Introduction
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, rehabilitation is difficult to be obtained in some cases and death may be caused eventually. The clinical manifestations are sudden 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 spontaneous 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 added.

Performance: For the treatment of asthenia syndrome, 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 moxaroll. 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.