a thick yellowish coating on the root of the tongue.

But this phenomenon can also be due to a high fever that lasts for several days, or in the event that the patient has suffered from recurrent diarrhea or vomiting.

What we should do in these cases is provide plenty of fluids, particularly tea or fruit juice. A home method to remove the white coating from the tongue is using a soft-fiber toothbrush or baking soda.

With white spots

If strange white spots appear on the tongue, this may be due to a lichen planus infection, or leukoplakia, due to a thickening of the mucosa of the tongue lining.

The spots are usually small and white, lace-like, located either on the tongue or on the inside of the cheek. Leukoplakia should be cured by a good doctor, while lichen planus responds well to simple treatment.

What we should do in the first place is reduce the consumption of meat, fats of animal origin and alcoholic beverages; instead we should have a diet rich in fiber and fish. We can integrate folic acid (1/2 mg a day), vitamin E (400 mg), beta-carotene (5 mg), selenium (200 mg), zinc (25 mg) into the diet.

Raspberry Rose

In this type, the taste buds appear pinkish and inflamed (raspberry tongue) and after a few days they appear more intense. In such cases the tongue resembles a strawberry. "Raspberry" tongue and "strawberry" tongue indicate the existence of an infectious disease such as scarlet fever.

What we should do in these cases is treat the disease immediately.

Antibiotic Swollen Papillae

In people taking antibiotics, the tongue appears pink and the taste buds are swollen; It gives the feeling that they are connected to each other. The back of the tongue appears smooth, particularly in the area near the edge.

The reason, in most cases, is due to a treatment based on antibiotics that lasts too long. But it can also be caused by a lack of group B vitamins or folic acid.

What we should do in these cases is consult the doctor in order to request the interruption of the antibiotic treatment and decide another type of treatment. Group B vitamins or folic acid should also be taken; consuming fish, grapes, brewer's yeast or foods that are particularly rich in this substance will not be enough.


A tongue that has pink-purple features often appears thickened due to the presence of gingivitis.

The cause of this disorder may be vitamin B deficiency, common in people who consume alcohol. For example, if the tongue is white and swollen and fiery pink, it is a vitamin B2 deficiency, while if the gums have a scarlet pink appearance, it is usually due to a vitamin B3 deficiency problem. Let us remember that a lack of group B vitamins can also be due to a diet very rich in refined carbohydrates, such as white flour, or excessive cooking of food.

What we should do in these cases is switch to a diet richer in B vitamins such as milk, meat, pasta, tomatoes and carrots.

Pink, swollen and painful

In some cases, the mucosa of the tongue, that is, the membrane that covers its surface, becomes inflamed, giving a sensation of painful swelling. This is a disease known as acute glossitis.

The first sign of the presence of this inflammation is the presence of a roughness over the entire surface of the tongue; With the passage of time, said disturbance causes severe pain. The chewing process or simply speaking becomes very painful.

The tongue, with a swollen appearance and with small cuts, appears dotted with white spots, which occupy all or part of the upper surface and are characterized by a well-defined color and an intense color.

The most frequent cause of this alteration is bacterial infection, trauma, allergy to a drug or to any product used daily in oral hygiene.

People who wear dentures can suffer from glossitis and in the event that the prosthesis is poorly manufactured or misplaced, said glossitis could damage the tongue and cause acute stomatitis, an inflammation of the mucosa of the mouth or the gums.

What we should do in these cases is consult a specialist allergist or consult the dentist, depending on the cause of the glossitis or stomatitis. In the case of a drug, the doctor who prescribed it should be consulted in order to find a more appropriate treatment.

Professional diagnosis of the tongue


In traditional Chinese medicine diagnosis, the appearance of the tongue is one of the main objective signs.

The examination of this organ - SHE ZHEN - occupies a very important place in analysis by observation. Ancient physicians placed great value on this kind of examination.

The Chinese have observed the language for centuries. The proof of this is constituted by classic books such as NEI JING and SHANG HAN LUN, texts concerning the diagnosis by observation of the tongue. For more than two thousand years, in the course of the development of Chinese medicine, considerable experiences have been accumulated in the examination of the tongue.

In our days, the examination of the tongue, based on the theories of Chinese medicine, has become a particular method of diagnosis. This exam is the emblem of traditional experiences and is considered one of the peculiarities of Chinese medicine.

Actually, by observing the language the following facts can be understood:

  • The presence and insufficiency of QI XUE (blood energy) of ZANG FU (viscera, entrails).

  • The superficial or deep penetration of the pathogen.

  • The evolution of the disease.

  • The prescription, the manipulation of YAO (medicine of all kinds), the reasoning and the prognosis depend on the facts previously indicated.

    Sometimes this kind of test is more important and more reliable than a pulse test.

