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By West Norwood Therapies Team, Sep 16 2019 10:30AM

Acupuncturist Philippa Summers shares what you can learn from looking at a tongue and why she might ask you to 'stick out your tongue' when you go to see her!

Tongue Diagnosis provides a clear contribution to overall diagnosis in Chinese Medicine.

Here’s a look at how it fits in with other information, what you can tell from a tongue and

how it relates to treatment.

Gathering Information

Your first session with a Traditional Acupuncturist, like myself, is usually quite lengthy. I

allow 90 minutes for most initial appointments* with about half that time set aside for

gathering information and half for the treatment itself. Alongside understanding the

problem with which you are seeking help, whether it is headaches, low mood, anxiety,

period pain, fertility, tiredness, eczema or something else, it is important to get a picture of

the background against which it has arisen and a more rounded picture of your health and

wellbeing. Digestion, sleep, your monthly cycle for women, reactions to heat and cold and

feelings, among other things, all contribute to a holistic diagnosis. Also important is the

context - your life and lifestyle, what is working well and supporting you and what is not.

Two additional contributions to the overall diagnosis and hence direction of treatment are

pulse and tongue diagnosis. Pulse diagnosis is subjective and is easily affected by what is

going on at that moment or that day. Tongue diagnosis gives a more objective clear picture

and provides a very reliable contribution to your diagnosis and subsequent treatment

strategy. I will almost always ask you to stick out your tongue, although I know that might

seem a little odd!

What do I look for on the tongue?

The tongue gives a glimpse of your insides and although it is a part of the digestive system it

gives clues that relate to the whole body. It can of course be affected by diseases of the

tongue itself and also affected by medication but here I am focussing on situations where

they are not influences. A healthy tongue is pink with a very thin white coating.

Fig 1 A generally healthy looking tongue. Even this healthy tongue gives some clues – there is slight

swelling indicated by the dip in the centre and toothmarks at the edges.

When I look at your tongue I am observing several aspects which include:

• The Tongue Body (the tongue itself beneath the coating) - the colour, shape, texture

and movements.

• The Tongue Coating - the colour, thickness and consistency.

• Points and Spots - their colour and size (distinct from the normal taste buds)

• Cracks and fissures

• Areas of the tongue and their correlation with parts of the body – see Fig 2.

How do these relate to physiology?

Some aspects of the tongue give clear indications on their own, but generally it is the

combined information that provides insight and gives meaning.

So, for example, the tongue body colour (ranging from pale to deep red) gives information

about relative heat and cold in the body, also about the state of the blood and whether it is

well nourished. Spots on the tongue (red or white) and the colour of the coating (white, to

various shades of yellow and even black) give further clarity to influences of heat and cold. A

very slight purplish tinge to the tongue, whether on a pale or red tongue generally indicates

some stagnation.

The relative moisture of the tongue gives the most direct indication of internal body fluids

which is further refined by the relative shape of the tongue and the consistency of the

coating. A very wet, swollen tongue, with a thick greasy coating is a usually a sign that body

fluids have accumulated which hampers function by congesting and blocking. A thin, dry

tongue with no coating may indicate a deficit in fluids which hampers function through lack

of lubrication and nourishment.

Cracks and fissures are more complex and can mean different things depending on their

location, appearance and other aspects of the tongue, but are often associated with a

depletion of body fluids and also with heat.

Different areas of the tongue also relate to different parts of the body. If we divide the

tongue roughly into thirds, the front portion relates to the chest area, the middle third to

the digestive organs above the navel, and the rear third to the area below the navel.

Fig 2 Areas of the tongue as they relate to organs. Note: These are the organs as they are understood in Chinese Medicine and don’t relate exactly to the physical organs although there is considerable overlap.
Fig 2 Areas of the tongue as they relate to organs. Note: These are the organs as they are understood in Chinese Medicine and don’t relate exactly to the physical organs although there is considerable overlap.

It is worth noting that the Spleen in Chinese Medicine includes pancreatic function, so is

very closely connected with digestion. The reproductive organs, especially in women, are

influenced by findings in all areas of the tongue despite their location below the navel.

Putting it all together.

Traditional Acupuncturists seek out the patterns that weave signs and symptoms together

and treatment is focused on bringing harmony, so that everything works together more

supportively. In doing so we aim to improve your health overall, including of course the

main issue that you are seeking help with. An important part of treatment is also working

out what factors are influencing and contributing to the imbalances, so that they too can be


Almost without exception the picture painted by gathering together all the signs and

symptoms will not be textbook patterns, but an individualised interaction of the patterns,

sometimes with some contradictions and some patterns masking others. Everyone is

different and at times the picture can be very confusing. The tongue can give real clarity

and help to prioritize treatment and the most important factors to focus on. Over time the

effects of treatment are reflected in the tongue.

