The Practical Herbalist

The Role of the Tongue

One of the most valuable diagnostic tools in traditional Chinese medicine and herbal medicine, is the tongue. I always ask my patients to stick out their tongues. At times, the look of the tongue will be key to determining which herbal formula I prescribe. The tongue is a window into the functioning of the body. Reading what the tongue says can be tricky, but it is a very accurate diagnostic tool.

The look of the tongue changes over time, sometimes rather quickly. If you look at the tongue of a small child there will be marked differences when it is compared to the tongue of an elderly person. The tongue shows wear and tear on the system. The tongue of a child is often smooth and clean looking. The elderly person will have a tongue that is rough and cracked. When reading the tongue, the shape, texture, location of cracks, the coating, and the color all are important. The difficultly is that the tongue must be read in the context of the person. A dark tongue with a thick coat can mean totally different things depending on the person who is presenting the tongue.

Patients ask if their tongues are good or bad. The answer is neither. The tongue is a reflection of the functioning of the body, and therefore it is not the tongue we are worried about. The best way that I have found to quickly explain tongue reading is this; Imagine a friend or a co-worker that you feel you know well. At some point you find yourself at the home of that person, where you get to see another side of the person. What you see may change your opinion of the person or just provide a deeper understanding of who this person is. The new knowledge is mixed with the old knowledge of countless conversations, and actions. We can not say we “read” all that we know from the look of the house. Explaining what information was conveyed is difficult because the information depends on past information as well as the new information.

This is much the same when reading the tongue. The look of the tongue is dependent on the functioning of the body, and the tongue can provide extra information needed to clarify the understanding of that function. The tongue has to be taken in context with what is already known about the person. This provides detailed information that is invaluable in determining what the patient needs.