    In the book LIN ZHENG YAN SHE FA (Method for Examining the Tongue in Clinic) it is stated: «If the XU SHI state (hypofunction or fullness) is judged based on the observation of the tongue, errors can be avoided.

    In the same way: If the state of YIN YANG and ZANG FU (entrails) is judged and if it can be prescribed based on the tongue, it is an infallible method.

    In urgent and difficult cases, especially when there are no other signs and the pulse is clear, in such cases there is no other choice but to examine the tongue.”

    According to recent research, in terms of clinical diagnosis, the appearance of the tongue and its point is of fundamental importance. From the appearance of the tongue and its point, the internal organs of the human body can be observed. And this because the language can objectively reflect internal physiological and pathological changes; the tongue shows at the same time the reactions of the body and the state of the functions as well as numerous vital movements.

    As a particular diagnostic method intended to distinguish the functions of the body, examination of the tongue is of great value.

    Clinically, changes in the appearance of the tongue are multiple and complicated. But knowing the principles, handling them is easy. Although the changes in the appearance of the tongue are multiple, they can be reduced to the following five sets:

  • Color of the tongue.

  • Appearance of the tongue.

  • Mobility of the tongue.

  • Color of the tongue tip.

  • It is enough to handle the rationale and clinical significance to easily perform the examination.

    It is important to understand the reality of Chinese medicine, its diagnoses and treatments by combining the four tests:

  • Observation.
  • Interrogation.
  • Hearing.
  • Touch.
  • In this way, the information from the physiological «image» of the language can be fully used to mislead the disease.


    Language has two parts:

    a) Body of the tongue (SHE ZHI): colour, shape and mobility of the tongue.

    b) Tongue (SHE TAI): color, characteristics or nature.

    In Chinese medicine, the tongue can reflect internal pathological changes. In order to discover them, one must base oneself on synthetic conceptions that have been experienced for a long time.

    The different parts of the human body that are both in opposition and in union form a whole in the same way as the body and everything that concerns its environment. The changes experienced by one of the parts of the body are closely related to the others. The ancients said: When things occur inside, they can be seen from the outside and thus LI (inside) can be understood by observing what happens to BIAO (outside).

    Chinese medicine analyzes and compares the reciprocal reactions due to different causes between the human body and the environment. The activities of the internal organs can be observed through external indications of the body. In addition, signs of the set of these activities can be found in any part of the body.

    According to the theory of organs and meridians of Chinese medicine, the relationship between the tongue and the internal organs is established thanks to a system of routes of the JING LUO and JING JIN (meridians).


  • The JING BIE of the SHOU SHAO YIN heart meridian communicates with the root of the tongue.

  • The ZU TAI YIN spleen meridian joins the root of the tongue and is distributed below it.

  • The kidneys ZU SHAO JIN meridian tightens the root of the tongue, just as the liver ZU JUE YIN meridian is tied to the roots of the tongue, etc.

  • In short, the five ZANG and the six FU are directly or indirectly related to the language. And since the JING QI (quintessence and energy) of the ZANG FU rises to the tongue to nourish it, the changes of JING QI due to the pathological state of the ZANG FU are reflected on the tongue.

    This is how in the chapter Distinction of the body of the tongue and the tongue point in the book XING SHE WAI ZHEN JIAN MO (generalities of the external examination of the form and coloration) the following passage is read: «the tongue is the orifice of the heart, its movements depend on the tendons controlled by the liver.

    When there are small red dots on the tip of the tongue, this indicates the rise of XIN QI (heart energy) which carries the ZHEN HUO (true fire) of MING MEN.

    If on the tongue there are white and soft thorns like fine hair, it is the result of the meeting of FEI QI (energy of the lungs) and ZHEN HUO of MING MEN.

    If on the tongue there are white and soft thorns like fine hair, it is the result of the meeting of FEI QI (energy of the lungs) and ZHEN HUO of MING MEN.

    As for the lingual point, this results from the vaporization of WEI QI that rises and is deposited on the tongue.

    Since the five ZANGs receive energy from the stomach, one can rely on the tongue point to examine the HAN RE, XU SHI state of the five ZANGs.

    When the daub can be removed, the disease concerns the QI FEN and the six FU (entrails). If the daub cannot be removed, the disease penetrates the XUE FEN to disturb the ZANG».

    Between the five ZANG and the six FU the tongue is above all in close relationship with the heart, spleen and stomach. Since the "tongue is the bud of the heart," it is also the external organ upon which the activities of the spleen are reflected. As for the stomach, it is the vaporization of WEI QI that forms the ointment.

    Since the heart controls the vessels, there is a significant amount of blood circulating through the tongue. The heart controls the SHEN (mental activity) that influences the movements of the tongue and elocution. Therefore, the appearance of the tongue can above all show the state of the heart functions, however. Considering that the heart is the master of the five ZANG, the functions of the latter are reflected in the tongue.

