What causes heatstroke with petechiae?

Sha manifestation refers to the appearance of red, purple, or dark spots or blisters on the skin after gua sha (scraping therapy). In cases of heatstroke, traditional Chinese medicine may recommend gua sha as a treatment, which could result in sha manifestation. This is generally associated with factors such as wind-heat pathogenic toxins, blood stasis and obstruction, internal damp-heat, qi stagnation with blood stasis, or spleen-stomach damp-heat. It is usually a normal phenomenon and not a cause for excessive concern. Specific causes are analyzed as follows:

1. Wind-Heat Pathogenic Toxins: After heatstroke, wind-heat pathogenic toxins may invade the body. Gua sha stimulates meridians and acupoints, promoting lymphatic and blood circulation, accelerating the elimination of pathogenic factors, thereby causing sha manifestation.

2. Blood Stasis and Obstruction: Heatstroke can lead to accumulation of internal heat toxins, resulting in poor blood circulation and blood stasis. Gua sha stimulates the skin and tissues, improving blood flow and alleviating blood stasis, which may lead to localized bruising.

3. Internal Damp-Heat: Following heatstroke, there may be an accumulation of damp-heat within the body, where damp-heat pathogens linger in the meridians and acupoints. Gua sha stimulates the skin, promoting the expulsion of damp-heat, leading to sha manifestation as these pathogens are discharged through the skin.

4. Qi Stagnation and Blood Stasis: Heatstroke may cause qi stagnation and blood stasis, disrupting the smooth flow of qi and blood. Gua sha stimulates meridians and acupoints, helping to relieve qi and blood stagnation, enhancing circulation, and thus triggering sha manifestation.

5. Spleen-Stomach Damp-Heat: After heatstroke, the spleen and stomach may be affected by damp-heat, leading to indigestion and internal accumulation of damp-heat. Gua sha stimulation of the skin and acupoints can enhance the digestive and transformation functions of the spleen and stomach, aiding in the removal of damp-heat, potentially resulting in sha manifestation.

If someone experiences heatstroke, they should immediately be moved to a cool, well-ventilated area, away from direct sunlight and high temperatures. Tight clothing should be loosened to promote body heat dissipation, and the person should be encouraged to drink plenty of fluids. If gua sha has been performed and the sha-affected areas cause discomfort, medical attention should be sought promptly to prevent adverse outcomes.