Coma refers to temporary loss of consciousness for a short period of time due to insufficiency of cerebral blood flow. Usually there is no sequela. However, rehabilita-tion is difficult to be obtained in some cases and death may be caused eventually. The clinical manifestations are sud-den faint, unconsciousness and cold limbs. According to TCM, coma is caused by asthenia of qi and blood or disorder of yin and yang, adverse flow of qi, disconnection between nutrient qi and defensive qi as well as obstruction of the upper orifices due to wind, fire and phlegm.

[Syndrome differentiation]

1. Asthenia syndrome

The symptoms are sudden coma, unconsciousness, cold limbs, indistinct respiration, open mouth and sponta-neous sweating, pale complexion, deep and thin pulse.

2. Sthenia syndrome

The symptoms are sudden coma, unconsciousness, cold limbs, dyspnea, lockjaw and deep-sthenic pulse.

[Treatment]

Prescription: Shuigou ( GV 26 ), twelve Jing-well acupoints and Baihui (GV 20).

Modification: For asthenia syndrome, Neiguan (PC 6), Qihai (CV 6) and Zusanli (ST 36) are added; for sthenia syndrome, Zhongchong ( PC 9 ), Taichong (LR 3), Laogong (PC 8) and Yongquan (KI 1 ) are add-ed.

Performance: For the treatment of asthenia syn-drome, reinforcing needling technique is used; Shuigou (GV 26), the twelve Jing-well acupoints, Baihui (GV 20) and Neiguan (PC 6) are needled with mild reducing and reinforcing techniques; Qihai (CV 6) and Zusanli (ST 36) are needled with reinforcing technique or with warmed needle or moxibusted with moxa-roll. For the treatment of sthenia syndrome, reducing needling technique is used; the twelve Jing-well acupoints and Zhongchong (PC 9) are pricked with the three-edged needle for bloodletting; Shuigou (GV 26), Laogong (PC 8) and Yongquan (KI 1) are needled with the rotation of the needles for reducing purpose.

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