    The tongue generates the taste that influences the appetite; which is closely related to the assimilation function of the spleen and stomach. Since the spleen and stomach are the foundation of what is acquired (HOU Tl AN ZHI BEN), the state of the functions of the spleen and stomach, as well as the state of QI XUE (energy and blood) are reflected directly on the tongue. .

    Thousand-year-old experiences allow Chinese medicine to affirm that any part of the body can contain the indications of the body as a whole.

    For example, the tip of the tongue corresponds to the upper hearth (SHANG J1AO), the midpoint of the tongue to the middle hearth (ZHONG JIAO); and the root to the lower hearth (XIA JIAO). These correspondences are comparable to the positions of the ZANG FU in taking the pulse: the upper position corresponds to the organs located upwards; the median position at the bodies located at average height of the body; and position inferior to the bodies located down.

    According to the YIJING (Mirror of medicine): «The tip of the tongue corresponds to the heart; the middle to the stomach and spleen; the edge of the tongue to the liver and gallbladder; the root to the kidneys.

    These are the theoretical bases in Chinese medicine of the examination of the tongue with which the pathological modifications of the internal organs are observed.

    According to modern studies, the tongue is an important common passageway to the digestive and respiratory tracts. There is also a significant amount of nerves and vessels in the body of the tongue and that the blood supplies massively. Furthermore, the lingual mucosa is fixed and transparent. Modifications of the lingual papillae are visible. Therefore, the tongue can be considered as a mirror in which the internal changes of the body can be observed.

    The tongue is not only closely related to the functions of the digestive system and the nutrition of the body, but also can reflect the functions of the circulatory system and the modifications of the JIN YE.

    In short, the tongue is the part of the body that best indicates organic reactions: it is a sign of the regularity of the body's automatic control system. Which means that it better expresses the functions of the nervous regulation system and organic fluids.

    Therefore, from the aspect of the tongue, it is possible to understand the modifications of the body's reactions.


    Examination of the tongue is the main objective support in the diagnosis. That it is the diagnosis according to BA GANG (eight principles); according to BING YIN (etiology), ZANG FU (viscera, entrails), LIU JING (six meridians or six divisions), WEI QI YING XUE (four FEN) or SAN JIAO (three hearths), the aspect of the tongue is always the essential objective sign.

    Changes in the appearance of the tongue may reflect the following facts:

  • The fullness or weakness of the XIE QI (evil energy).

  • The LI or BIAO (deep or superficial) location of the XIE QI.

  • The nature of XIE QI.

  • The aggravation and improvement of the disease.

  • With this kind of examination, the trend of the disease can be predicted and prevented. It is also possible to rely on this examination to prescribe and manage the medicines used.

    1. Determination of the state SHENG (fullness) or SHUAI (weakening) of the ZHENG QI (correct energy):

  • If the body of the tongue is red and wet, it is the state of fullness of QI XUE (blood energy).

  • If the body of the tongue is pale, it is the state of weakening of QI and XUE.

  • If the tongue tip is thin, white, moist, it is the state of fullness of WEI QI (stomach energy).

  • 2. Location distinction (LI or BIAO):

    Depending on its thickness, the tongue tip can reflect the location (deep or superficial) of the perverse energy at the beginning of diseases of external origin.

  • If the spot is thin but abundant, the disease is located in BIAO; the penetration of XIE (XIE QI) is not deep.

  • If the oil is thick, the XIE QI has already penetrated LI; the localization of the disease is deep.

  • As for the scarlet tongue (SHE JIANG) it indicates the penetration of RE into the YING FEN and XUE FEN; the disease is then deep.

  • 3. Differentiation of the nature of XIE QI:

  • Yellow tongue spot primarily indicates the presence of ER.

  • The white dot mainly indicates the presence of HAN.

  • The buttery spread, and the tofu-shaped spread mostly indicates excess food and the presence of TAN ZHUO (turbid TAN).

  • In the case that the body of the tongue presents spots or small bodies of blood, it is the sign of XUE YU (blood stagnation).

  • 4. Forecast of worsening and improvement of the disease:

    In acute ER disease if the tongue tip changes from white to yellow and finally black, this indicates penetration of the XIE QI from BIAO to LI. The disease worsens; HAN becomes RE.

  • If the tongue tip, previously wet, becomes dry, there is a presence of excessive RE that hurts the JIN (liquid).

  • If the ointment, which was thick, becomes thin, or if it was dry and becomes moist, this means improvement of the disease and the sign of the reappearance of JIN YE (organic fluids).

  • It should be noted that, in clinical practice, in certain serious diseases, the appearance of the body of the tongue does not change at all. On the contrary, in a person in good health, an abnormal-looking tongue can be found.

