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Nighttime Fever

How Chinese medicine differentiates fever that appears or worsens at night into the six patterns you'll actually meet in practice, and the points for each. Distinct from this site's Tidal Fever, Low-Grade Fever and Feeling of Heat pages. Acupuncture only β€” no herbs.

This page is educational, for practitioners and students β€” it is not a diagnostic tool and does not replace a proper in-person assessment. Any fever in an infant, a high or persistent fever, or fever with a stiff neck, rash or confusion needs prompt medical assessment.
General Acupuncture Points

Acupuncture points traditionally used for nighttime fever β€” 3 key points, used across the patterns below rather than tied to just one.

PointKey action
KI-3Tonifies the Kidneys (both Yin and Yang). Strengthens the Kidney’s receiving of Qi. Calms the Mind.
SP-6Strengthens the Spleen. Resolves Dampness. Promotes the function of the Liver and the smooth flow of Liver-Qi.
HE-7Calms the Mind and opens the Mind’s orifices. Nourishes Heart-Blood.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Empty-Heat Caused by Yin Deficiency View full pattern →

Clinical manifestations: Low-grade fever rising in the afternoon and evening; night sweats; heat in the palms, soles and chest; dry mouth with a desire to sip; flushed cheekbones; restlessness; insomnia.
Tongue: Red, thin, dry, cracked, little or no coat. Pulse: Fine and rapid, weak on deep pressure, especially at the left rear position.
Treatment principle: Nourishes Yin, clears deficiency Heat and anchors floating Yang.
Note: no moxa (Yin deficiency with heat signs).

2. Blood Deficiency

Clinical manifestations: Mild, low-grade nighttime fever; pale or sallow complexion; pale lips and nails; dizziness; scanty, pale menstruation; palpitations; difficulty staying asleep.
Tongue: Pale, thin, thin white coat. Pulse: Fine, weak, forceless.
Treatment principle: Tonifies Qi and Blood and strengthens the Spleen's Blood-generating capacity.
Note: moxa is appropriate. No combined Qi-and-Blood-deficiency slide exists on this site's decks β€” no pattern link is given here.

3. Qi Deficiency Fever

Clinical manifestations: Low-grade fever worse with exertion; extreme fatigue; shortness of breath; reluctance to speak; poor appetite; loose stools; spontaneous sweating; pale or sallow complexion.
Tongue: Pale, puffy, tooth-marked, thin white coat. Pulse: Weak, empty, fine; collapses under pressure.
Treatment principle: Tonifies Spleen Qi, raises clear Yang and extinguishes stagnant Heat.
Note: moxa is appropriate.

4. Liver Qi Stagnation Turning into Heat View full pattern →

Clinical manifestations: Irritability or explosive anger; bitter taste; distending rib-cage pain; a red face and eyes; fever worse with emotional stress; restlessness.
Tongue: Red with redder sides, yellow coat. Pulse: Wiry and rapid, forceful at the left middle position.
Treatment principle: Soothes Liver Qi, clears Heat and cools irritability.
Note: no moxa.

5. Disharmony between Heart and Kidneys View full pattern →

Clinical manifestations: Low-grade nighttime fever; insomnia with difficulty falling asleep; lower-back and knee soreness and weakness; five-palm heat; night sweats; palpitations; mental restlessness.
Tongue: Red body and tip, thin, little or no coat. Pulse: Fine and rapid, weaker at the rear position.
Treatment principle: Nourishes Kidney Yin, anchors Heart Fire and calms the Spirit.
Note: no moxa (Yin deficiency with heat signs).

6. Phlegm-Fire Harassing the Heart View full pattern →

Clinical manifestations: Chest oppression with copious sticky phlegm; mental restlessness and agitation; nighttime fever with thirst; bitter taste; difficulty sleeping.
Tongue: Red, often swollen with a red prickly tip, thick yellow greasy coat. Pulse: Slippery and rapid, full and forceful.
Treatment principle: Clears Heat, transforms Phlegm and calms the Mind.
Note: no moxa.
Related conditions

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