Acupuncture Treatment for Heatstroke Syndrome in Traditional Chinese Medicine

The etiology and pathogenesis of heatstroke often involve weakened vital energy, compounded by exposure to summer heat or damp, turbid qi during peak summer months, allowing pathogens to invade through deficiencies. The accumulated heat fails to dissipate externally, further depleting vital energy, clouding the clear orifices, and causing reverse flow of meridian qi, leading to high fever, unconsciousness, and even signs of extreme heat-induced wind. If the condition progresses, depletion of qi and yin may result in critical conditions such as collapse. Records of acupuncture treatment for heatstroke are frequently found in Ming and Qing dynasty acupuncture texts, particularly in works like *The Great Compendium of Acupuncture*, *Yang Jingzhai’s Complete Book of Acupuncture*, *Sources of Acupuncture*, and *Classic of Divine Moxibustion*.Based on disease progression, it can be differentiated into mild and severe types. Mild heatstroke: Symptoms include dizziness, headache, chest tightness, nausea, high fever without sweating, irritability, rapid and full pulse, yellow greasy tongue coating. Severe heatstroke: In addition to the above symptoms, if heat obstructs the heart, there may be unconsciousness, shortness of breath, muscle cramps; if both qi and yin are injured, symptoms include pale complexion, sweating, shortness of breath, cold extremities, sudden collapse, weak and fine pulse, pale tongue. Treatment may be tailored accordingly for these two types.(1) Mild Heatstroke1. Treatment Principle: Clear and drain summer heat.2. Prescription: Neiting (ST44), Quchi (LI11), Neiguan (PC6), Taichong (GB4).3. Rationale: Neiting is the Ying point of the Stomach Meridian; “Ying governs body heat” (Classic of Difficult Issues). Quchi is the He point of the Large Intestine Meridian; combining both points effectively drains yangming heat. Neiguan connects to the Yinwei Vessel, which runs through the abdomen and thorax, thus harmonizing the stomach and stopping vomiting. Taichong is an extra-meridian point; blood-letting here clears heat and relieves headache and dizziness.4. Treatment Method: Quickly move the patient to a cool, ventilated place and loosen clothing. First, use a three-edged needle to puncture both Taichong points and squeeze out dark blood. Apply cooling draining technique to the remaining points. Leave needles in place until symptoms significantly improve, with intermittent manipulation during retention.(2) Severe HeatstrokeHeat Obstructing the Heart1. Treatment Principle: Clear heat, open orifices, stop convulsions.2. Prescription: Shuigou (GV26), Baihui (GV20), Weizhong (BL40), Shixuan (EX-HN1); add Yanglingquan (GB34), Chengshan (BL57), Houx溪 (SI3) for muscle cramps and convulsions.3. Rationale: When heat obstructs the heart, orifices become blocked; use Shuigou and Baihui to awaken the mind and open orifices. Weizhong, the He point of the Bladder Meridian and a blood reservoir, when blood-letting is performed, clears blood heat. Shixuan has the effect of clearing heat, treating mental disorders, and balancing yin and yang. Muscle cramps and convulsions indicate extreme heat-induced wind; Yanglingquan, the meeting point of tendons, relaxes muscles and relieves spasms; Chengshan is a proven point for stopping convulsions and relieving tension; Houx溪 connects to the Governor Vessel and supports brain function, offering calming and anti-seizure effects.4. Treatment Method: First, deeply insert a needle into Shuigou, aiming upward toward the teeth, and apply a draining technique. Use the three-edged needle to bleed at Weizhong and Shixuan; apply draining technique to other points, with intensity appropriately increased. Retain needles until consciousness returns and convulsions cease, with intermittent manipulation during retention.Qi and Yin Deficiency1. Treatment Principle: Tonify qi and nourish yin.2. Prescription: Qihai (RN6), Baihui (GV20), Taixuan (LU9), Fulu (KI7).3. Rationale: Qihai is the sea of original qi; moxibustion here greatly replenishes primordial qi. Baihui, the convergence point of all yang meridians, elevates yang and consolidates the exterior. Taixuan is the Yuan point of the Lung Meridian; in this severe stage of heatstroke, with profuse sweating and absent pulse, this point nourishes lung yin and secures defensive qi. Fulu is the Jing point of the Kidney Meridian, capable of replenishing kidney yin and invigorating kidney qi. Together, these four points nourish internal yin fluids of the lungs and kidneys while securing the failing exterior qi.4. Treatment Method: Apply moxibustion with a moxa stick using the sparrow-pecking method on Qihai and Baihui, continuing intermittently until consciousness returns. Use acupuncture with reinforcing technique on the remaining points, retaining needles with repeated manipulation during treatment. This type is critically severe and should be combined with other traditional Chinese and Western medical therapies.