    The author of BIAN SHE ZHI NAN notes: “The tongue of a person in good health can have different shapes and colors. This can be without greasing or covered by a very thin layer of greasing. The tongue can be bright red or pale white. It can be hard and pointed or mobile and soft. The tongue of some people in good health sometimes shows dental imprints. It all depends on the constitution of each one. The difference in constitution engenders a different aspect of the body of the language.”

    Therefore, to make a good diagnosis, apart from observing the tongue, you have to combine the 4 tests and make a global analysis.


    Since disease is a complicated process, it is not enough to handle the fundamental modifications of the body and tongue tip. In addition to observing them in their reciprocal relationships, it is necessary to examine them together in order to analyze them.

    In principle, the observation of the body of the tongue is to determine the state (fullness, weakening) of ZHENG QI (true energy). Regarding the observation of the point, it allows to locate the location (LI or BIAO) of the disease and to verify the state of WEI QI.

    By examining the lingual point, it is possible to distinguish the HAN or RE nature of the disease, and locate the location, LI or BIAO, of the disease».

    That is why the body of the tongue and the tongue tip must be examined separately. But since the relationship between them is very close, they must be observed together in order to fully understand the pathological changes.

    The book SHANG HAN ZHI ZHANG further reveals: «In the case of FENG RE (hot wind) humidity I, the body of the tongue is white, moist and without oil. If there is a point, it is very thin. If the heat is accompanied by humidity (SHI) we find a point ZHUO (disturbed) accompanied by TAN. The XIE QI of this case is found in WEI FEN.

    If the dot is white, thick and dry, the XIE QI is found in the QI FEN. In case the dot is both white and yellow, it is the penetration of RE into QI FEN.

    The white dot, with the red edge of the tongue means that WEN XIE has penetrated the lung. It can be understood with this indication that the WEN XIE dries the JIN (liquids of the lungs)».

    With this we see that the body of the tongue and the lingual tip are closely related. This relation is almost the same with respect to that which exists between man and his own shadow.

    Indeed, the modifications of the body of the tongue and the lingual tip go together. But sometimes those modifications are not uniform. Therefore, the 4 tests must be combined to determine the diagnosis.

    For example: in general the white dot indicates the presence of HAN and SHI. But if the scarlet tongue is accompanied by white and dry smear, it means the presence of ZAO and RE that wounds JIN. The ZAO QI then quickly transforms into HUO, which immediately penetrates the YING FEN before the dot turns yellow. In addition, the white dot compared to the flour does not indicate the presence of HAN at all, but rather excessive RE XIE.



    As light can modify the color, it is necessary to take natural daylight, soft and bright, as a criterion. Avoid, at the time of the exam, standing in front of colored objects, such as windows, painted walls, which can reflect their color in the light. If the exam is done at night, or in a dark place, it is advisable to use a fluorescent lamp. If necessary, it will be examined again, the next day, with natural light.

    Position of the Tongue:

    ask the patient to stick out the tongue by opening the mouth completely. A tongue that is stretched out for a long time, tense or curved, can influence the blood circulation in the body of the tongue, and thus present a false appearance! The patient, before consulting his doctor, should do the following exercise: relax the tongue; extend it equally to both sides; pull the tip of the tongue down. The observation time will be short. If necessary, the tongue will be observed several times.

    Moments of the observation:

    It will be verified whether or not there is tongue stitch. If there is, whether it is thick or thin; in the form of tofu or butter; its color; whether it is dry or wet.

    Secondly, the language is observed: its color; if it has spots or spots; if it is hard or tender; greasy or not; how the tongue moves The observation will be made from the tip to the root of the tongue.

    Food: these can change the appearance of the tongue. These, or certain medicines, can color the tongue stick: false stick or RAN TAI. On the other hand, observe:

  • If the spread becomes thin when in contact with food or cleaning it.

  • Very hot or very cold foods change the color of the tongue, just like exciting foods.

  • Breathing through the mouth, or the absorption of water modifies the dryness or humidity of the surface of the tongue.

  • Seasons:

    The appearance of the tongue changes with the seasons. In summer, for example, the oil is often thick, pale, and yellow. In autumn it is generally thin and dry. And in winter it is usually humid.

    Relations of the tongue test with other tests:

    according to Chinese medicine, to avoid a partial diagnosis, due to a single method, the four tests must be combined : observation, listening, interrogation, touch. It is essential to associate the language exam and other exams.

    For example: the gray-black dot can indicate both extreme RE and extreme HAN.

    In WAI GAN disease (external) the scarlet tongue indicates penetration of RE XIE into the YING FEN.

    But in disease NEI GAN (internal) indicates the state XU YIN with HUO (excessive fire). In this case it is necessary to resort to the set of signs to make a decision.

