Five Methods of Acupuncture for Emergency Rescue

Chinese Medicine Book Club Issue 2483

One issue daily, accompanying the growth of TCM practitioners

IIntroduction: Acupuncture is the quickest method to save critically ill patients, often allowing for timely intervention to rescue those in danger, thus it should be used first. In emergencies, acupuncture can alleviate urgent symptoms, buying time for treatment, and is often effective when combined with herbal remedies for both symptomatic and root treatment. (Editor/Yan Qifeng)

Clinical Application and Experience of Five Methods of Acupuncture for Emergency Rescue

Author/Deng Chunlei

The “Biao You Fu” states: “The method of rescue, the wonderful use is acupuncture,” which emphasizes the quick efficacy of acupuncture in rescuing critically ill patients, often allowing for timely intervention. Most acute conditions in clinical practice arise suddenly, with rapid progression; any delay can result in lost treatment opportunities. It is common to see cases where waiting for herbal remedies leads to irreversible situations. Therefore, I diligently seek ancient teachings and gather effective prescriptions, always using acupuncture first in emergencies to alleviate urgent symptoms, buying time for treatment, and achieving good results when combined with herbal remedies for both symptomatic and root treatment.

I have summarized these into five methods of acupuncture for emergency rescue, along with successful case studies and experiences, for the reference of fellow practitioners in emergency situations.

1. Awakening the Spirit and Opening the Orifices Method:

This method can be used for patients in early stages of coma due to stroke, heatstroke, febrile diseases, hysteria, drowning, electric shock, and certain types of poisoning.

Acupuncture Points:

Baihui (百会), Renzhong (人中), Hegu (合谷) (both sides), Yongquan (涌泉) (both sides).

Use a reducing technique with strong stimulation, leaving the needles in for a longer duration, and needling every 3-5 minutes. Once the patient is awake, the interval between needling can be extended, but do not remove the needles to prevent relapse. Most patients will moan, cry, show pain, or even open their eyes and respond to questions after needling. At this point, treatment can be tailored to the cause of the condition or combined with appropriate rescue measures.

This method is primarily used for patients with coma due to excess Yang heat obstructing the orifices. It is not suitable for patients with traumatic brain injury, hemorrhagic shock, or late-stage poisoning.

For example, a 48-year-old male farmer presented with moderate coma after being found unresponsive. Family members reported he had been sleeping while warming himself. Upon examination, he was nearly in severe coma, with cyanosis of the lips, frothy saliva, wheezing, and dilated pupils (2mm) with sluggish light reflexes. Blood pressure was 100/60 mmHg, heart rate 110 bpm, and lung sounds were coarse. He was diagnosed with carbon monoxide poisoning. He was immediately taken to the emergency room for oxygen, warming, ventilation, and intravenous administration of 10% glucose solution (500ml) along with vitamin C and B6. The intended medication, “Chlorpromazine” (a central nervous system stimulant), was unavailable, so acupuncture was employed. After needling, the patient opened his eyes and looked around. However, after being moved out of the emergency room, the needles were removed, and he fell back into a coma. Reapplying the method led to him waking up again, and the needles were left in for 2 hours, with intermittent needling until he was out of danger and discharged.

This method has also been successfully used for patients with coma due to bee stings, electric shock, and drowning. For heatstroke or stroke, additional needling at Shixuan (十宣) or Twelve Jing points to induce bleeding can also be effective.

2. Raising Yang and Benefiting Qi, Stabilizing and Stopping Bleeding Method:

This method is applicable for patients with prolonged illness or postpartum deficiency leading to sudden loss of Qi and blood, or spleen not governing blood, resulting in continuous bleeding, accompanied by pale complexion, cold limbs, sweating, rapid breathing, and coma, with a weak pulse indicating imminent collapse.

