The tongue body color is the first aspect we must observe to determine the overall conditions of the patient's physiological and pathological state.
"The tongue is the sprout of the Heart, it should be red in color, but not too intense... a healthy tongue is pink with a thin and white coating" If a person has sufficient blood and normal circulation of Yang-Qi, this carries blood throughout the body, which is why the tongue is pink, alive and bright.
Normal Tongue
- Pink: The color is neither deep nor superficial, bright red, moist and bright. The Heart controls the vessels, these reach the tongue through the Heart channel that arrives at the tongue and give the reddish coloration, the body Qi and the Stomach fluids nourish the tongue and give it the pale tone.
Pale Tongue
The pale color on the tongue in general terms is a Cold syndrome, specifically the pale tongue means two things: Blood deficiency, with which there is a tendency to find dry tongues or Yang-Qi deficiency, with which we will find moist tongues.
- Pale: deficiency or Cold syndrome.
- Pale and dry: Most common is blood deficiency (Blood and fluids belong to Yin, deficiency of one leads to the other). It can also be Yang deficiency since fluids come from the transformation of the Stomach, if there is Qi deficiency of Lung, Spleen and/or Kidney the Stomach cannot transform the fluids.
- Pale and moist: Spleen-Yang deficiency, fluid retention, Dampness. The Spleen-Yang cannot transform or transport the fluids so they accumulate on the tongue. Qi deficiency cannot carry blood to the tongue causing it to be pale.
- Pale, moist, swollen and tender: Cold from Kidney-Yang deficiency; Spleen-Yang deficiency leads to Kidney deficiency aggravating the pathology. There is accumulation of Phlegm. Usually seen in elderly people.
- Pale and without coating: Gives the impression of being fluorescent (like freshly plucked chicken meat). Injury of Spleen and Stomach. It is a chronic deficiency of Qi and Xue (Spleen is the source of Blood and Stomach is the source of Qi). Excessive deficiency of the ZangFu. Treatment: Tonify the Spleen and Stomach deficiency
- Gray: Terminal patient.
Pale tongue with a red part
Almost the entire tongue is pale but a small portion is red. It is a manifestation of empty-heat.
- If the red part is in the center: Spleen-Yin deficiency and Stomach-Yin deficiency.
- If it is at the root of the tongue: Kidney-Fire.
- If it is at the tip: Heart-Yin deficiency or Heart-Fire excess.
- If it is on the sides: Liver-Yang rising
Red Tongue
Tongue of fresh red or dark color indicate heat pathologies in Blood. The pink tongue color is normal, before becoming dark, it goes through fresh red until reaching dark red. Heat pathologies can be excess or deficiency depending on the presence or absence of coating. In cases of excess heat there is coating with root (regardless of color), while in cases of deficiency there will be no coating or the coating will not have root.
In an invasion of external heat the tongue body always becomes red indicating the presence of heat, this theoretically develops from the differentiation of syndromes according to the four layers in which we study the penetration of heat through layers from the Qi level to the Blood.
When the heat is chronic the red tongue indicates that the heat is inside at the level of the Nutritive Qi or the Blood
- Red: Pathogenic heat in Blood, Yin deficiency or Yang hyperactivity.
- Red and moist: In external diseases it indicates that the heat pathogen has penetrated the Nutritive Qi level and accumulates inside along with dampness; in an internal disease it is due to the rising of Liver heat or fire from deficiency. The tongue becomes red from the rising of heat, which attacks the Spleen weakening it and causing dampness. This syndrome is known as "false heat and true cold".
- Red and dry: Heat dries the Body Fluids.
- Red, dry and with coating: Excess heat mainly from Heart.
- Red, dry and without coating: Heat from deficiency. If the tongue is shiny the deficiency is mainly of Kidney and/or Stomach.
- Red without coating or with very thin coating: Heat from deficiency, deficiency of Stomach and it cannot produce Body Fluids.
- Red with thin white coating: External pathogen injuring a previous Yin deficiency.
- Red with yellow coating: Full heat, attack of pathogenic heat or external Cold wind that transforms into heat.
- Red with white and dry coating: Dryness heat that injures the Body Fluids.
- Dark red without coating: Heat from deficiency greater than usual.
Red tongue with spots or patches
They are a product of Ming Men. The pathology of spots on the tongue varies according to their color. Spots of any color on the tongue are mainly a product of toxic heat in the middle or upper Jiao although it can also be found in the lower. This tells us there is a pathogenic heat in the Yin or Nutritive Qi system and the location of the spots indicates the areas most affected by said heat.
The general treatment for this type of tongue will be: Clean the nutritive system and sedate the heat.
- Red with red spots: Pathogenic heat in Blood. The location of the spots indicates the place of heat.
- Red spots at the tip: Heart-Fire.
- Red spots on the sides: Liver-Fire. Only on the right border: Gall Bladder Heat
- Red spots in the center: Spleen heat and/or Stomach-Heat.
- Red spots at the root of the tongue: There are two types, with or without coating.
- Red spots at the root of the tongue with coating: Bladder heat or intestines
- Red spots at the root of the tongue without coating: Excess heat from Kidney-Yin deficiency.
- White spots: Excess of toxic heat that burns, ulcer, the heat causes deficiency of the Spleen and Stomach Qi.
- Purple spots: Stagnation of Qi and Blood. from excessive heat in Blood.
Red tongue with redder parts
- Red tip: Heart-Fire with Blood-Heat and heat in the Nutritive Qi.
- Red sides: The sides are redder than the tongue body and swollen. Liver-Yang rising or Liver-Fire excess.
- Red in the center: The center of the tongue is redder than the rest of the tongue. It can indicate Stomach-Heat. If the center is red and without coating it is: Stomach-Yin deficiency which can come from a Kidney-Yin deficiency.
- Red at the root of the tongue: Kidney-Yin deficiency although often the entire tongue becomes red and without coating.
Purple Tongue
The purple color on the tongue indicates blood stagnation. It appears in chronic conditions as stagnations take a long time to develop. It should be said that if the tongue color is neither pale nor red it is surely slightly purple, therefore we need to observe carefully and with patience to differentiate between purple, red or pale.
Both pale and red tongues can become purple after a long period of time.
- Purple: Blood stagnation.
- Pale purple and moist: Excess of Cold that stagnates the Blood.
- Pale purple, moist, without coating, thin and small: Yin syndromes, attack of Cold (obstruction of microcirculation) of Kidney and Liver.
- Reddish purple: Excess of heat - fire that condenses Blood and Body Fluids and causes Blood stagnation.
- Purple with bluish-black background: Cold.
- Purple and dull: Blood stagnation.
- Purple and greenish: Direct attack of Cold to Liver and Kidney.