    Another important relationship is that the modifications of the body of the tongue and the tongue tip are made in pairs. Therefore, to determine the pathological state, it is necessary to examine the whole:

    For example: red tongue with dry yellow dot indicates SHI RE (heat fullness) syndrome. Sometimes it does not give the same indication.

    For example: scarlet tongue indicates RE; the white and wet dot indicates HAN.

    If they are found together in the field of WEI GAN WEN BING (exogenous warm disease) it indicates the presence of RE in the YING FEN and SHI (dampness) in the QI FEN.

    In the NEI SHANG field (endogenous wound) this tongue and this point indicate the state of XU YIN with excessive HUO accompanied by TAN ZHUO and accumulation of food.

    Modifications of point are linked to weather factors. At the beginning of the external disease, the tongue dot does not change.

    If the thin dot becomes thick, it is the penetration of the XIE QI towards the LI.

    When the white dot turns yellow it indicates that with the penetration of XIE QI towards the LI, there is RE heat.

    A yellow dot that becomes dry indicates the presence of excessive RE that hurts JIN.

    If the tongue turns scarlet it indicates penetration of RE into the YING FEN and XUE FEN.

    In case of less thick smear and pale tongue, it is a sign of XIE QI regression. With this sign it is known that ZHENG QI is going to be restored.

    If the tongue becomes smooth, shiny and without a stitch, it indicates JIN dryness and YIN depletion. This is a bad sign.

    It is thus possible to predict the tendencies of the disease thanks to the observation of the language.


    Observation of the body of the tongue.

    Nerves and vessels are found in the tongue. His observation consists in determining the color, shape and mobility of the tongue. Normal appearance of the tongue: pale red color, splendid and moist appearance; their movements are loose.

    Observation of the color of the tongue.

    1. Pale Tongue: A little paler than a normal tongue.

    This language corresponds to the XU HAN syndrome that can be in accordance with YANG XU or QI XU; or XUE XU.

    2. Pale red tongue: the tongue is the normal state. It also corresponds to the beginning of the disease of the BIAO syndrome or the SHI syndrome (hyperfunction); or RE syndrome and perhaps also XU syndrome.

    We find this language in healthy people or benign diseases. In chronic diseases, the presence of this kind of tongue indicates only the benign character of the disease.

    3. Red tongue: a stronger red than a normal tongue. Correspondences: RE syndrome. In the field of WAI GAN BING this language indicates the penetration in LI of WEN RE, in the field of NEI SHANG (internal injury) it indicates the state SHI (hyperfunction) in LI of the syndrome. RE or the XU YIN state with the presence of internal heat.

    4. Scarlet Tongue: Deep red in color, stronger than Red Tongue. Correspondences: excessive internal RE. In the field of WAI GAN BING indicates the penetration of RE in YING FEN and XUE FEN. In the field NEI SHANG indicates the state of XU YIN with excessive HUO.

    5. Violet blue tongue: you have to distinguish the strong and pale tone of these colors. If it looks pale or blue to purple and looks wet, it indicates the presence of excessive HAN and XUE YU (blood stagnation). Strong purple tongue that does not have too much JIN indicates the presence of RE with QI XUE obstruction. Violet tongue accompanied by small black dots generally indicates XUE YU.

    Observation of the shape of the tongue.

    1. Splendid/Withered Tongue: When wet and bright red in color, it is called RONG (splendid). This language indicates the state of fullness of ZHEN QI and abundance of JIN RE. When the body of the tongue is dry, dull, K.U (withered) tongue indicates JIN dryness and YIN depletion.

    2. Old or Young Language: The LAO (Old) language is a dull, hard language with rough textures. Indicates the SHI syndrome (hyperfunction) and the RE syndrome. It is found in the extreme phases of chronic diseases. The language called NEN (young) is lively and with many fine textures. Indicates XU syndrome (hypofunction) or HAN syndrome. She is found in the first phase of chronic diseases.

    3. Thick or large tongue: it is a swollen and large tongue that occupies the entire oral cavity. If it is pale, white, thick and young, it indicates the XU YANG state of the kidneys and spleen. In addition, it indicates obstruction by TAN, YIN or by SHI. If it is swollen and bright red, it often indicates excessive ER in the heart and spleen; or it indicates the presence of harmful SHI (humidity) and RE. If the tongue is swollen, blue and turning purple, it indicates intoxication.

    4. Thin and thin tongue: its body is small and thin. Indicates the XU state of YIN and XUE. When it is white or pale red, it is the XU state of QI and XUE. When scarlet red it is the XU state of YIN with excessive HUO. It is found in consumable diseases.

    5. Cracked Tongue - A variety of cracks can be found on its surface. It indicates deficiency in YIN liquids. If it is scarlet, indicate the presence of excessive RE that hurts YIN. When it is pale it is a sign of XUE XU that does not lubricate the body.