Acupuncture Points:

Baihui (灸), Renzhong (针), Qihai (气海) (灸), Guanyuan (关元) (灸), Zusanli (足三里) (针), Sanyinjiao (三阴交) (针), Yinbai (隐白) (灸).

Use a reinforcing technique for needling, and moxibustion should be applied until the patient regains consciousness, leaving the needles in place and using gentle moxibustion to consolidate the effect. If conditions allow, blood transfusion (or plasma replacement) and fluid resuscitation should be combined for better results.

For example, a family member of a teacher at our hospital suffered from uterine fibroids, experiencing heavy menstrual bleeding and severe anemia. On March 3, 1994, after taking a “blood-activating and stasis-resolving” formula, she experienced a sudden and severe hemorrhage. In a state of emergency, the patient, aged 50, presented with a pale complexion, cold limbs, sweating, and a vacant expression, with rapid breathing and a weak pulse that was nearly undetectable. Blood pressure was unmeasurable due to severe hemorrhage leading to shock. Observing the heavy blood flow and the full basin of fresh blood, the bleeding did not stop. The acupuncture method was urgently applied, and within 5 minutes, the bleeding stopped, and the pulse was present. After 10 minutes, the patient regained consciousness and could answer questions. The needles were left in for 2 hours, and she was given 10 grams of ginseng and 10 dates in a concentrated decoction (three times daily), with a recommendation for plasma replacement and the “Shi Quan Da Bu Tang” to support recovery. Seven days later, she was discharged in good health. To prevent recurrence, she underwent a total hysterectomy at a Western medical facility. She is now healthier than before. Other cases of hemorrhage or shock can be treated similarly.

3. Pacifying the Liver and Extinguishing Wind Method:

This method can be used for acute stroke due to excessive Yang rising and wind-fire stirring.

Acupuncture Points:

Hegu (合谷), Taichong (太冲), Zusanli (足三里) (both sides).

Use a reducing technique, and additionally, puncture Dadu (大敦) to draw blood (three drops). Effective signs include a decrease in blood pressure and relief of functional impairment.

For instance, a 43-year-old female cadre suddenly experienced severe headache and dizziness on January 9, 1986, followed by left-sided numbness and paralysis, and speech difficulties. She was urgently sent to our hospital. Examination revealed left facial muscle relaxation, disappearance of the nasolabial fold, deviation of the tongue to the left, and left-sided paralysis. Blood pressure was 180/130 mmHg, diagnosed as a stroke warning. This method was immediately applied, and after 10 minutes, the patient regained consciousness, her speech was clear, and her headache resolved, although she reported palpitations, with blood pressure measured at 158/120 mmHg. She regained voluntary movement in her left lower limb. The patient was then given “Tianma Guoteng Yin” for further treatment, with daily acupuncture for five days, leading to her recovery. This case illustrates that early acupuncture during the acute phase of stroke can prevent or mitigate intracranial bleeding or thrombotic obstruction and its sequelae. The success of this case was due to timely intervention, leading to a favorable prognosis, which can serve as a reference.

4. Clearing Heat and Draining Fire to Stop Nosebleeds Method (Including Stopping Hemoptysis):

This method is primarily used for treating epistaxis. Generally, it is effective for cases of wind-heat invading the lungs, liver fire attacking the lungs, or stomach fire disturbing the nasal vessels, which can lead to nosebleeds. In severe cases, the bleeding may not stop, posing a critical situation. Timely acupuncture to clear and drain the evil heat can quickly stop the bleeding, effectively addressing the root cause.

Acupuncture Points:

Shangxing (上星), Hegu (合谷) (both sides), Yingxiang (迎香) (both sides), Neiting (内庭) (both sides).

