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The Tongue: A Window to Your Health in Chinese Medicine

Posted on by Natalie Grigorian

In Chinese medicine, the tongue is more than just a muscle—it’s a powerful diagnostic tool that reflects the state of your internal organs, blood flow, and the presence of pathogenic factors. At Aetherium, patients are familiar with tongue diagnosis as a key part of their treatment. Alongside the intake and pulse diagnosis, the tongue provides objective insights that help practitioners create personalized treatment plans.

The tongue’s appearance is a dynamic gauge of health, offering clues about the progression and sometimes improvement of a patient’s condition. By carefully analyzing the tongue’s color, shape, coating, and moisture, practitioners can identify patterns of disharmony and tailor treatments accordingly. This is especially valuable in complex cases, such as chronic conditions or long-term medication use.

Close-up of a patient sticking out their tongue for diagnostic observation in Chinese medicine, showing a pale pink tongue body with a central crack and slight pinched sides and scalloping along the edges.
The tongue offers valuable insight in Chinese medicine. This image shows a pale pink tongue with a red tip, a central crack, pinched sides, and slight scalloping along the edges. These visual clues help practitioners identify internal imbalances that are explored further through personalized consultation and diagnosis.

The Tongue as a Diagnostic Tool

In Chinese medicine, the tongue is examined systematically, with attention to specific aspects that reveal underlying imbalances. Here’s what practitioners look for:

1. Vitality of the Tongue

The “spirit” of the tongue reflects overall vitality. A tongue with a vibrant, lively appearance suggests a good prognosis, even if other symptoms are present. Conversely, a dark, withered tongue indicates a more serious condition and a poorer prognosis.

2. Tongue Color

The color of the tongue body (beneath the coating) provides insights into the state of the blood, yin organs, and qi. For example:

  • A purple tongue suggests blood stagnation.
  • A very pale tongue may indicate blood or yang deficiency.
  • A dark red tongue points to intense heat in one or more organs.

3. Tongue Shape

The shape of the tongue—whether thin, swollen, long, or short—helps identify excess or deficient patterns. For instance:

  • A swollen tongue often indicates dampness or phlegm caused by pathogenic fluid accumulation.
  • Pinched sides suggest stagnation.
  • Cracks on the tongue, resembling dry soil, signal severe depletion of body fluids.

4. Tongue Coating

The coating reflects the state of the internal organs and the presence of pathogenic factors.

  • A white coating corresponds to cold, while a yellow coating indicates heat.
  • The thickness of the coating reflects the strength of pathogenic factors.
  • The topography of the coating can reveal whether the disease is internal or external.

Pro tip: Never scrape off your tongue coating before a consultation—it holds valuable diagnostic information!

5. Tongue Moisture

The moisture level of the tongue indicates the status of the body’s fluids. A healthy tongue should be slightly moist—neither too dry nor too wet.

What Does a Healthy Tongue Look Like?

A healthy tongue is a reflection of balanced qi, blood, and fluids. Here’s what to look for:

  1. Spirit: The tongue should appear vibrant and lively, like that of a healthy child.
  2. Body Color: A pale red, “fresh” color indicates a healthy supply of blood and fluids.
  3. Shape: The tongue should be supple—neither too flabby nor too stiff—with no cracks, tremors, or ulcers.
  4. Coating: A thin, white coating reflects normal digestive function and a healthy gut biofilm.
  5. Moisture: The tongue should be slightly moist, indicating proper fluid balance.

Fat Tongues: A Modern Phenomenon

In today’s society, thin tongues are rare. Modern diets and lifestyles have led to an increase in swollen, “fat” tongues or wide tongues. While a quick Google search might attribute this to spleen qi deficiency, the underlying issue is often water retention caused by insufficient nitric oxide and ATP production. In Chinese medicine this may be known as dampness or phlegm.

Over time, this fluid accumulation can lead to systemic issues, making it crucial to address the root cause before attempting to nourish the body. Otherwise, you risk feeding pathogenic bacteria and worsening the condition. This is why patients on tonic substances, adaptogenic supplements or improper supplementation, don’t get better. At times can sometimes do more harm than good.