    6. Spiny Tongue: Abundant bud-like papillae are found on the tongue. These papillae are thick and spiny.

    If you touch them, they can cause pain.

    Indicates the excessive state of RE XIE.

    7. Dotted tongue: with copious papillae on the surface, swollen with blood. The papillae are located towards the tip and midpoint of the tongue. They are shaped like raspberries. It is called CAO MEI SHE (raspberry-shaped tongue). It indicates the excessive state of RE XIE that penetrates XUE FEN. That the points are red, white or black; all indicate the presence of excessive internal ER.

    8. Tongue with dental imprints: The imprints are on the edges of the tongue. Indicates the XU state of the spleen with abundant SHI (moisture).

    9. Double tongue: The lower vessels of the tongue are swollen, giving the impression of a small tongue.

    That's why it's called a double tongue. It indicates the presence of HUO in the heart, or the agitation of the HUO in the heart caused by external XIE QI.

    10. Tongue hemorrhage: When the surface of the tongue bleeds it means the presence of HUO and RE in the heart, stomach and liver.

    11. Anthrax of the tongue: This tongue is red and swollen (YONG Abscess). Indications: excessive HUO status in the heart, and RE accumulation in the spleen and lo; kidneys.

    12. Furuncle of the tongue: This kind of tongue is found with large purple blisters like a soybean. These blisters are hard and cause pain (DING abscess). This kind of language is the result of the presence of HUO XIE in the heart and spleen.

    13. Grains of the tongue: the grains are the size of a rice.

    If the disease is caused by HUO of the heart, it is accompanied by chills; the pimples appear on the surface and are painful. In the event that the YIN of the XIA JIAO is XU and the HUO of the XU state, the pimples that are towards ulcerative, but not very painful, rise. Hence the name SHE GAN (ulcerative tongue).

    14. Tongue fungus: the tongue presents a tumor in the shape of a lotus or a cockscomb or a cauliflower. The surface of the tongue is ulcerative and very sore. It indicates accumulation of fire and RE QI in the heart and spleen.

    Observation of the mobility of the tongue.

    1. Hard tongue: hard and does not move easily. Because of this the person speaks with difficulty. It is called SHE JIANG.

    In the field of WAI GAN BING this language class indicates the following situations:

    RE penetration into the pericardium.

    Internal obstruction by TAN ZHUO.

    Fever that damages the JIN.

    In the field of NEI SHANG, this language indicates: ZHONG FENG prodrome due to LUO obstructed by FENG TAN.

    2. Loose tongue: the body of the tongue is weak and soft; has difficulty stretching and bending. It is called SHE WEI (loose tongue).

  • If it is pale it indicates the XU state of QI and XUE.

  • If it is scarlet it indicates deep depletion of YIN.

  • If, at the beginning of an illness, this tongue is also dry and red, it indicates YIN injured by RE.

  • 3. Shrunken Tongue: His body is tense and shrunken. It doesn't stretch. It is a deadly sign.

  • If it is pale, clear and wet-looking, it means concentration of HAN in JING JIN.

  • If it is scarlet and dry it means JIN wound by RE BING (hot disease).

  • When this tongue is also thick, it is a sign of internal obstruction due to TAN SHI.

  • 4. Deviated tongue: the body of this tongue is tilted to one side. It is often the ZHONG FENG or the prodrome thereof.

    5. Trembling Tongue: The body of this tongue trembles to such an extent that it is uncontrollable. In the field of WEI GAN BING this language indicates excessive RE that engenders FENG. It can also indicate internal FENG agitation due to the XU state.

    In the ZA BING field, state:

  • Energy and blood XU.

  • YUAN QI deficiency.

  • 6. Protruding tongue and moving tongue: when the tongue tends to come out of the mouth it is called SHE TU (protruding tongue). If it moves constantly it is called SHE NONG (moving tongue).

    These two tongues generally indicate the presence of ER in the spleen and heart.

    A protruding tongue is seen when the heart has been attacked by a contagious disease. Also in the case of complete depletion of ZHENG QI. As for the moving tongue, it is observed in the agitation of the internal FENG by

    RE to the heart, or in the wound of JIN by the RE of the spleen.

    7. Numb tongue and paralyzed tongue: It is called SHE MA and SHE BI respectively.

    Both indicate:

  • Internal turmoil of liver FENG due to XU state of XUE.

  • Presence of FENG QI accompanied by TAN.

  • Observations of the tongue point.

    The product that covers the surface of the tongue, according to Chinese medicine, this product is due to the vaporization of WEI QI. According to modern medicine it is a product from the decomposition of the filiform papillae.

    The tongue spot has the appearance of a liverwort.

    The tongue stick exam is done in two parts:

  • Observation of the color of the tongue tip.

  • Observation of the nature of the daub.

