Pulse and Tongue Diagnosis
What is Pulse Diagnosis in TCM?
In traditional Chinese medicine (TCM), pulse diagnosis is one of the major and effective assessments that health professionals perform to identify certain health conditions of a patient. Pulse diagnosis is also a common health assessment used in Western medicine. However, it is more in-depth in TCM. The difference between pulse diagnosis in TCM and Western medicine is that TCM practitioners use it to determine the health of Zang-organ functions, whereas western doctors use it to measure the heart rate (Bouhdili, 2015).
In TCM, pulse diagnosis uses the same meridian point system and Zang-Fu organ system as other Chinese therapies to diagnose and treat diseases. The TCM pulse
diagnosis consists of about 29 different pulse types, which includes, slow pulse, moderate pulse, weak pulse, faint pulse, scattered pulse, hollow pulse, irregular pulse, swift pulse, long pulse, deep pulse, and more (Lan, Litscher, & Hung, 2020). Some pulse types describe one element of a pulse, while other pulse types describe more than one element of a pulse (Tang, 2012). The characteristics and qualities of each pulse type give the practitioner a clear understanding of certain diseases and their symptoms.
Moreover, it guides the practitioner in choosing the proper treatment modality and Chinese herb teas for the individual. Descriptions of pulse conditions are usually either qualitative or quantitative. However, most pulse conditions are described as qualitative. For instance, one of the qualitative descriptions, such as slippery pulse, is described as an illustration of beads rolling (Tang, 2012). On the other hand, one of the quantitative descriptions, such as rapid pulse, is described as the number of beats per breath (Tang, 2012).
Additionally, the pulse diagnosis is based on six locations and eight elements in TCM. Acupuncturists use the six locations, such as left and right Cun, Guan, and Chi, and the eight elements, such as depth, rate, regularity, width, length, smoothness, stiffness, and strength, to assess the pulse (Tang, Chung, & Wong, 2011). In TCM, it is believed that there must be a balance between each element to achieve optimal health. It means that there has to be an equal balance of Qi and Yin & Yang to keep one’s health status high.
What is TONGUE Diagnosis in TCM?
Tongue diagnosis is an essential, non-invasive TCM technique that allows the practitioner to better understand an individual’s overall health; the analysis of the tongue’s appearance, color, shape, and texture help the practitioner determine which treatment modality best suits the patient. A tongue diagnosis is usually done if there seem to be some symptoms or uncommon signs on the tongue. However, it is still recommended even if there are no apparent signs or symptoms.
During a tongue diagnosis, the TCM doctor or acupuncturist also looks at the length, amount of saliva, and coating details that the tongue has (Carolina Natural Medicine, 2019). It takes about 15 seconds for the tongue assessment to be completed (Wong, 2019). Much like the pulse diagnosis, areas of the tongue connect to specific Zang- and Fu-organs or meridians in the body; the locations correspond to certain organ systems, such as Liver, Heart, Spleen, Lung, and Kidney. Health professionals say that a normal tongue should be pink with no cracks, swelling, teeth marks, or sores, and with a thin white coating and a low
amount of saliva (Carolina Natural Medicine, 2019). Otherwise, there may be an underlying health condition or issue that needs to be checked out. For instance, if the tongue has a thick white coating and looks pale and swollen, it could mean that the individual has Yang deficiency (Carolina Natural Medicine, 2019). This implies that the individual may show signs and symptoms of feeling cold easily, having a pale complexion, having back pain, having the tendency to panic, being emotionally low, having infertility, and much more (Carolina Natural Medicine, 2019).
What do TCM doctors or acupuncturists exactly do when they check pulse and tongue conditions?
During the pulse diagnosis, TCM doctors and acupuncturists examine various pulse qualities - the eight elements in the six locations. When examining the width, TCM professionals look at the amplitude or intensity of the pulse (Bouhdili, 2015). If the pulse is thin or thready, it indicates that the person might have fatigue, nutrient deficiency, insomnia, or weakness; whereas if the pulse is slippery, the person might show signs of digestive or allergy problems (Bouhdili, 2015). For strength, a strong pulse represents headaches, high blood pressure, or stress; whereas a weak pulse represents depression, low blood pressure, or fatigue (Bouhdili, 2015). Lastly, regarding pulse rate, if the pulse is fast, it represents heat in the body; whereas if the pulse is slow, it represents cold in the body (Bouhdili, 2015).
When a tongue diagnosis is performed, TCM doctors and acupuncturists examine the tongue’s color, shape, coating, length, and other features. Before performing the tongue assessment, it is suggested that patients should not eat food, drink beverages, or take any vitamins that may affect the tongue’s color (Wong, 2019). According to the Verywell Health article, the tongue’s pink or light red color represents an individual’s Qi (Wong, 2019). Different colors, such as dark red, purple, or pale pink, could indicate chronic illness or other health issues. In terms of shape, the tongue should be smooth and not too thick or thin; it should not have cracks, teeth marks, or swelling. Regarding coating, TCM professionals use the tongue’s coating to examine its connection to the health of the Zang- and Fu-organ function. When they see an absent tongue coating, they believe that it may be a Kidney Yin deficiency (Wong, 2019).
Checking the pulse and examining the tongue in person allows the TCM doctors or acupuncturists to perform a proper and successful assessment. By looking and examining the actual characteristics, shape, color, and appearance of the tongue, TCM doctors will be able to know which systems or areas in the body are out of balance. The same also goes for pulse examination; reading the pulse and feeling the rhythm of the beats allows the acupuncturist to identify what may be the cause of the illness. Then TCM practitioners will be able to recommend proper treatment modalities or Chinese herb teas that will help the individuals prevent illness and improve health.
The clinic director and chief acupuncturist at Rapha Acupuncture, Dr. Weon Seob Lee, holds a board-certified Diplomate in Oriental Medicine from NCCAOM since 2003 and is licensed in the states of Florida, Georgia, and California. He has been practicing TCM and acupuncture in 7 countries and states for more than 20 years. Check out Dr. Lee’s full bio here.
Schedule a wellness consultation with Dr. Lee to find out your pulse and tongue condition.
Bouhdili, N. (2015, October 8). How pulse diagnosis works by transformational acupuncture. Retrieved March 1, 2021, from
Carolina Natural Medicine. (2019). Brief overview of Chinese tongue and pulse diagnosis. Retrieved from
Lan, K. C., Litscher, G., & Hung, T. H. (2020). Traditional Chinese medicine pulse diagnosis on a smartphone using skin impedance at acupoints: a feasibility study. Sensors (Basel, Switzerland), 20(16), 4618.
Tang, A. C. (2012, October 17). Review of traditional Chinese medicine pulse diagnosis quantification, Complementary Therapies for the Contemporary Healthcare, Marcelo Saad and Roberta de Medeiros, IntechOpen, doi: 10.5772/50442
Tang, A. C., Chung, J. W., & Wong, T. K. (2012). Validation of a novel traditional Chinese medicine pulse diagnostic model using an artificial neural network. Evidence-based complementary and alternative medicine : eCAM, 2012, 685094.
Wong, C. (2019, November 14). How tongues are used to assess health in traditional Chinese Medicine. Retrieved March 1, 2021, from