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Tongue Ulcers

How Chinese medicine differentiates tongue ulcers into the five patterns you'll actually meet in practice, and the points for each. Distinct from this site's Canker Sores and Tongue Pain pages. Acupuncture only β€” no herbs.

This page is educational, for practitioners and students β€” it is not a diagnostic tool and does not replace a proper in-person assessment. Tongue ulcers that are large, persistent beyond three weeks, or accompanied by unexplained weight loss need medical assessment.
General Acupuncture Points

Acupuncture points traditionally used for tongue ulcers β€” 3 key points, used across the patterns below rather than tied to just one.

PointKey action
HE-7Calms the Mind and opens the Mind’s orifices. Nourishes Heart-Blood.
SP-6Strengthens the Spleen. Resolves Dampness. Promotes the function of the Liver and the smooth flow of Liver-Qi.
L.I.-4Expels exterior Wind and releases the Exterior. Promotes the diffusing of Lung-Qi, regulates the Defensive Qi and sweating. Stops pain.
The Five Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Heart Fire Blazing View full pattern →

Clinical manifestations: Burning, intensely painful ulcers, especially on the tongue tip; a red, swollen tip with prickly red dots; thirst for cold drinks; dark, scanty urine; mental restlessness, irritability, sleep disturbance.
Tongue: Red with a distinctly redder tip, yellow dry coat. Pulse: Rapid, forceful, overflowing, strongest at the left front position.
Treatment principle: Clears Heart Fire, nourishes Yin and guides Heat downward through urination.
Note: no moxa.

2. Stomach Fire View full pattern →

Clinical manifestations: A burning ulcer; excessive hunger; bad breath; swollen, painful, bleeding gums; thirst for cold drinks; constipation with dry stools.
Tongue: Red, possible prickles, thick dry yellow coat. Pulse: Rapid, slippery, full, strongest at the right middle position.
Treatment principle: Clears Stomach Heat, cools the Blood and reduces the swelling and pain from upward-rising Fire.
Note: no moxa. Linked to this site's own Stomach-Heat slide.

3. Liver Qi Stagnation Turning into Heat View full pattern →

Clinical manifestations: Ulcers often on the tongue sides; worse with stress and anger; irritability, explosive anger; bitter taste; distending rib-area pain; worse premenstrually.
Tongue: Red, especially redder on the sides, yellow coat. Pulse: Wiry and rapid.
Treatment principle: Soothes Liver Qi and clears the resulting Heat.
Note: no moxa.

4. Kidney Yin Deficiency with Empty-Heat View full pattern →

Clinical manifestations: Recurrent, shallow, mildly burning ulcers worse at night and with overwork; night sweats, five-palm heat; lower-back soreness and weakness; dry mouth wanting small sips.
Tongue: Red, thin, dry, little or no coat, possible cracks. Pulse: Fine and rapid, weak at the rear position.
Treatment principle: Nourishes Kidney Yin, anchors floating Heat and replenishes depleted fluids.
Note: no moxa (Yin deficiency with heat signs).

5. Damp-Heat in the Stomach and Spleen View full pattern →

Clinical manifestations: Thick yellow greasy tongue coating; bloating and upper-abdominal fullness; a sticky mouth sensation; bitter taste; loose, sticky stools; a heavy body and limbs.
Tongue: Red, possibly swollen and tooth-marked, thick yellow greasy coat at the centre and root. Pulse: Soggy, rapid, often slippery.
Treatment principle: Clears Heat and drains Dampness; regulates Qi and harmonizes the Middle Burner.
Note: no moxa. Linked to this site's own Damp-Heat-in-the-Stomach slide.
Related conditions

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