  • In a healthy person the tongue tip is white and thin. It is neither dry nor wet, neither smooth nor rough.

    Observation of the color of the tongue tip.

    1. White dot: Usually indicates BIAO syndrome and HAN syndrome.

    Regarding SHANG HAN, it is a sign of affectation of the TAI YANG division.

    Regarding WEN BING, it is a sign of penetration of XIE QI in WEI FEN.

    This point can also be found in XU syndrome and RE syndrome.

    This point is observed in:

  • Beginning of a disease.

  • Benign symptoms.

  • Chronic diseases.

  • 2. Yellow dot: corresponds to RE syndrome and LI syndrome.

    In terms of WEN BING, it is the penetration of XIE QI into QI FEN.

    This point can be found in cases where YANG, in the XU state, does not manage to transform SHUI and SHI.

    It can be distinguished:

  • Pale yellow spot.

  • Strong (and old) yellow.

  • "Burnt" yellow.

  • The first indicates the presence of benign ER, the second severe ER, the third cumulative ER.

    This point class is found at:

  • Infectious fevers.

  • Illnesses that are too serious.

  • Poor digestion.

  • 3. Grey: its color is a little black. Corresponds to LI, RE and HAN syndromes.

    When this point is damp gray it means internal obstruction by HAN and SHI (dampness), or even a sign of TAN YIN.

    When this point is dry, it indicates:

  • Excessive RE that hurts JIN.

  • XU YIN state with excessive HUO.

  • It is found in the serious phases of diseases.

    4. Black dot: it is an evolution of the "burnt" gray or yellow dot. Corresponds to the LI syndrome with abundant HAN or excessive RE.

    When it is dry it is a sign of excessive RE that dries JIN.

    When it is smooth it means XU YANG state with abundance of HAN.

    It is found in the serious phases of diseases.

    Observation of the nature of the tongue joint.

    1. Thick/thin smear: Both are distinguished by the fact that the bottom of the tongue may or may not be seen.

    If the body of the tongue is still visible, it is a thin point.

    Otherwise it is a thick paste.

    The thin spot usually indicates BIAO brooding from external damage or benign disease. The thick indicates the penetration in LI of the external XIE QI or the presence of TAN YIN with accumulation of SHI (moisture).

    It is found in diseases that disturb the digestive system.

    2. Wet/dry smear: The dry smear does not feature any JIN.

    In severe cases it can be rough like sandpaper. It is called CAO TAI (rough spot).

    This dot indicates:

  • RE abundant that hurts JIN.

  • Depletion of YIN and desiccation of YE.

  • XU YANG state. The YANG does not manage to transform JIN nor to make it circulate.

  • When the surface of the tongue is moist and smooth, it is called the wet spot. If it contains enough water and it drips, it is called HUA TAI (smooth spot). This point corresponds to an internal concentration of SHUI, SHI and TAN YIN.

    3. Tofu/Butter Cheese Spread: The spread called FU TAI (Tofu) is a spread that forms into coarse, thick, brittle grains. Like the remains of tofu (TOU FU) that covers the surface of the tongue. In severe cases it is called GOU TAI (dirty oil) or ZHUO TAI (turbid oil).

    This dot indicates:

  • Overabundance of YANG and RE.

  • Rise of cloudy materials such as stagnant food and TAN ZHUO.

  • The spread called NI TAI (buttery) is a spread that is formed in very fine, dense grains that are very difficult to remove. If it is cloudy it is called NIAN NI TAI (sticky buttery daub).

    This point class indicates:

  • Internal accumulation of SHI ZHUO.

  • YANG's arrest by SHI ZHUO.

    Accumulation of TAN YIN, SHI RE, retention of food. This point is less serious than the point FU TAI.

    4. Scaly smear: it is a smear that peels off; They are found on the surface of the tongue, clean and shiny sectors.

    It is called HUA BO TAI.

    Indicates the injury of QI and YIN of the stomach.

    If it is fatty, it indicates accumulation of TAN SHI and injury to ZHENG QI.

    If it appears on the edge of the tongue it is called DI TU SHE (map tongue). This indicates the XU YIN state or the interruption of QI and XUE.

    Where this point is completely scaly, if new scales appear it is LEI BO TAI (pseudo-scaly point).

    Indicates the interruption of QI and XUE due to chronic illness.

    If the tongue is shiny, like a mirror, it will be called JING MIAN SHE (mirror appearance) or GUANG YING SHE (shiny tongue).

    Indicates deficiency of QI and YIN of the spleen and stomach.

    5. Partial / total spread: if it covers a part of the language, it is called partial.

    If it covers the tip of the tongue, it's called an outer partial dot.

    Indicates shallow LI penetration of XIE QI with depletion of WEI QI.

    If the point is in the root of the tongue, it is the internal partial point.

