Tongues and Diagnosis

From time to time people will send me a picture of their tongue and ask “what formula should I take?” (I love this job.) Tongue diagnosis is not a standalone method for making a diagnosis and writing a formula. The tongue can tell a lot but its not the complete “picture” so to speak without a list of symptoms at least. Still, I’ve been doing this for more than 20 years so I can make a few generalizations. Here are a few examples:

The same tongue from above with red prickles (indicating heat), some yellow (off white) coating in the middle and a center (stomach area) crack. This patient might benefit from a formula with Huang Qin, Dan Shen and Ban Xia among the ingredients.

Assuming the color is correct on this photo, it shows a pale purple (dusky) tongue. There is a combination of blood deficiency and blood stagnation. In addition the coating is rather moist. It is quite puffy. The patient might benefit from a formula with He Shou Wu and Bai Zhu as ingredients.


Yikes, pretty bad- and I’m assuming this photo is rather yellow. Lots of scalloping on the edges, a thicker yellow coat and pretty bad cracks. This might be the first patient after a decade of bad food habits. We might think of He Shou Wu again, Ban Xia, Bai Zhu and Cang Zhu.

Pretty nasty- the tongue has indications of Stomach yin deficiency (no coat in the middle) with a thick yellow coat (dampness). One might use Cang Zhu for the phlegm dampness combined with Mai Men Dong among the ingredients.


Ok, this is bad. Phlegm dampness. One needs a full on Shi Wei Wen Dan Tang or at least Wen Dan Tang here. When there is this much phlegm damp then no “qi” is going to move at all.

this tongue has the scalloped edges but its not so bad. There are stomach area cracks (in the middle) but the tongue itself is not so red so there isn’t much heat. Probably the patient would benefit from Bai Zhu and Mai Men Dong in their formula.