It really is an invaluable tool and it is amazing how different each tongue is. So, when I ask

you to stick out your tongue, please don’t be shy!

*The exception would be when treating a simple muscle of joint problem, like an ankle

sprain, where going into your background health and looking at things from a more holistic

perspective is not as important. An hour is then usually long enough for the first session, but I

may still ask to see your tongue as it can still be helpful.

By West Norwood Therapies Team, Jun 24 2019 08:26AM

Acupuncturist Philippa Summers shares her new passion for broadbeans and a delicious and simple recipe to enjoy them this summer.

I have discovered a new love of broad beans. We have a bumper crop on the allotment – picked young, podded and lightly steamed is a simple and delicious way to fully appreciate their unadulterated sweet earthy flavour. They are loaded with nutrients, in particular protein, minerals, folate and vitamins. In Chinese Medicine they stimulate the action of the spleen and calm the stomach. Eat them on their own with a dollop of butter, toss them in a salad or add them to risotto, use them instead of chickpeas to make humous or try these tasty easy to make falafels. I have used half dried chickpeas and half fresh broad beans but you can vary the proportions as you like, especially if you have a glut of broad beans.

Falafels with minty yoghurt sauce (adapted from a recipe in The Guardian)

Serves 4


150g broad beans, 150g when podded but skins left on

150g dried chickpeas, soaked overnight (no need to cook!)

3 cloves garlic, crushed

½ leek, finely chopped

1 tsp gram (chick pea) flour

1 tbsp chopped coriander

1tbsp chopped parsley

1tsp ground cumin

1/2tsp bicarb of soda

A pinch of cayenne pepper

Salt and Black pepper

3 tbsp Sesame seeds

Oil (Rapeseed or sunflower) for frying

Minty Yoghurt Sauce

250ml plain yoghurt

3tbsp Tahini

1 garlic clove, crushed

Juice of ½ lemon

Salt and black pepper

2 tbsp chopped mint

Flatbreads and salads to serve.


1) Steam the broad beans for 3-4 minutes.

2) Whizz all the ingredients (except sesame seeds and oil) together in a food processor or mash them and mix well.

3) Divide the mixture into 12-16 golf ball sized pieces and press to form small patties.

4) Sprinkle sesame seeds onto a plate and coat patties on both sides.

5) Heat 1 cm of oil in the pan until hot, then turn down the heat a little.

6) Fry the patties 3 minutes on each side, until golden brown.

7) For the sauce, simply whisk all the ingredients together and thin down to pouring consistency with cold water if needed.

8) Serve with warm flatbreads and a salad. Delicious and nutritious!

By West Norwood Therapies Team, May 16 2019 09:34AM

Acupuncturist Philippa summers considers the view from her allotment and how this interpretation of nature and environment mirrors Chinese medicine's approach to our bodies.

I have recently found an unexpected place of peace, tranquillity and contemplation in the heart of London. It is particularly beautiful at this time of year, with spring flowers, fruit trees in blossom and song birds in full chorus. Sitting on a hill above the worst of the pollution with spectacular far reaching views across the city, it is a world of discovery and unexpected surprises. Today we found lizards beneath some wooden boards. It’s an allotment, or rather a share of one, which is even better and far more manageable, in a stunning location close to Brockwell Park. I frequently use metaphors of nature, landscape and environment to illustrate the way that Chinese Medicine views the body. Working on the allotment has fuelled those ideas.

The allotment is quite different from my garden. More mess and earth, getting down and dirty in the soil, with plenty of muck involved. I’ve learnt a thing or too already from the other plot holders generously sharing tips on what grows well up there and how to improve the soil. It’s clay, which is rich in minerals but heavy, and by adding well rotted horse manure and straw the texture and drainage is improved. It feels good to look at the soil more closely, feel its texture rich in fat worms, and know the difference it will make to the health of the plants and the taste of the produce if the slugs don’t get there first.

The muck is like eating really good fresh vital food, as opposed to processed foods and vitamin pills, the equivalent of chemical fertilisers. An organic approach to gardening builds strength in the plants naturally so that they withstand pests, akin to having a healthy immune system. Nurturing and nudging health in positive directions through good nutrition, appropriate exercise, adequate rest and relaxation, affects how we feel in body, mind and spirit. Even when it comes to genetics, we now know that how we live influences which genes are switched on and off.

