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Why Do We Look At Your Tongue?

Tongue-regions diagnosis

When you get acupuncture, your acupuncturist will look at your tongue.  You might be self conscious of this, you do not need to be.  We are not looking at it to show the quality of your dental hygiene.

When we look at your tongue, it tells us a lot about your health.  We are looking for:

  • General color
  • Color in certain areas such as on the tip or sides
  • Coating – how thick is it and is any missing?
  • Shape of tongue – Is it swollen?  Do you have teeth marks?
  • Are there any cracks?  If so, where?

As an acupuncture student, you have to look at hundreds of tongues to learn to differentiate the different qualities.  To the average person, a tongue is a tongue.  After you have looked at about 100 to 200 tongues, you can easily tell the difference.

For example, if a person has a very red tongue, that usually indicates heat.  Heat can be caused by many things, but stress is a common factor.  Drinking alcohol and taking drugs also cause a lot of heat.  Alcoholics sometimes have very red tongues when they are older.

If you have a thicker tongue coating, it often indicates you are not digesting your food very well.  We can treat that.

If you have a red tongue tip, that indicates you have heat in your heart.  That can cause insomnia and anxiety very easily.

Your tongue is one of the signals we use to determine what your diagnosis is.  It tells us a lot, but we always consider your symptoms.

Dr. Giovanni Maciocia is the author of a tongue diagnosis book.  He has written most of the books that are used in acupuncture schools in the West.

In China, there are many books on tongue diagnosis.  They have page after page of tongue pictures and have case studies that explain what the diagnosis is and how it is shown on the tongue.

Here is a link to a tongue diagnosis page for Giovanni Maciocia, he writes most of the books used in Western Acupuncture schools:  http://www.giovanni-maciocia.com/tonguegallery/default.html

Do not scroll down if you are squeamish or sensitive. Tongues can look very unattractive sometimes:

  This tongue is very red and has cracks.  It is also peeled.  You can see the fact that there is no coating on the outer edges.  He has a lot of what we call heat, in his system.  The cracks can be caused by a yin deficiency.


  This tongue is dark red or purple.  You can see all the spots on the tip of the tongue.  You can also notice at the root of the tongue there is a thick coating.  He probably has digestive issues also.  This is a serious case and will take quite some time to treat him.

  This is a geographic tongue.  This is usually caused by a yin deficiency in Chinese medicine.  The coating is just peeling away over time.  You can address this problem with herbs.
For more information on tongue diagnosis, there is no better resource that the book by Giovanni Maciocia:

Here is the link on Amazon for this book:  Tongue Diagnosis in Chinese Medicinehttp://www.assoc-amazon.com/e/ir?t=purchiher-20&l=as2&o=1&a=093961619X