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Forget the eyes… the tongues have it.

Have you ever wondered what makes traditional Chinese medicine (TCM) different?

When I first learned TCM one of the things that mystified me greatly was how this ancient system of medicine could diagnose things so precisely based simply on taking a good history, palpation of the pulse, and looking at the tongue. I wondered, as you might, how could so many secrets be hidden in the pulse and the tongue?

Today I thought I’d share a couple examples of tongues and discuss what I see in them as a trained veterinary TCM practitioner.

Just a cat tongue? Not quite.

This attractive tongue belongs to a young exotic shorthair kitten. This is not a normal tongue. If you look closely at the edges you will notice three things: The edges of his tongue are quite shiny. The sides of his tongue are very rounded. If you look very closely you will also see some indentations in the sides of his tongue from where it has been pressing against his teeth when his mouth is closed.

Another thing I notice when I look at this tongue is that it is redder than it should be, and there is more free saliva (see the bubbles where the tip of his tongue is a bit creased?) than I expect to see in a normal cat tongue.

To sum up, Mr. Walter has a red, swollen, wet tongue. Without the benefit of pulse diagnosis or history I can already tell you that this kitten is experiencing what we call “Damp Heat” in TCM. I have this picture because he had terrible diarrhea ever since he was adopted. It stopped briefly when he was treated for intestinal parasites, but as soon as the treatment stopped the diarrhea started up again. His fecal samples showed no further parasites, he’d already been on probiotics, and his diet was stable and appropriate, so his poor mom was stumped as to how she could treat him.

After I diagnosed him with Damp Heat in the intestines and we treated him with herbs his diarrhea finally cleared up and he’s been normal since.

Let’s look at another tongue:

This tongue, taken as part of an ultra-close up photo study is what I would classify as a normal cat tongue.


Tongues in TCM are considered to be the color of a peach blossom. This is a bit species dependent and breed dependent: Herbivores often have paler tongues than omnivores or carnivores, and certain breeds can have dark coloration to their tongues as a normal pigmentation. This tongue on the right is a normal pink shade, relatively dry, and the spines nearly go to the edge. Spines that are very much confined to the middle (like Walter’s tongue) make me think that the edges are swollen. Moisture of the tongue is species dependent as well. Cat tongues, for example, are normally moist, but not wet. Dog tongues are normally moist to slightly damp. Horses often have moderately wet tongues and some amount of free saliva is normal for a horse.

Let’s look at a couple more not-quite normal tongues.

This tongue is a bit red around the edges.

This photo is a bit blurry, as you might imagine, cat’s tongues are not the easiest things to photograph!

The most prominent feature of this tongue is the red edge. You can see there is a dark red edge that goes all the way around the tongue from the sides to the tip. This is actually about the fifth photo we took of this tongue. In each photo the tongue got redder and redder. Unfortunately, this is the only one in the series that turned out.

Red around the edge of the tongue indicates Heat. The tip corresponds to the Heart, the emotional seat of the body as well as the physiological heart, and the edges correspond to the Liver, which is not only the detoxification organ we think about, but also the organ responsible for handling stress and frustration.

This little Siamese mix, Kato, is prone to having problems with Heat anyway, and was getting quite stressed and upset that we kept trying to photograph his tongue. This explains why the edges and tip of the tongue got redder and redder as we kept on.

The final tongue belongs to my young, fairly healthy Maine Coon, Pippilotta Fluffstockings.

This tongue is almost normal!

Pippi’s tongue is almost normal. On most of the tongue body the color is a nice pink color. If you look closely at the tip, however, you will notice that not all is right. The tip of Pippi’s tongue is a bit pale. This is actually also a response to stress. After I noticed the abnormality in the photo I checked her tongue again and it appeared normal as long as I looked for only a moment and we were not photographing it.

This response to stress is a response of Blood deficiency, and as we already established the tongue’s tip corresponds to the Heart, this Blood deficiency is in the Heart. Pippi and Kato have different responses to stress, Kato immediately gets frustrated and experiences Heat, whereas Pippi gets a bit more quietly stressed and worried and experiences a temporary Blood deficiency.

It’s a great idea to inspect your cat’s tongue and teeth! (Just watch out not to be bitten if they object.) If their tongue does not look entirely normal, Dr. Erika or Dr. Carter will be happy to have a look and tell you what Chinese medicine has to say about it. If the teeth don’t look right, well, February is dental month, so it’s a great time to come in and have one of our technicians examine your cat’s teeth and let you know if they need a dental cleaning!

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