TCM Tongue Diagnosis Glossary

Qi (气)

Pronunciation: chee

fundamental

The vital life force or energy that flows through all living things in Traditional Chinese Medicine. Qi is responsible for all physiological functions, movement, warmth, protection, and transformation in the body. It circulates through meridians and organs, maintaining health when balanced.

Yin-Yang (阴阳)

Pronunciation: yin-yahng

fundamental

The fundamental duality in Chinese philosophy representing complementary opposites that interact to create balance. Yin represents cooling, moistening, descending, passive qualities (like water, night, female). Yang represents warming, drying, ascending, active qualities (like fire, day, male). Health requires their dynamic equilibrium.

Blood (Xue, 血)

Pronunciation: shway

fundamental

In TCM, Blood is more than the physical fluid - it nourishes tissues, moistens organs, and provides material foundation for mental activities. Blood is closely related to Qi; they support each other. Blood deficiency or stagnation creates distinct patterns visible on the tongue.

Essence (Jing, 精)

Pronunciation: jing

fundamental

The fundamental substance inherited from parents that determines constitution, growth, development, and reproduction. Stored in the Kidneys, Jing is gradually depleted through life and can be partially replenished through diet and lifestyle. It forms the basis of Qi and Blood.

Shen/Spirit (神)

Pronunciation: shun

fundamental

The spirit or consciousness housed in the Heart. Shen manifests in mental clarity, emotional balance, coherent speech, and bright eyes. Disturbed Shen causes insomnia, anxiety, incoherent speech, or mental illness. Tongue spirit reflects in luster and vitality.

Wei Qi/Defensive Qi (卫气)

Pronunciation: way chee

fundamental

The protective Qi circulating on body surface that defends against external pathogenic factors (Wind, Cold, Heat). Produced by Spleen and Kidney, distributed by Lung. Wei Qi deficiency causes frequent colds, spontaneous sweating, and poor immunity.

Body Fluids (Jin Ye, 津液)

Pronunciation: jin yeh

fundamental

All normal physiological fluids in the body except Blood. Jin are clear, thin fluids (sweat, tears, saliva) that moisten skin and muscles. Ye are turbid, thick fluids (synovial, cerebrospinal) that lubricate joints and nourish brain. Deficiency causes dryness.

Constitution (体质)

Pronunciation: tee jr

fundamental

The inherent physical and energetic makeup determined by genetics, early environment, and lifestyle. Nine constitution types in modern TCM classification: Balanced, Qi-deficient, Yang-deficient, Yin-deficient, Phlegm-Dampness, Damp-Heat, Blood-stasis, Qi-stagnation, Special. Guides prevention and treatment.

Zang-Fu Organs (脏腑)

Pronunciation: zahng-foo

anatomy

The 12 organ systems in TCM divided into Zang (yin, solid organs: Heart, Liver, Spleen, Lung, Kidney, Pericardium) and Fu (yang, hollow organs: Small Intestine, Gallbladder, Stomach, Large Intestine, Bladder, Triple Burner). Each has physical and energetic functions beyond Western anatomy.

Heart (Xin, 心)

Pronunciation: shin

anatomy

The emperor organ that governs Blood circulation, houses the Spirit (Shen), and controls consciousness and mental activities. Heart opens to the tongue - its condition directly reflects on tongue color and coating. Heart Fire manifests as red tip; Heart Blood deficiency shows pale tongue.

Liver (Gan, 肝)

Pronunciation: gahn

anatomy

Stores Blood, ensures smooth flow of Qi throughout the body, controls tendons and ligaments, and opens to the eyes. Liver governs emotional well-being - stagnation causes irritability and depression. Reflected on tongue sides - purple or red sides indicate Liver issues.

Spleen (Pi, 脾)

Pronunciation: pee

anatomy

Central organ of digestion that transforms food into Qi and Blood, controls muscles and limbs, and keeps Blood in vessels. Spleen raises clear Qi upward. Deficiency causes fatigue, loose stools, and poor appetite. Reflected in tongue center and overall body quality.

