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Petechiae

How Chinese medicine differentiates petechiae (tiny purple/red skin spots from bleeding under the skin) — distinct from Bruising and Henoch-Schonlein Purpura already covered — the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. New or spreading petechiae, especially with fever, easy bruising elsewhere, or bleeding gums, needs prompt medical evaluation (a blood or clotting disorder must be ruled out) before assuming a simple pattern.
General Acupuncture Points

Acupuncture points traditionally used for petechiae — 10 key points, used across the patterns below rather than tied to just one.

PointKey action
L.I.-4Releases exterior Wind-Heat and alleviates itching.
L.I.-11Clears Heat and cools the Blood.
SP-10Sea of Blood point, cools the Blood and stops bleeding.
PC-3Clears Heat and cools Blood. Invigorates Blood and eliminates stasis.
LR-3Subdues Liver-Yang, which often underlies Blood Heat.
REN-12Tonifies the Spleen and Stomach to generate Qi and Blood.
ST-36Master point for Qi and Blood deficiency; strengthens the Spleen.
SP-6Harmonizes the organs, nourishes Blood and supports the Spleen's holding function.
BL-20Back-Shu point of Spleen; directly tonifies Spleen-Qi.
KI-3Nourishes Kidney-Yin to anchor the empty Heat.
SP-9Drains Damp-Heat from the lower body.
ST-40Resolves Dampness and Phlegm, unblocks channels.
BL-17The influential point for Blood; regulates and moves Blood to resolve stasis.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Wind-Heat

Clinical manifestations: Acute onset often after a cold or sore throat, itching, red or bright purple spots, fever, mild chills, sore throat, thirst.
Tongue: Red tip and edges with thin yellow coating. Pulse: Floating and rapid.
Treatment principle: Dispel Wind-Heat from the exterior, cool the Blood, relieve itching.
Note: no moxa. This is an exterior Wind-Heat skin eruption, not a respiratory invasion — this site has no skin-specific Wind-Heat slide, so no pattern link is given here; points still link fine individually.

2. Heat in the Blood

Clinical manifestations: Bright red or dark red spots, bleeding from nose, gums, or heavy periods, internal heat worse at night, thirst with desire for cold drinks, restlessness and irritability.
Tongue: Deep red with red spots or prickles, thin yellow dry coating. Pulse: Rapid, wiry, and forceful.
Treatment principle: Clear Heat from the Blood level, cool the Blood, stop bleeding.
Note: no moxa. This site has no standalone Blood-Heat slide on any deck, so no pattern link is given here; points still link fine individually.

3. Spleen Not Controlling Blood View full pattern →

Clinical manifestations: Pale purple or brownish spots appearing gradually, chronic fatigue and shortness of breath, poor appetite and loose stools, pale or sallow complexion.
Tongue: Pale, puffy, tender with teeth marks, thin white coating. Pulse: Fine and weak, especially at the right middle position.
Treatment principle: Tonify Spleen-Qi, nourish Blood, stop bleeding.
Note: moxa applicable throughout. Direct exact-name match with this site's own Spleen-not-controlling-Blood slide.

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

Clinical manifestations: Dark red spots (not bright red), night sweats, low-grade afternoon or evening fever, heat in palms/soles/chest, dry mouth and throat worse at night, flushed cheekbones.
Tongue: Red, thin, and dry with little or no coating, cracks may be present. Pulse: Fine and rapid.
Treatment principle: Nourish Yin and drain Empty-Heat to stop bleeding.
Note: no moxa given the Yin deficiency. Matched to this site's own Kidney-Yin-deficiency-Empty-Heat-blazing slide via the night-sweats/five-center-heat/flushed-cheekbones symptom set.

5. Damp-Heat View full pattern →

Clinical manifestations: Purple spots often on the lower legs, heavy sensation in limbs, chest and upper abdominal stuffiness, sticky greasy taste in the mouth, loose sticky stools, thirst with little desire to drink.
Tongue: Red body with yellow greasy coating, may be swollen with teeth marks. Pulse: Soggy-rapid or slippery-rapid.
Treatment principle: Clear Damp-Heat from the lower body, unblock channels, stop bleeding.
Note: no moxa. Linked to this site's Damp-Heat-invading-the-Spleen slide via the fullness/heaviness/sticky-mouth/loose-stools symptom set, the same match used for Perioral Dermatitis and Myasthenia Gravis.

6. Blood Stagnation View full pattern →

Clinical manifestations: Dark purple spots that persist and don't fade easily, fixed stabbing pain in the spot area, pain and spots worsen at night.
Tongue: Dark purple or dusky body with stasis spots and engorged sublingual veins, thin white coat. Pulse: Choppy, rough and uneven.
Treatment principle: Invigorate Blood, move Qi, and dispel stasis to help stop bleeding and fade dark spots.
Note: no moxa. Direct match with this site's own Liver-Blood-stasis slide via the well-established stasis-spot-tongue marker.
Related conditions

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