Tongue Diagnosis
By Dr. Renae Haldeman · New to some of these words? See the glossary.
The Tongue: A Small but Important Part of the Body
“Behold also the ships, which though they be so great, … are turned about with a very small helm…. Even so the tongue is a little member, and boasteth great things.” (King James Bible, James 3:4-5)
Many patients who have an acupuncture interview will first have their tongue looked at. Traditional Chinese Medicine (TCM) uses tongue diagnosis to help plan treatment. The tongue is one of the only muscles we can see, and it gives clues about the health inside the body. TCM teaches that the tongue is “the ‘offshoot’ of the Heart.” The Heart controls the color, shape, taste, and look of the tongue.(1) The tongue shows a person’s constitution (their basic health makeup). The tongue coating also comes from the stomach. The coating shows whether the stomach’s qi (say “chee,” the body’s vital energy) is in balance or out of balance. We can watch the tongue body and its coating for changes in health.
A recent article on tongue diagnosis in Scientific American magazine (Nov 2025) says that tongue color and coating may help find low iron, diabetes, and fatty liver. The article also says that how severe a person’s COVID was could be confirmed by the tongue, which changes from mild to severe cases. This fits with what is taught in Chinese herbal medicine. A light pink tongue shows an illness that is more on the surface. A deep red tongue body shows a more severe case of COVID.
You can look at your own tongue. If the coating is peeling or has holes, the stomach may be out of balance. Teeth marks on the sides of the tongue, caused by the teeth pressing on it, mean you may be overworking. A tongue with a red tip often goes along with trouble sleeping, among other problems. All of these clues can help you decide on small changes to your lifestyle to support your health.
References
- 1. The Foundations of Chinese Medicine, Maciocia, 3rd Edition, page 283
- Image: The Foundations of Chinese Medicine, Maciocia, 3rd Edition, page 324
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This article is educational and is not medical advice. Individual results vary. Please talk with a licensed healthcare provider about your own health.