Lung (Fei, 肺)

Pronunciation: fay

anatomy

Governs Qi and respiration, controls skin and body hair, regulates water passages, and opens to the nose. Lung receives Qi from air and combines it with Spleen Qi to form true Qi. Deficiency causes shortness of breath and weak voice. Reflected in front third of tongue.

Kidney (Shen, 肾)

Pronunciation: shun

anatomy

Stores Essence (Jing), governs birth-growth-reproduction-development, produces Marrow (brain and bone marrow), controls water metabolism, grasps Qi from Lung, and opens to ears. Root of all Yin and Yang in body. Reflected in tongue root.

Tongue Body (舌质)

Pronunciation: shuh jr

diagnosis

The substance of the tongue itself, reflecting the condition of Qi, Blood, Yin, and Yang. Color indicates Heat or Cold; shape indicates Excess or Deficiency. Normal tongue body is pale red, neither too thick nor thin, with free movement.

Tongue Coating (舌苔)

Pronunciation: shuh tai

diagnosis

The fur or moss on tongue surface formed by Stomach Qi vapors. Reflects the nature and location of pathogenic factors. Thickness indicates strength of pathogen; color indicates Cold (white) or Heat (yellow). Moist or dry indicates fluid status.

Tongue Color

diagnosis

The color of tongue body indicates the nature of condition: Pale (Blood or Yang deficiency, Cold), Red (Heat), Deep red (extreme Heat or Yin deficiency), Purple (Blood stasis or extreme Cold), Blue (extreme Cold or Blood stasis).

Tongue Shape

diagnosis

The form and size of tongue reflects organ conditions: Thin (Blood or Yin deficiency), Swollen (Spleen deficiency, Dampness, Phlegm), Stiff (Wind, stroke), Deviated (Wind, stroke), Cracked (Heat injuring fluids, Yin deficiency), Teeth-marked (Spleen Qi deficiency).

Sublingual Veins

diagnosis

The two veins under the tongue that reflect Blood circulation and stasis. Normal veins are light purple, thin, and not distended. Dark purple, thick, or distended veins indicate Blood stasis. Useful for diagnosing cardiovascular and gynecological conditions.

Excess and Deficiency (实虚)

Pronunciation: shr shoo

diagnosis

Fundamental diagnostic distinction. Excess patterns involve presence of pathogenic factor (Heat, Cold, Dampness, Phlegm, Blood stasis) with relatively intact vital Qi - strong pulse, loud voice, constipation. Deficiency patterns involve weakened vital Qi - weak pulse, soft voice, fatigue.

Root and Branch (本标)

Pronunciation: bun byow

diagnosis

Diagnostic principle distinguishing underlying cause (Root) from manifesting symptoms (Branch). For example, in chronic cough from Lung Yin deficiency - deficiency is Root, cough is Branch. Treatment may address Root, Branch, or both depending on urgency and strength.

Qi Deficiency (气虚)

Pronunciation: chee shoo

pattern

A pattern of insufficient Qi causing fatigue, shortness of breath, weak voice, spontaneous sweating, poor appetite, and weak immunity. Often results from chronic illness, overwork, poor diet, or constitutional weakness. Requires tonifying Qi through herbs, diet, and rest.

Blood Deficiency (血虚)

Pronunciation: shway shoo

pattern

Insufficient Blood to nourish organs and tissues, causing pale complexion, dizziness, dry skin, numbness, insomnia, scanty menstruation, and anxiety. Often follows hemorrhage, chronic illness, or poor nutrition. Treated with Blood-nourishing herbs and iron-rich foods.

Qi Stagnation (气滞)

Pronunciation: chee jr

pattern

Blockage of Qi flow causing distension, pain that moves or comes and goes, emotional irritability, sighing, breast distension, and irregular menstruation. Often caused by emotional stress, especially frustration and anger. Liver is most commonly affected organ.

Blood Stasis (血瘀)

Pronunciation: shway yoo

pattern

Stagnation or congealing of Blood causing fixed stabbing pain, purple discoloration, masses or lumps, and dark menstrual blood with clots. Results from Qi stagnation, Cold, Heat, trauma, or Blood deficiency. Requires moving Blood with specific herbs and therapies.

