At the early stage of gastric cancer, we can refer to the relevant contents of “Cancer” in Chinese medicine, and depending on individual’s condition, tongue coating can be thin and white, white and greasy, dark tongue with petechiae, dry and reddish-vermilion tongue, etc. It is recommended to combine with systemic symptoms to make a clear diagnosis. 1. Thin white tongue coating: it is mostly a manifestation of liver-stomach disharmony (disharmony between the ascending function of the liver and the descending function of the stomach and internal organs). Other symptoms include heartburn and chest tightness, lack of desire for food and drink, pain in the abdomen and ribs, belching (hiccups) and vomiting. 2. White and greasy tongue coating: This is mostly a manifestation of Spleen Deficiency and Phlegm-Dampness (weak function of the spleen, resulting in phlegm and dampness not being able to be dispelled) syndrome. Other symptoms include tastelessness, bloating and diarrhea, weakness and limb weakness. 3. Dark tongue with petechiae: This is mostly a manifestation of stasis blocking the stomach channels. Other symptoms include stabbing pain in the stomach and epigastric region, vomiting blood and black stools, and skin with interlocking nails (rough and dry skin, like the interlocking nails of dried fish). 4. Dry and red tongue with reddish-red color: it is mostly the manifestation of stomach heat and yin deficiency, which is characterized by colorlessness, generalized fatigue, heart-heat (heat in the hearts of hands and feet, and self-consciousness of heart and chest), and dryness of stools, etc. Note that the above tongue signs are found in other diseases. It should be noted that the above mentioned signs can also appear in other diseases, and we cannot judge whether stomach cancer is purely from the signs of tongue, but the histopathological examination of western medicine is the gold standard for diagnosing stomach cancer. Specific tongue manifestations at the early stage of stomach cancer are related to specific types of symptoms. If stomach cancer is suspected, it is recommended to consult doctor and take active treatment.