Pericardial Effusion in Traditional Chinese Medicine

Soggy (Ru), Slowed-down (Huan), Slippery (Hua), Deep (Chen)

The tongue is characteristically pale and swollen, often appearing puffy and tender, with clear teeth marks indented along both edges. The coating is white and greasy (or thick and greasy in more pronounced cases), reflecting the accumulation of Dampness in the Middle Burner. The tongue surface is typically moist or even excessively wet. In some cases, the coating may be slightly slippery. If the Dampness is particularly heavy, the coating may appear thick and white across the entire tongue body, sometimes most prominent in the centre (corresponding to the Spleen and Stomach area).

Slippery (Hua), Deep (Chen), Slow (Chi), Wiry (Xian)

The tongue is characteristically pale and swollen, often with teeth marks along the edges from pressing against the teeth, indicating fluid accumulation. The coating is notably thick, white, and greasy, particularly at the root (back portion) of the tongue, which corresponds to the Lower Burner. The entire tongue surface tends to appear wet or slippery. In some cases the coating may extend thicker toward the centre and rear while being thinner at the front, reflecting that the pathological material is concentrated in the lower and middle parts of the body.

Deep (Chen), Wiry (Xian), Slippery (Hua)

The tongue is typically pale and may be slightly swollen or puffy, reflecting underlying Yang deficiency and fluid accumulation. The coating is white and slippery (or white and greasy), which is a hallmark sign of internal water-fluid retention. The moisture level is noticeably wet, indicating that body fluids are not being properly transformed and transported. In more chronic cases, the coating may become thicker. The tongue body itself rarely shows heat signs in this pattern's base presentation.

Slippery (Hua), Wiry (Xian)

The classic Phlegm tongue is swollen and pale with tooth marks along the edges, reflecting the Spleen's inability to properly manage fluids. The coating is the most diagnostic feature: it is characteristically white, thick, and greasy or sticky, indicating the presence of turbid Phlegm and Dampness. The tongue body is typically moist to wet. If Phlegm begins to transform with Heat, the coating may turn yellowish and greasy, but in the base pattern the coating remains white. The tongue body itself is not red or purple, distinguishing this from Phlegm-Heat or Phlegm with Blood Stasis transformations.

Deep (Chen), Wiry (Xian), Slippery (Hua)

The tongue typically shows a pale, slightly puffy body with a slippery white coating, reflecting the cold, fluid-retaining nature of this pattern. In the early stage when external pathogenic factors are involved, the coating may be thin and white. As fluid accumulates, the coating becomes white and greasy or slippery. In some cases with Heat developing during the initial invasion phase, the coating may have a slight yellow tinge. Teeth marks on the edges reflect underlying Spleen Qi weakness. The tongue body is moist or wet rather than dry, consistent with the retention of pathological fluid.