Dampness (湿)

Pronunciation: shr

pattern

Heavy, turbid pathogenic factor that obstructs Qi movement, causing heaviness of body and head, sticky sensations, edema, loose stools, turbid discharges, and sticky greasy tongue coating. Originates from Spleen deficiency, external dampness, or diet (dairy, greasy foods).

Phlegm (痰)

Pronunciation: tahn

pattern

Condensed or congealed form of Dampness that creates masses, nodules, cysts, or mental confusion. Visible Phlegm appears as sputum; Invisible Phlegm causes dizziness, numbness, goiter, or mental disorders. Results from Spleen deficiency failing to transform fluids.

Heat (热)

Pronunciation: ruh

pattern

Yang pathogenic factor causing fever, thirst, red face, irritability, dark scanty urine, constipation, and red tongue. Can be Excess Heat (from external pathogen or emotional stress) or Deficiency Heat (from Yin deficiency). Treated with cooling, clearing herbs.

Fire (火)

Pronunciation: hwoh

pattern

Extreme form of Heat showing high fever, severe thirst, mental restlessness, insomnia, bleeding (nosebleed, hematemesis), and deep red tongue. More intense and acute than Heat. Often affects Heart, Liver, or Stomach. Requires strong clearing and draining treatment.

Cold (寒)

Pronunciation: hahn

pattern

Yin pathogenic factor causing aversion to cold, cold limbs, pale face, clear abundant urination, loose stools, and desire for warmth. Can be Excess Cold (from external invasion) or Deficiency Cold (from Yang deficiency). Treated with warming, dispersing methods.

Wind (风)

Pronunciation: fung

pattern

Yang pathogenic factor characterized by movement, change, and rapid onset. External Wind causes common cold, flu, and skin rashes. Internal Wind (from Liver) causes tremors, spasms, dizziness, and stroke. Wind often combines with Cold, Heat, or Dampness.

Dryness (燥)

Pronunciation: dzow

pattern

Yang pathogenic factor that injures Body Fluids causing dry skin, dry cough, dry throat, dry stools, and thirst. External Dryness occurs in autumn; Internal Dryness results from chronic Yin or Blood deficiency. Affects Lung most commonly.

Yin Deficiency (阴虚)

Pronunciation: yin shoo

pattern

Insufficient Yin fluids and cooling function causing night sweats, five-palm heat (palms, soles, chest), dry throat, thirst, insomnia, and afternoon fever. Often affects Kidney or Lung. Creates relative excess of Yang (Deficiency Heat). Treated with nourishing Yin herbs.

Yang Deficiency (阳虚)

Pronunciation: yahng shoo

pattern

Insufficient Yang warming function causing cold limbs, aversion to cold, cold pain relieved by warmth, clear abundant urination, loose stools, and low libido. Often affects Kidney or Spleen. More severe than Qi deficiency. Treated with warming, tonifying Yang herbs.

Rebellious Qi (气逆)

Pronunciation: chee nee

pattern

Qi moving in wrong direction - Lung Qi should descend but rises causing cough/asthma, Stomach Qi should descend but rises causing nausea/vomiting, Liver Qi should spread smoothly but rises causing headache/dizziness. Treated by redirecting Qi to proper direction.

Collapse of Qi (气陷)

Pronunciation: chee shyahn

pattern

Severe Qi deficiency where Spleen Qi cannot hold organs in place, causing prolapse (uterus, rectum, stomach), chronic diarrhea, heavy limbs, and desire to lie down. More severe than simple Qi deficiency. Requires strong tonification and lifting methods.

Summer-Heat (暑)

Pronunciation: shoo

pattern

Seasonal External pathogen occurring in hot weather causing high fever, profuse sweating, thirst, irritability, and scanty dark urine. More severe than regular Heat due to combination of Heat and Dampness. Treated with clearing Summer-Heat herbs.