People often ask if acupuncture can help, such and such a condition. Of course, acupuncture is better suited to treating some things than others, but it is the bodily landscape that is at the heart of a Chinese Medical diagnosis and treatment, rather than the condition. The landscape - be it hot, cold, dry, damp, stagnant, depleted, etc - creates the conditions in which certain imbalances are more likely to arise and progress. The disease label is very often not as important as the landscape against which it has arisen. Two people with migraines may have very different types, arising from very different bodily landscapes and they will be treated differently. A landscape that gives rise to stomach pains in one person, may cause anxiety in another and the treatments may be very similar. So the landscape, rather than the disease label, is more important when it comes to treating with acupuncture and often has more influence on how easily a health issue will resolve. By addressing the imbalance people often find that their overall health and wellbeing improve, not just the issue that they sought treatment for.

Chinese Medicine sees the body as an interconnected whole, where every part of the body is interrelated, and each part exerts an influence on the whole. With climate change we can see just how delicately balanced and interdependent the whole planet is. This too is reflected in our small allotment, with its lizards, foxes and insect life. Our bodies are not so different, as an example I think of the influence that a healthy gut biome has on brain function.

I find the Daoist view, where the internal landscape of the body is influenced by the same forces that influence nature, to be enlightening, inspirational and nature is a great teacher, as well as a great healer. We often give priority to nurturing our physical health and we can do the same for our mental health and wellbeing. Being out in nature is a soothing counterbalance to the bustle of city life. I have found that tending the allotment and looking out over the view in quiet contemplation, or while hanging out with friends, is food for mind, body and soul, both literally and metaphorically. I certainly wouldn’t do it for economic reasons – at an hourly minimum wage it probably works out about £100 a spud!

By West Norwood Therapies Team, Sep 13 2018 09:00AM

Acupuncturist Philippa Summers shares some Chinese medicine wisdom around supporting your digestive system particularly around this time of year.

It’s Late Summer, the short 5th season in the Chinese 5 element calendar, the time of Earth and the harvest. The Earth element and its associated organs – Stomach and Spleen – play a central role in digestion. In particular the Spleen has a very broad digestive function with an influence throughout the body, very importantly on the quality of qi, blood and fluids. When Spleen Qi is out of balance there is a knock-on effect and many aspects of our health can be affected. Giving attention to the Earth element and the function of the Spleen is frequently a starting point of treatment, so it seems an appropriate time to take a closer look at digestion.

Spleen means pancreas

I should clarify that in Chinese Medicine the Spleen was a mistranslation and the ancient Chinese texts were actually talking about the pancreas. For continuity the digestive system has continued to be named as comprising Stomach and Spleen. The actual spleen actually comes under the role of the Liver in Chinese Medicine and is more concerned with storage of blood. So, whenever we use the term Spleen in Chinese medicine, think pancreas, and the important role it plays in secreting enzymes into the intestines and controlling blood sugar.

A Healthy Earth Element

In health a strong Earth element with good Stomach and Spleen qi provide nourishment for the whole body. It keeps us strong, active and stable with endurance and a good appetite and digestion. It also provides qualities that enable us to nurture ourselves and others, and fosters free thinking, imagination and creativity.

Spleen Qi

When the Spleen Qi is weak we often experience tiredness and a tendency to bloat after eating. Stools may be loose and appetite low or erratic with a tendency to food intolerances It can manifest in other ways affecting concentration, food intolerances, menstrual issues, anaemia, weak limbs and give a tendency to prolapse, such as haemorrhoids. Difficulty regulating weight can be part of the picture, either overweight without overeating or thin and unable to gain weight. If it is allowed to worsen then signs of cold can also appear – cold limbs and a chronic aversion to cold. The Spleen likes easily digestible simple warm food.

Accumulation of Damp and Phlegm

When the ability of the spleen to transform fluids is compromised ‘damp’ builds up which often manifests as feelings of heaviness in the limbs and joints along with soreness and aching. Our head may be affected with foggy thinking, a heavy sensation in the head, mental and physical stagnation and a feeling of being ‘stuck’ which hampers creativity.

As damp gets worse the fluids become thicker, more cloying, toxic and gooey often causing mucousy discharges and encouraging the proliferation of microbes in the body with conditions such as candida and thrush.

If they become even more congealed and stagnation builds up then they can progress to phlegm in the lungs or cysts in the genitourinary tract. Weak Spleen Qi, certain foods and also living in damp conditions all contribute.

Stomach Qi

The stomach is responsible for preparing the food we eat for absorption further down the gastro-intestinal tract. Erratic eating habits, rich food and overindulgence play havoc and can lead to acid reflux, heartburn, burning pains, gas and bloating. The stomach does not like to be hot and dry, so dehydration and too many of the hotter spicy foods can affect the stomach. So can flooding it with too much fluid at mealtimes, overdiluting the digestive enzymes. It is about getting a balance.

Next time: How to Support Your Digestion

My next newsletter piece in a couple of weeks will focus on things you can do to aid digestion and keep your inner Earth element happy and functioning well.

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