"Stick Out Your Tongue and Say, 'Aahh!'" Acupuncture Assessment (Part 3)

by Thomas E. Turpen, MS, R.Ac. on 09/01/11

A lot of patients are puzzled when going to an acupuncturist and are asked, Would you please show me your tongue?" In our experience as patients in the conventional medical scene, this doesn't seem to make a lot of sense. Of course, most of my patients who show me their tongues are usually curious to see what it means.  A lot of them will ask things like "Why do you look at my tongue?"  Or, "What can you see in my tongue that is related to my insomnia?"

The answer to these questions goes right to the heart of one of the key concepts of Oriental Medicine (OM) -- the concept of wholeness/integrity. In OM, the body is viewed as an integrated whole. Any disorder in one area will have an effect globally (i.e. throughout the body). For example, a person may complain of insomnia, and we find that their tongue has a dark red color with no coating. We may feel their pulse and find that it is thin and rapid. Upon further inquiry, we may find that their urine is dark yellow and scanty in volume.  Each of these little pieces fit together to complete the puzzle of assessing their syndrome or pattern of imbalance that manifests with the "symptom" of insomnia.

When we look at the tongue, we are looking at a number of things such as the color, shape, moisture, coating, and any other distinguishing features on the tongue body such as teeth-marks, inflamed/raised taste buds, and cracks in the body of the tongue. Also we look at the spirit of the tongue overall. Is it quivery? Or does it deviate?

We also look at the areas of the tongue that are affected. The ancient Chinese mapped out areas on the tongue that were related to each of the zang fu* organs. For example if a tongue were red on the sides, we might inquire into possible Liver or Gall Bladder** syndromes (patterns of disharmony). Each feature that we notice becomes yet another clue -- another piece of the puzzle -- to be able to determine what is the nature of a person's disease or dis-ease.

Now in my practice, I do not take what is called the tongue picture as sufficient to make any diagnosis. I will look at the overall presentation of symptoms (what the patient presents to me as a complaint) and signs (what I find upon examination).  Based on this overall presentation, I then make my assessment.

*zang fu -- to be discussed in another post

**not necessarily the liver or gallbladder as known in conventional medicine.