Latent Heat (伏热)

Pronunciation: foo ruh

pattern

External pathogenic Heat that penetrates deeply and remains dormant in the body, emerging later when conditions favorable. May cause recurrent febrile episodes, skin eruptions, or chronic inflammatory conditions. Requires deep-clearing treatment.

Damp-Heat (湿热)

Pronunciation: shr ruh

pattern

Combination of Dampness and Heat causing sticky yellow discharges, burning urination, foul-smelling stools, jaundice, eczema with yellow discharge, and yellow greasy tongue coating. Common in urinary, digestive, and gynecological conditions. Requires clearing Heat and draining Dampness.

Cold-Dampness (寒湿)

Pronunciation: hahn shr

pattern

Combination of Cold and Dampness causing cold heavy limbs, abdominal pain relieved by warmth, watery diarrhea, clear copious urination, and white greasy tongue coating. Affects Spleen most commonly. Requires warming and drying.

Phlegm-Heat (痰热)

Pronunciation: tahn ruh

pattern

Combination of Phlegm and Heat causing yellow thick sputum, rattling breathing sounds, fever, red face, and yellow tongue coating. Often affects Lung causing productive cough. Requires clearing Heat and resolving Phlegm.

Tonify (补)

Pronunciation: boo

treatment

Treatment principle to strengthen and supplement what is deficient - Qi, Blood, Yin, or Yang. Uses tonifying herbs, acupuncture with reinforcing technique, and nourishing foods. Fundamental strategy for treating deficiency patterns. Must be used cautiously with Excess conditions present.

Drain/Clear (泻)

Pronunciation: shyeh

treatment

Treatment principle to eliminate or reduce Excess conditions - Heat, Fire, Dampness, or Phlegm. Uses draining, clearing, or purging methods with specific herbs and acupuncture techniques. Fundamental strategy for treating Excess patterns. Must avoid with Deficiency conditions.

Move Qi (行气)

Pronunciation: shing chee

treatment

Treatment principle to promote smooth flow of Qi and relieve stagnation. Uses aromatic, moving herbs, specific acupuncture points, and techniques like Tuina massage or Qigong exercise. Essential for treating Qi stagnation and associated pain, distension, and emotional issues.

Move Blood (活血)

Pronunciation: hwoh shway

treatment

Treatment principle to invigorate Blood circulation and remove stasis. Uses Blood-moving herbs, acupuncture, cupping, or external applications. Essential for treating Blood stasis, fixed pain, masses, traumatic injuries, and menstrual problems with clots.

Transform Dampness (化湿)

Pronunciation: hwah shr

treatment

Treatment principle to resolve accumulated Dampness using aromatic, drying herbs and acupuncture. Includes draining Dampness, resolving Phlegm, and strengthening Spleen. Often combined with tonifying Spleen for lasting results to prevent recurrence.

Warm (温)

Pronunciation: wun

treatment

Treatment principle to expel Cold and warm the Interior using hot or warm herbs, moxibustion, and warming foods. Addresses both External Cold invasion and Internal Cold from Yang deficiency. Essential for Cold patterns showing aversion to cold and cold limbs.

Cool/Clear Heat (清热)

Pronunciation: ching ruh

treatment

Treatment principle to clear Heat and Fire using cold or cool herbs and specific acupuncture points. Different methods for clearing different types of Heat - Full Heat, Empty Heat, toxic Heat, or Heat in specific organs. Essential for fevers, inflammation, and red tongue.

Four Natures (四气)

Pronunciation: sz chee

treatment

The thermal properties of herbs: Cold, Cool, Warm, Hot (plus Neutral). Cold/Cool herbs clear Heat and Fire; Warm/Hot herbs expel Cold and warm Interior. Nature must match pattern - Cold herbs for Heat conditions, Warm herbs for Cold conditions. Fundamental principle in herbal medicine.

Five Flavors (五味)

Pronunciation: woo way

treatment

The five tastes of herbs indicating their therapeutic actions: Pungent (disperses, moves Qi), Sweet (tonifies, harmonizes), Sour (astringes, prevents leakage), Bitter (drains, dries), Salty (softens, drains downward). Each flavor enters specific organs and has distinct effects on body.