Tongue Appearance: Symptoms and Remedies in Traditional Chinese Medicine - Traditional Chinese Medicine

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Appearance of the tongue


Hello Dr.
Chang: I have noticed that my tongue is swollen, with a white coating on it, and there are indentations along the edges resembling teeth marks.
I also experience a bitter taste in my mouth upon waking.
What condition could this be? What can I do in my daily life to improve these symptoms? Thank you!

Xiao Ke, 50~59 year old female. Ask Date: 2022/04/16

Dr. Zhang Weidong reply Traditional Chinese Medicine


Hello, Xiao Ke: You mentioned that your tongue is thick, which may be what we refer to as macroglossia, along with the presence of indentations on the edges, indicating Qi deficiency according to Traditional Chinese Medicine (TCM) theory.
A thick white coating on the tongue generally suggests dampness, so your tongue presentation indicates a combination of Qi deficiency and dampness.
Waking up with a bitter taste in your mouth is often associated with liver fire, which may be related to the Qi deficiency and dampness, or it could be independently linked to poor sleep quality.
More information is needed for a proper assessment.
I recommend consulting a TCM practitioner nearby to address your issues.
Wishing you good health, Zhang Wei-Dong, Department of Traditional Chinese Medicine, Changhua Hospital.

Reply Date: 2022/04/16

More Info


In Traditional Chinese Medicine (TCM), the appearance of the tongue is a crucial diagnostic tool that reflects the overall health of the body. The characteristics of the tongue, including its color, shape, texture, and the presence of coating, can provide insights into various internal conditions. Based on your description of a thick tongue, white coating, tooth marks on the edges, and a bitter taste in the mouth upon waking, several interpretations can be made.

1. Thick Tongue and White Coating: A thick tongue with a white coating often indicates the presence of phlegm or dampness in the body. This can be associated with digestive issues, where the spleen is not effectively transforming food into energy, leading to the accumulation of dampness. In TCM, the spleen is responsible for digestion and the production of Qi (vital energy). When it is weak, it can lead to symptoms such as a thick tongue coating.

2. Tooth Marks on the Edges: The presence of indentations or tooth marks on the sides of the tongue suggests that the tongue is swollen, which can be a sign of dampness or heat in the body. This swelling can also indicate a deficiency in the spleen's ability to manage fluids, leading to an accumulation of excess moisture.

3. Bitter Taste in the Mouth: A bitter taste, especially in the morning, is often associated with liver heat or gallbladder issues. In TCM, the liver is responsible for the smooth flow of Qi and blood, and any stagnation or excess heat can lead to a bitter taste. This could also be related to dietary habits or emotional stress, which can impact liver function.


Remedies and Lifestyle Adjustments
To address these symptoms, several remedies and lifestyle changes can be considered:
1. Dietary Adjustments:
- Avoid Damp-Producing Foods: Reduce the intake of dairy products, fried foods, and sugary items, as these can contribute to dampness in the body.

- Incorporate Digestive Herbs: Consider adding ginger, garlic, and green onions to your meals, as they can help stimulate digestion and reduce dampness.

- Stay Hydrated: Drink warm water or herbal teas, such as chrysanthemum or peppermint tea, which can help clear heat and promote digestion.

2. Herbal Remedies:
- Traditional Chinese Herbal Formulas: Formulas such as Ping Wei San (平胃散) can help strengthen the spleen and resolve dampness. However, it is essential to consult with a qualified TCM practitioner to tailor the herbal treatment to your specific condition.

- Detoxifying Herbs: Herbs like Huang Lian (黃連) and Long Dan Cao (龍膽草) can help clear heat from the liver and gallbladder, addressing the bitter taste.

3. Lifestyle Changes:
- Stress Management: Engage in activities that promote relaxation, such as tai chi, yoga, or meditation, to help manage stress, which can impact liver health.

- Regular Exercise: Incorporating regular physical activity can help improve digestion and promote the smooth flow of Qi throughout the body.

4. Tongue Care:
- Tongue Scraping: Gently scraping the tongue each morning can help remove excess coating and improve oral hygiene. This practice can also stimulate the digestive system.

5. Consultation with a TCM Practitioner: It is advisable to seek a consultation with a TCM practitioner who can provide a comprehensive diagnosis and personalized treatment plan based on your specific symptoms and overall health condition.

In summary, your symptoms suggest a combination of dampness and possible liver heat. By making dietary adjustments, incorporating herbal remedies, managing stress, and consulting with a TCM practitioner, you can work towards improving your tongue appearance and alleviating the associated symptoms. Always remember that TCM emphasizes a holistic approach, addressing both the symptoms and the underlying causes of health issues.

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