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How to Take Useful Tongue Pictures

Sending us your tongue pictures before your visit would help us to know your body function and the progress of treatment.  As a result, Dr. Kwok can treat your specific conditions more effectively.  Observing the appearance of the tongue is an important part of the diagnostic process in Chinese medicine. 

Please follow the following guide to take quality tongue pictures, and see the example pictures: 

  1. WHEN:  The best time to take the pictures is in the morning, before eating / drinking anything and without scraping / cleaning your tongue's coating (so the color and the thickness of tongue coating will not be altered).  

  2. LIGHTING: the best is under natural light; if outdoor, be sure to stay in the shade; if indoor, be in a location where there is plenty of light. 

  3. IMAGES:

    • Top: extending the tongue in a relaxed manner, do not "point" your tongue out, and take the picture within 5-seconds of sticking out your tongue.  It is important to show the full length of your tongue, including the tip and the root

    • Bottom: showing the root of your tongue by opening your mouth, rolling up the tongue, and reaching your tongue towards your upper soft palate. 

Tongue Picture 1
Tongue Picture 2

Frequently Asked Questions


Traditional Chinese Medicine (TCM) has its own unique theory.  Some “simple questions” may not always have a straightforward answer.  Therefore, the “short answers” without through explanation are often either incomplete or misleading.  We would like to provide the following information for the general educational purpose.  The information is not intent to be used as self-diagnose nor a explanation for the your case.  To explore additional information that’s related to your individual condition(s), be sure to read the instruction at the end. 

  •   What do I need to do for the ACUPUNCTURE?   

Before acupuncture, have a semi-full stomach, empty bladder, wear loose comfortable clothes (e.g. a yoga pant that allows you to roll the leg to above knee without restricting the circulation), bring a soft thin scarf if you might be pregnant.  


During the resting, keep the same posture, do not move your body for the safety reason. 


After the session, take it easy for the rest of your day, avoid intense exercises/activities, and drink lots of water until 2 hours before your bed time.


  •   Is acupuncture painful? 

Many first-time patients are concerned that acupuncture needles will feel like hypodermic injections at their family doctor’s office.  They won't.  Acupuncture uses hair-thin, flexible needles that you will hardly feel when I insert them.  When I gently stimulate the needles, they may produce a unique sensation that Chinese medicine calls De Qi (得气).  De Qi means the acupuncture points and meridians are activated, which helps to increase the effectiveness of the treatment.  Patients often describe De Qi as a mild sourness-achy, numbness, heavy, pressure, or spreading-travelling feeling ("electrical" like sensation).  Most patients find these acupuncture sensations deeply satisfying and leave the treatment feeling relaxed both mentally and physically.   


In rare occasion, you might feel sharp pain.  When this happens, please bring it to my attention immediately, so I can adjust the needle to ease the discomfort.  The difference between mild sourness-achy vs sharp pain is that: mild achy is manageable but sharp pain is intolerable.  Sometimes, you may feel brief prick during the insertion process; in most cases, the discomfort does not last, it goes away quickly when the needles “settle in”.  


  •   What does this acupuncture point do?  How many needles are you using?  

My goal is to provide the best possible result for every treatment.  Often, after reading your pulse and getting updates, I may use a “new” point depends on the different treatment focus (e.g. different needs along the specific phase of menstrual cycle, changes along the progress).  Each acupuncture point may have multiple actions.  In clinic, I would like to focus on selecting the best points and applying the right technique, instead of counting the number or explaining why certain points are chosen.  But please know that I select the acupuncture points carefully in order to provide you a more effective treatment.  

  •   What do you see from my TONGUE pictures?  What do my PULSE tell you? 

In TCM, observing tongue presentation and reading pulse are part of the diagnostic process.  Tongue picture and pulse reading helps to confirm my diagnosis, monitor the progress, and identify “new” changes.  


We look at multiple aspects of the tongue: color, shape, coating, moisture, Shen (神, the spirit), sublingual veins, etc. Pulse reading is far more complicated than just determining the heart rate.  There are almost thirty different types of pulses, based on a combination of factors like: rate, rhythm, force, shape, depth, length, location, feel, tension, etc. 


  •   Why do you need to have a copy of the original lab/scan report?  Can I just tell you the numbers? 

I often look into the original reports for additional information than just the test result.  For example, certain hormone level may have different reference range depends on lab’s specific testing spec and the products used for the test.  The original reports allow me to have accurate assessment and document patients’ medical history properly. 

  •   How long does each treatment last?

Each treatment usually lasts about 45-60 minutes.  The needles are typically retained for 30 minutes.  The very first session may take extra 10 minutes.  

  •   When is a good time to ask questions in clinic? 

The good time to ask quick treatment related questions is either before or after the needling process.  During the treatment, I need to concentrate on treating you in order to provide a better result for you.  Unless you need my immediate attention (e.g. sharp pain), please hold off your questions and ask me after I complete the needling process.  


  •  How can I get the answers if I have additional questions?  

In clinic, I would like to utilize the amount of the time allocated to the acupuncture session on: (1) getting quick updates including reading pauses, (2) focusing on treating you, and (3) providing sufficient time for you to rest, which result a more effective treatment.  


It’s very understandable that you might be curious about TCM.  However, it’s not that helpful for your treatment outcome by trying to understand how TCM works.  Therefore, I encourage my patients to focus on paying attention to the changes of their body function, for example, PMS, menstrual cycle quality, ovulation, energy level, sleep quality, stress level, etc.  


There is not enough time to discuss individual diagnosis in clinic.  If you still have additional questions related to your treatment and/or would need to have a longer discussion, you may schedule a consultation.  

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