equine tongue

Your horse’s tongue can tell you more about his health and well-being than you may think!

Have you ever really looked at your horse’s tongue? It can be a challenging task if he’s private about his mouth, but it can also be important. In Traditional Chinese Medicine (TCM), the tongue’s appearance – including its shape, color, thickness, movement and coating – tells a story about what’s going on inside the body.

The Chinese medicine art of tongue assessment is complex and can be a lifelong study. It’s an effective way to confirm a horse’s condition when considered along with other indicators. Let’s cover a few basics to get a sense of what tongue assessment is all about.

The heart and tongue

As a whole, the tongue is said to have a special relationship with the heart. When the heart is functioning optimally, the vessels in the it indicate that the blood is circulating properly – that is, it is nice and full and pleasantly pink. In TCM, heart health manifests in the tongue because that’s where you can see the blood vessels being nourished.

Understanding tongue color

If the horse’s tongue is unusually red, the animal may be experiencing “Heat Pattern of Disharmony”. For there to be a “pattern”, there needs to be a few indicators. The tongue is only one indicator and is usually used to confirm the pattern of disharmony. For instance, if the horse is restless, overly anxious, and his tongue is red, the TCM practitioner’s assessment of his condition is clearly Heat Pattern of Disharmony.

If the horse’s tongue appears pale, his eyes are dull, and he is lethargic, his condition is said to be a “Cold Pattern of Disharmony”. This pattern of indicators lets the practitioner know the animal is suffering from a lack of healthy blood or chi (life-promoting energy) circulation, or both. Chi is responsible for the movement of blood, and blood nourishes the vessels. When blood and/or chi are not vital enough, it will be pale and this is interpreted as a “Cold” syndrome.

Red or pale colors are the two most basic observations leading to an evaluation of the horse’s health. Other colors indicate other health issues. For instance, a purple tongue means blood is stagnating in it. This is related to a Cold syndrome because the blood is stuck and not circulating properly. If the tongue has a redder cast to the purple, it indicates Heat stagnation. The stagnation is more extreme when the tongue is gray or black; this can indicate the horse is in shock.

Size matters

The size and thickness of the tongue is also meaningful. If it is narrow and thin, the horse may be dehydrated, which in TCM terms means he may not have enough yin body fluids and/or the volume of blood he needs. A full, flabby tongue can indicate a stagnation of fluids and not enough Heart and Spleen chi to keep them moving.

These are just a few examples of how the TCM practitioner can gain an understanding of what’s happening internally. But ancient Chinese medicine practitioners didn’t stop there. They took observation to an even more refined level of detail.

Tongue topography

After thousands of years of clinical observation, Chinese doctors saw that the tongue is actually a reflection of the trunk of the body. The tip of the tongue corresponds to the upper part of the body which houses the heart and lungs. In TCM terms, the upper portion of the body is called the “Upper Jiao”.


When the tip is red and swollen, it most likely indicates the horse is suffering from an Excess Heat Pattern of Disharmony related to the heart. Here’s another example: the horse has nasal discharge, his breathing sounds congested, and the next section back from the tip of the tongue appears pale with a white coating. This horse is probably experiencing a Cold Pattern of Disharmony related to the lungs.

The center corresponds to the internal organs in the center of the body, also called the “Middle Jiao”, where the stomach and spleen/pancreas reside. If the center of it appears pale purple, for instance, he may be experiencing digestive issues of a Cold Stagnant nature.

When the sides of the middle section are red, there could be Heat Pattern of Disharmony related to the liver and/or gall bladder (Note: though horses to do not have a gall bladder, the energy of the gall bladder still exists in TCM.) Other indicators combined with a red coloration on the sides would lead to an assessment that the liver and/or gall bladder are not functioning properly.

The back section is related to the lower abdomen or “Lower Jiao”. The health of the bladder, kidney, small and large intestines can be seen by observing that portion of the tongue. If the very back is red and has a yellow coating, the practitioner will suspect a Heat syndrome related to the kidney and look for other indicators to confirm the suspicion. In other words, the topography of the tongue provides a fairly detailed assessment tool to assist in determining the horse’s condition.

Trained TCM practitioners become astute at observing the subtle signs of color variation, shape, coating, and movement as part of their assessment process. You can also become more aware of your horse’s health by using some of these techniques when examining his tongue.