How Medications Affect the Tongue

Medications can significantly alter the tongue’s appearance, providing further diagnostic clues:

  • Antibiotics: Often cause the tongue coating to peel in patches, reflecting injury to stomach yin.
  • Corticosteroids: Oral steroids can make the tongue red and swollen after about a month of use.
  • Bronchodilators: Prolonged use may cause the tongue tip to become red.
  • Diuretics: Long-term use can lead to yin deficiency, drying out the tongue.
  • Anti-inflammatory Drugs: Certain medications can thicken or darken the tongue coating.
  • Antineoplastics: Cytotoxic drugs used in cancer treatment often cause a thick, brown, or black coating.

Why Tongue Diagnosis Matters

The tongue is a mirror of the body’s internal state, offering a wealth of information about organ function, fluid balance, and overall health. By understanding its nuances, practitioners can pinpoint areas of imbalance and provide targeted support.

At Aetherium, tongue diagnosis is an essential part of our holistic approach to health. Whether you’re dealing with a chronic condition or simply seeking to optimize your well-being, your tongue can tell a story—and we’re here to listen.

References

Maciocia, G. (1995). Tongue diagnosis in Chinese medicine. Churchill Livingstone.

Kaptchuk, T. J. (1983). The web that has no weaver. Congdon & Weed.

Zhang, B., Wang, X., & Li, J. (2023). Tongue diagnosis in traditional Chinese medicine: Potential diagnostic and therapeutic applications. ScienceDirect. https://www.sciencedirect.com/science/article/pii/S2405844023098237

Chen, H., & Xu, J. (2022). Clarifying the connection between tongue diagnosis and systemic health: A review of clinical evidence. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008461

The Future of Healthcare: A Time for Change

Posted on by Natalie Grigorian

Every new administration brings the opportunity to reimagine how we deliver healthcare in America. Having worked within the Veterans Health Administration and Health and Human Services, I’ve seen firsthand both the strengths and deep challenges of our system.

There’s no doubt that the U.S. is facing a healthcare crisis—rising costs, disparities in access, and chronic disease burdens continue to impact millions. As policy shifts take shape, we must ask: What kind of healthcare system do we truly want for our future?

Now is the time to advocate for integrative, patient-centered solutions that improve outcomes and make healthcare more accessible and effective. In my field of acupuncture and integrative medicine, we see how holistic approaches can bridge gaps in care, reduce dependency on pharmaceuticals, and support long-term well-being.

Below are five policy changes that I would like to see implemented.

1. Pass H.R. 3133: Acupuncture for Our Seniors Act

The Issue: Seniors under Medicare have limited access to acupuncture, despite its proven effectiveness for pain management, neuropathy, arthritis, and post-surgical recovery. Currently, licensed acupuncturist are not recognized as healthcare providers under Medicare and Medicaid. Patients can submit claims to Medicare only for chronic low back pain, and only receive coverage for services when provided by an MD or other non-acupuncturist provider.

Policy Recommendation:
✔ Pass H.R. 3133 (Acupuncture for Our Seniors Act) to officially recognize licensed acupuncturists as Medicare providers.
✔ Expand Medicare coverage for acupuncture beyond chronic low back pain to include arthritis, migraines, post-stroke recovery, and chronic disease management.
✔ Reduce opioid dependency among seniors by making acupuncture a first-line treatment for pain relief.

Impact:
By passing H.R. 3133, more seniors will gain access to safe and effective pain management options without relying on opioids. Acupuncture will become a widely recognized medical service, strengthening the profession and improving healthcare equityacross communities. Additionally, Medicare costs will decrease as patients use fewer prescription drugs and require fewer hospital visits.

2.  Expand Insurance Coverage for Acupuncture & Integrative Medicine

The Issue: Acupuncture is clinically proven for pain management, fertility, anxiety, digestive disorders, and more. Yet, insurance coverage remains inconsistent and limited, forcing many patients to pay out of pocket.