    Indicates the decrease of XIE QI in LI with the stomach still obstructed or by the presence of TAN YIN.

    If the partial point is to the left of the tongue, it indicates the accumulation and penetration of XIE QI in ZANG.

    If the partial dot is to the right of the tongue, it indicates the presence of XIE QI in BAN BIAO BAN LI (between BIAO and LI).

    In short, whether the point is on the right or the left is a sign of liver and gallbladder disease.

    In case of total suture, which covers the entire surface of the tongue, it indicates obstruction of the ZHONG JIAO by TAN SHI.

    6. True/False Daub: When the daub is sticky and rooted, it is called ZHEN TAI (true daub). It indicates the SHI syndrome (hyperfunction), the RE syndrome, and WEI QI that is still active.

    When the stitch is brittle and can be easily removed, it is called JIA TAI (false stitch) or FU TAI (floating stitch). Indicates XU and HAN syndromes. It means weakening of the WEI QI that is still active.

    When the stitch is brittle and can be easily removed, it is called JIA TAI (false stitch) or FU TAI (floating stitch).

    Indicates XU and HAN syndromes. It means weakening of WEI QI.

    Summary of language changes

    Modifications of the language and its point are very complicated, but can be summarized as follows:

  • Pale white tongue: HAN syndrome, XU syndrome.

  • Pale red tongue: normal state; BIAO and RE syndromes are benign diseases.

  • Red tongue: ER and SH1 syndromes (hyperfunction).

  • Blue-violet tongue: XU syndromes; excessive RE; THEY HAVE.

  • Thick and large tongue: XU and RE syndromes.

  • Thin and fine tongue: QI and XUE state XU; XU YIN state; ER syndrome.

  • Old language: SHI (hyperfunction) and RE syndromes.

  • Young tongue: HAN and XU syndromes.

  • Cracked tongue: deficiency of YIN and XUE; Excessive RE that hurts YIN.

  • Thorny and dotted tongue: excessive RE that hurts JIN; Inward penetration of XIE QI and HUO.

  • Loose, shrunken, quivering tongue: QI and XUE state XU; Excessive RE that hurts YIN and shakes FENG.

  • Hard tongue: high fever that hurts YIN; internal obstruction by TAN ZHUO.

  • Deviant language: ZHONG FENG; LUO obstructed by TAN ZHUO.

  • Protruding and movable tongue: presence of excessive ER in the heart and spleen with agitation of FENG.

  • White spot: BIAO and HAN syndromes.

  • Yellow spot: LI and RE syndromes.

  • Grey and black spot: LI syndromes; RE excessive and HAN excessive.

  • Damp smear: JIN that is still intact; Shi Xie's presence.

  • Dry dab: JIN damage; ZAO XIE.

  • Unto espeso: IHS syndrome (hyperfunction); serious and deep attack by XIE QI.

  • Unto thin: XU syndrome; benign and shallow attack by XIE QI.

  • Unto tofu: IHS (hyperfunction) and RE syndromes; presence of SHI ZHUO.

  • Buttery oil: presence of HAN SHI or presence of SHI (humidity) RE.

  • Bright spot: weakening of stomach QI and YIN.

  • Unto, small quantity: XU YIN state.

  • Squamous dot: insufficient QI and YIN, accumulation of TAN and SH.I This summary facilitates the application of the tongue test.

  • References consulted:

    1. Book written in 1341 (YUAN dynasty) by DU QING BI. See Great Dictionary of Chinese Medicine, History and Works volume, p. 202.

    2. Specialized book on the language exam written by YANG YUN FONG (QING dynasty). See Great Dictionary of Chinese Medicine, History and Works volume, p. 181.

    3. Book written by ZHOU XIE HAI in 1984. See Great Dictionary of Chinese Medicine, History and Works Volume, p. 95. This book is specialized in diagnosis by observation.

    4. YI JING (Mirror of Medicine), book written by WANG KEN TANG, 1641. See Great Dictionary of Chinese Medicine, vol. History and works, p. 120.

    5. BIAN SHIZHIN AN (Guide to the language exam) book written by CAO B ING ZHANG in 1920. See Chinese Medicine Dictionary, History and Works volume, p. 266.

    6. SHANG HAN LUN BEN ZHI (Fundamental Significance of SHANG HAN LUN) book written in 1835 by ZANG XU GU. See the Great Dictionary of Chinese Medicine, History and Works volume, p. 71.

    7. SHANG HAN ZHI ZHANG (Clear explanation about SHANG HAN) specialized book on SHANG HAN (cold disease), WEN RE B ING (hot disease) written by WU KUN AN in 1796.

    8. ATLAS OF LANGUAGES AND LINGUAL JOINT IN CHINESE MEDICINE book written by SON TIAN BIN and published by Publishing House, Beijing 1981.