Use a reducing technique. If the patient exhibits a red face, bitter taste in the mouth, dry stools, irritability, and a wiry pulse with a red tongue and yellow coating, it indicates liver fire, and additional needling at Xingjian (行间) and Dadu (大敦) to draw blood should be performed. If the nosebleed occurs after an external pathogen with fever and cough, it indicates lung heat, and additional needling at Chize (尺泽) and Shaoshang (少商) to draw blood is recommended. For mild nosebleeds, moxibustion at Shaoshang (左衄灸右、右衄灸左) can also effectively clear lung heat and stop the bleeding. If the patient experiences thirst, irritability, constipation, red tongue, yellow coating, bad breath, and a rapid pulse, it indicates stomach fire causing bleeding. When using this method to stop bleeding, Neiting (内庭) (both sides) should also be needled. Cases of hemoptysis due to pulmonary tuberculosis can be treated with garlic paste mixed with sulfur and borneol applied to Yongquan (涌泉) to draw blood downward, along with needling at Yiji (鱼际), Taiyuan (太渊), Chize (尺泽), and Feishu (肺俞) to drain fire and stop lung bleeding. However, the simplest method is to use a plum blossom needle to tap along the carotid artery for 15 minutes, generally achieving hemostasis within 5-10 minutes.

5. Clearing Heat, Unblocking the Bowels, Stopping Pain, and Stopping Diarrhea Method:

The six fu organs function through unblocking; blockage is harmful. Generally, dampness, food, evil heat, and epidemic toxins can disrupt the qi mechanism of the stomach and intestines, leading to abdominal pain, flank pain, vomiting, diarrhea, and dysentery, which can be treated with this method to clear and drain evil heat, regulate qi, stop pain, stop vomiting, and stop diarrhea.

The method involves identifying the location of the disease based on the ancient teaching from the “Neijing” that states “treat the internal organs together,” first needling the “he points” or “lower he points” and the corresponding mu points of the affected organ, using a reducing technique. Then, select three points to clear heat (Dazhui (大椎), Quchi (曲池), Hegu (合谷)) and the key point for stopping vomiting (Neiguan (内关) (both sides)) to achieve the effects of regulating qi, stopping pain, clearing heat, unblocking the bowels, and stopping vomiting and diarrhea.

For example, in cases of acute gastritis with severe stomach pain and persistent vomiting, needling Neiguan (内关), Zhongwan (中脘) (mu), and Zusanli (足三里) (he point) can harmonize the stomach, descend rebellious qi, and relieve pain and vomiting. For flank pain due to cholecystitis, needling Yanglingquan (阳陵泉) (he point), Riyue (日月) (mu point), Zhongwan (中脘), and Neiguan (内关) (for stopping vomiting) can quickly clear heat, unblock the bowels, and relieve pain. In the early stages of intestinal abscess, needling Tianshu (天枢) (mu point), Shangjuxu (上巨虚) (he point) can unblock the intestinal stagnation, along with needling Hegu (合谷) and Quchi (曲池) to drain Yangming evil heat for a cure. For dysentery with red and white stools and cramping abdominal pain, needling Tianshu (天枢) (he point), Shangjuxu (上巨虚) (he point), along with Quchi (曲池) and Hegu (合谷) can stop diarrhea. These are practical experiences of “treating the internal organs together,” and relevant case studies have been introduced in detail elsewhere.

In summary, when using acupuncture to treat emergencies, the following points should be emphasized:

First, the diagnosis must be clear, especially regarding the location, cause, mechanism of the disease, and prognosis. It is essential to determine whether it is suitable for acupuncture and whether it is “safe to needle or not.” For the latter two cases, do not force treatment, and refer to another department as soon as possible to avoid delays that could lead to irreversible situations.

Second, early and timely intervention is crucial. As long as the condition is suitable for needling, acupuncture should be performed as soon as possible; the earlier, the better the effect.

Third, for critical conditions, blood transfusion, fluid resuscitation, oxygen therapy, suction of secretions, and anti-infection measures should be combined with acupuncture for comprehensive treatment, which can improve efficacy and success rates. Accurate point selection and skilled techniques are fundamental requirements, which will not be discussed further.

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