Policy Recommendation:
✔ Mandate licensed acupuncturists provide care under Medicare, Medicaid, and private insurance for chronic pain, mental health, post-surgical recovery, and women’s health.
✔ Increase insurance reimbursement rates to meet the financial strains of healthcare providers, inflation costs, and fair wages.
✔ Expand FSA & HSA eligibility to cover acupuncture and herbal medicine.
✔ Support Medicaid reimbursement for acupuncture, particularly for pain relief, to reduce opioid dependence in underserved communities.

Impact: This would reduce opioid use and pharmaceutical dependences, lower long-term healthcare costs, and provide affordable alternatives for chronic conditions. Additionally, this would increase the likelihood of integrating acupuncture and Chinese medicine in hospital settings who have difficulty offering these services due to the lack of profitability.

3. Integrative Medicine in Veterans Affairs & Federal Healthcare

The Issue: The Veterans Health Administration (VHA) has piloted acupuncture programs for PTSD, chronic pain, and traumatic brain injuries—but these programs are not widely accessible.

Policy Recommendation:
✔ Expand acupuncture access through licensed acupuncturist within the VA system, making it a standard offering in pain clinics, PTSD treatment centers, and long COVID programs.
✔ Provide licensed acupuncturists the opportunity to work along VA doctors and healthcare providers to better integrate patient-centered care into veteran services.
✔ Increase research funding for acupuncture and herbal medicine within the National Institutes of Health (NIH) and Department of Veterans Affairs.

Impact: This would improve veteran healthcare outcomes, lower opioid dependency, and reduce healthcare spending on chronic conditions.

4. Preventative Healthcare Through Integrative Medicine

The Issue: The U.S. healthcare system prioritizes treating disease rather than preventing it. Yet, conditions like anxiety/depression, gastrointestinal issues, hypertension, autoimmune conditions, and reproductive health can be prevented or managed holistically before requiring expensive medical interventions.

Policy Recommendation:
✔ Develop Preventative Healthcare Reimbursement Programs that cover acupuncture, dietary therapy, and herbal medicine for stress management, metabolic health, and immune support.
✔ Incentivize employers to offer acupuncture and integrative healthcare benefits as part of workplace wellness programs.
✔ Expand hospitals and federally funded community clinics that integrate Chinese medicine with primary care.

Impact: This would lower healthcare spending in the long term, reduce chronic disease rates, and promote whole-body wellness.

5. Improve Accessibility & Training for Integrative Medicine Practitioners

The Issue: Many healthcare professionals lack training in integrative medicine, leading to missed opportunities for patient-centered care.

Policy Recommendation:
✔ Require all health professionals practicing acupuncture to gain certification from NCCAOM the authority of Chinese medicine in the United States.
✔ Require basic acupuncture and integrative medicine training in medical schools, nursing programs, and public health curricula so proper referrals and patient-centered outcomes can occur.
✔ Provide federal grants for interdisciplinary research between acupuncturists, MDs, and public health experts

Impact: This would create better collaboration between Eastern and Western medicine, improve patient outcomes, and broaden access to integrative medicine.

Final Thoughts

Acupuncture isn’t just a complementary treatment—it’s a proven whole system of medicine that should be a core part of the US healthcare system. The new administration has a unique opportunity to redefine healthcare by incorporating acupuncture, herbal medicine, and integrative treatments into mainstream care. These policies would reduce costs, improve patient outcomes, and expand access to evidence-based integrative medicine.

Let’s make acupuncture and Chinese medicine a core part of U.S. healthcare policy. The future of medicine is integrative, accessible, and patient-centered—will our leaders take action?

Understanding the Five Elements in Chinese Medicine: A Guide to Health and Harmony

Posted on by Natalie Grigorian

In Chinese medicine, the body is seen as a reflection of nature, and the balance within our bodies is influenced by the dynamic forces of the natural world. One of the core frameworks used to understand and treat imbalances in Chinese medicine is the Five Element (or Phases) Theory (Wu Xing). Xing means to walk or to move, and therefore when the word ‘Element’ or ‘Phase’ is used to describe the movement or quality of qi that represent the fundamental qualities of all matter in the universe. This theory categorizes everything in the universe—and within us—into five elements: Wood, Fire, Earth, Metal, and Water. Each element has unique qualities and associations that inform how Chinese medicine practitioners approach physical, emotional, and spiritual health.

