Tongue and Pulse Diagnosis

In traditional Chinese medicine theory, there are a number of diagnostic tools and principles available to practitioners. All of them provide valuable information on what is happening with a patient, however, tongue and pulse diagnosis gives practitioners an almost real time view of what is happening internally within a patient. This makes tongue and pulse diagnosis two of the most important tools available to practitioners.

Tongue Diagnosis

Inspection and observation of the tongue is one of the pillars of TCM diagnostics, as it provides clear and visible clues to a patient’s disharmony. Tongue diagnosis can provide much clarity in complicated cases where there may be conflicting manifestations of illness.

Observation is based on four main areas.

  • Tongue body colour
  • Tongue body shape
    • Shows the state of Blood and Ying Qi
  • Coating
  • Moisture
    • Indicates the state of Body Fluids

Tongue and Pulse Diagnosis Different areas of the tongue correspond to the different Zang or Fu organs as shown here. This helps to give indications of the state of the internal organs.

This information will assist practitioners in developing an accurate picture of what is happening internally in the body. When inspecting the tongue, it is also important to ensure that false manifestations are ruled out. These may arise if a patient has consumed food or drink, such as tea or coffee, which may stain the tongue, or lighting conditions which may not provide a true relection of tongue colour.

Pulse Diagnosis

Along with tongue diagnosis, this is an extremely important, but also complex part of the overall Chinese medicine diagnostic process. It not only gives a reflection of the state of the Zang-Fu organs, but also of the overall state of Qi and Blood. Despite its ability to provide detailed information, pulse diagnosis is a subjective field and is also subject to short-term, external influences.

Tongue and Pulse DiagnosisThe pulse is usually taken on the radial artery, and is felt at three positions. Each one corresponds to one part of the San Jiao, the Upper, Middle or Lower Jiao. Each of the three pulse positions subsequently relates to a pair of Zang-Fu organs.

In TCM, the three areas for pulse diagnosis are known as Cun, Guan and Chi.


Tongue and Pulse DiagnosisCun: This is the front portion of the pulse. On the left it relates to the Heart and Small Intestine. On the right it corresponds to the Lungs and Large Intestine.

Tongue and Pulse DiagnosisGuan: This is middle portion of the pulse. On the left it relates to the Liver and Gall Bladder. On the right it corresponds to the Spleen and Stomach.

Tongue and Pulse DiagnosisChi: This is the rear protion of the pulse. On the left it relates to the Kidney-Yin and Bladder. On the right it corresponds to the Kidney and Bladder-Yang.

Traditional Chinese medicine tongue and pulse diagnosis are both crucial to syndrome differentiation in TCM, and should be taken into consideration within the context of the whole diagnostic process. They are complex and take time to master, but with practice they will provide a practitioner with a wealth of information which aids diagnosis and syndrome differentitation, ultimately guiding the most appropriate path for treatment.

For a more detailed description of tongue and pulse diagnosis, please refer to: The Foundations of Chinese Medicine: A Comprehensive Text by Giovanni Maciocia.