Let’s explore how each element is connected to different aspects of health, emotions, and organ systems, and how understanding this theory can deepen our approach to wellness.

What Are the Five Elements?

Each element in Chinese medicine has specific correspondents that are linked to certain qualities in a life or a person (See Table 1). Here’s a closer look:

1. Wood represents growth, flexibility, and renewal. Like the trees and plants that thrive in spring, Wood energy encourages expansion and forward movement. When balanced, Wood brings vitality, purpose, and resilience. When unbalanced, it may manifest as irritability or frustration. Individuals who tend to have wood constitutions tend to have issues and difficulties with boundaries, power, being correct, personal growth and development.

2. Fire is the element of warmth, energy, and passion. It rules the summer and encourages connection, laughter, and love. Fire’s energy is uplifting and vibrant, and its influence on the Heart and Small Intestine relates to circulation, communication, and the assimilation of nutrients. A balanced Fire element brings joy and enthusiasm, while an excess or deficiency might lead to restlessness, anxiety, or emotional instability.

3. Earth represents stability, nurturing, and grounding. Earth is the center of balance, symbolizing the end of the growing season when we harvest and reflect. It governs the Spleen and Stomach, which in TCM are central to digestion and energy distribution. When Earth is in harmony, it brings a sense of peace and connection to our surroundings. When unbalanced, it may show up as worry, overthinking, or digestive issues.

4. Metal symbolizes structure, clarity, and reflection. Just as autumn encourages letting go of what no longer serves us, Metal energy supports the processes of elimination and release. Metal is associated with the Lungs and Large Intestine, governing respiration and elimination. A balanced Metal element brings a sense of acceptance and clarity, while an imbalance might manifest as respiratory issues, skin problems, or difficulty releasing emotions.

5. Water embodies adaptability, wisdom, and introspection. Like rivers and oceans, Water’s nature is fluid and powerful, representing the depths of winter and a time for rest. The Kidneys and Bladder are linked to this element, governing essential energies, fluid balance, and growth. A balanced Water element brings resilience and a calm sense of self, while imbalances might lead to fear, anxiety, or kidney and bladder issues. Winter in TCM is the time to conserve energy, rest deeply, and focus on inner resources.

Table 1. Five Element Correspondences

The Cycles of Interaction in the Five Elements

In TCM, the elements interact in two primary cycles that reflect the natural rhythms of growth and balance:

  • Generating (Sheng) Cycle: This nourishing cycle is a supportive flow where each element fuels the next—Wood feeds Fire, Fire creates Earth, Earth bears Metal, Metal enriches Water, and Water nourishes Wood. This cycle encourages growth, healing, and regeneration.
  • Controlling (Ke) Cycle: This regulating cycle maintains balance by keeping each element in check. Wood controls Earth, Earth controls Water, Water controls Fire, Fire controls Metal, and Metal controls Wood. When an element becomes excessive, this cycle helps to rebalance it by tapping into a controlling relationship.

These interactions inform TCM treatments, helping practitioners understand where imbalances lie and how to restore harmony. For instance, if someone has an excess of Fire (such as irritability or insomnia), practitioners might work with the Water element to cool and soothe the excess heat.

Applying the Five Elements to Health and Wellness

The Five Element Theory provides a holistic approach to understanding and treating health concerns in TCM:

  • Physical Health: Each element corresponds to an organ pair, and by understanding these connections, practitioners can identify and address imbalances in the body. For example, respiratory issues in autumn might indicate a Metal imbalance, leading to targeted treatment of the lungs and large intestine.
  • Emotional Health: Emotions are integral to each element. For instance, grief (Metal) can affect the lungs, while anger (Wood) can influence the liver. TCM practitioners work to balance both physical and emotional aspects, understanding that the two are interlinked.
  • Preventative Care: The seasonal aspects of the Five Elements provide a guide for preventative health. Each season offers an opportunity to support different organ systems, promoting wellness through dietary, lifestyle, and emotional adjustments.