Key Learning Points
Heat Exhaustion and Heatwave! In Britain heatwave is good news. In India, it’s bad news. What about China? What does Chinese medicine have to say about this?
Well, first, there’s common sense. Let’s go through that, even if it’s not strictly speaking from Chinese medicine.
But even before that, click here to read about Heat. Heat is one of the causes of disease.
You’re more likely to experience problems if you’re dehydrated, there’s no breeze or ventilation, or you’re wearing tight, restrictive clothing.
Let’s talk about the WRONG foods first! Foods that you should avoid during a heatwave!
Many city people in developed countries have rather lost touch with rural life. Rural life keeps you in touch with nature, and inculcates respect for its power and extravagance. If you live a rural life, you get to know what foods suit you and when.
The further you are from growing and eating your own food, the less you know about it and what’s good or bad.
Some foods are warming, others are cooling. Some are Heating. (For more see Hot Foods.) Usually, if you follow your ‘gut’ instinct, you’ll choose the best or most appropriate food for your situation. But fashion and availability may deny you what your body actually needs.
Think about it. In winter we eat warm food, often stewed, or food baked, grilled, roasted or fried. In summer we eat salads and fruit. Such winter food is warming, whereas salads and fruits, eaten in summer, are cooling. (For more on this, see Cold Foods.)
The ancient Chinese went into this much more deeply than we have. They classified their foods into different qualities.
For example, a food could be heating, warming, cooling or cold. It could be moistening or drying. If taken in excess it might affect a particular acupuncture channel. It might be better for Qi or for Blood. It might affect one of the zang-fu energy organs more than another.
And it would have a flavour (eg, bitter, sour, salty, sweet, spicy). That flavour would enter or nourish one of those zang-fu, and too much of a particular flavour would damage it.
So a little spicy food encourages your Lung Qi to work better. Too much spicy food dissipates your Lung Qi. This is rather like praising a child that has done well: it encourages more of the same. But people vary: heaping too much praise on another child may encourage it to exhaust itself through over-trying.
If too moistening it could introduce Damp or even Phlegm.
The Chinese system of food cures suggests that you eat foods that keep you in ‘balance’. Suppose, for instance, you are a chilly person, with poor circulation, who tends to feel cold even on hot days. You should avoid salads and fruits even on hot days, or only eat them in small quantities between having warm things to eat or drink.
What about if you are naturally a ‘hot’ person, who wears less clothes than others without feeling or looking cold, whose hands and feet are always warm whatever the weather? For you, too much warming or heating food is ‘bad’. Conversely, you can eat more raw salads and fruit, even in winter – but not too much!
For ‘hot’ people, a heatwave can be bad news if they’re unfit. Surprisingly, for a cold person, a heatwave isn’t necessarily a good thing. Why? Because they are probably lacking in Yang energy, which is what they need to circulate warmth OR cold round their bodies. So initially they welcome the warmth, but later they can feel even more enervated by it than the ‘hot’ person!
Now, something very important, that you may overlook: your Stomach! (You may think that we’ve covered this, but no, we’ve hardly started!) Probably, unless you suffer pain or digestive problems, you take your Stomach for granted.
In Chinese medicine, your Stomach is hugely important. If it doesn’t work, you’ll absorb no food and will have no energy. During hot weather, and especially during a heatwave, your body is running at full tilt to keep you cool. To do that it needs energy. It gets that energy from food. That food supplies its energy only when your Stomach is working properly.
So, be very careful to keep your Stomach on your side during a heatwave!
How do you do that? Well, you’ll find much more about that throughout this site, for instance on pages like Nutrition.
So, today is not just a warm sunny day but part of a heatwave!
Why are you planning to eat meat grilled on a barbecue? It is ridiculously heating, and gives you piles of calories too. The heat of the weather will make you less inclined to take exercise, and you’ll put on weight, even from protein! So in heatwaves, eating barbecued meat makes absolutely no sense – apart from the fact that barbecuing is fun!
OK! What about ice-cream? If you eat just the cream and the sugar together, it would be warming. Freezing it makes it harder to digest if your digestion is weak, but it is otherwise still warming! However, its coldness weakens your Spleen and Stomach energies and easily causes pain in your upper abdomen. It will be delicious, I grant you, but it won’t really help to keep you cool for long. It may even introduce phlegm: check your nose and throat for this a little while after eating it.
All right! Perhaps a sorbet or chilled water-ice? That’s more like it, but even here, the energy of your stomach is being challenged by the coldness. If you’ve just eaten something warming, perhaps it will balance it out. Otherwise, although moistening, it may be too cooling.
I hope from the above you’ll have realised that during this exceptional weather, this heatwave with the threat of heat exhaustion, you have to be more careful.
Do what the natives of hot, relatively undeveloped countries do: drink tea, tepid or warm, but not cold. (Doctors of Chinese medicine, in China, drink their tea warm all year round, whatever the weather.)
Indian or Chinese tea is excellent. Many herbs have a cooling effect like the following, but take them as a warm tea:
By the way, for best effect, take Indian and Chinese teas ‘neat’. That is, without milk or sugar.
These have what is called a secondary action of cooling, (see Primary and Secondary actions) which is even better. Use fresh leaves if possible. Don’t take too much of these herbs, or make them too concentrated, because then their other more medicinal effects will start to affect you. For more on this interesting subject, click on Energetics of Western Herbs.
Indian or Chinese tea is mildly diuretic and is regarded as being cooling and moistening, even when taken warm. If you dislike tea, warm or tepid water will do. It won’t be exciting or delicious, but it will be the best food your body can take to keep itself balanced.
Well, it’s moistening and cooling, but takes energy to digest so if your energy is down – as it will tend to be in a heatwave – give your Stomach every support you can. What that means is, don’t load it with too much icy or chilled food.
If you take note of all this, you’ll cope better with the heat than your neighbour who drinks and eats whatever is fashionable.
Alcohol? Mostly its effect is warming, although sometimes this takes longer to become apparent, as with beer.
Good choice! But preferably not chilled. Let its moistening and energising energies do what they’re designed to do, to moisten you (which helps you sweat) and energise you (because fruit contains sugars) and gently cool you. (Remember, we’re talking about during a heatwave. At other times of year, especially when it’s cold, fruit is often not such a good idea.)
Excellent choice, unless you have deficient Stomach Qi, in which case have a warm soup before the salad and some warm tea afterwards, thereby keeping your tubes warm!
During a heatwave you really don’t need much protein. Unless you’ve been under-nourished beforehand, your body will cope better without too much heating food, as from protein.
During a heatwave wear cotton, light-coloured or white. (See the picture of Armenian cotton gatherers in the 19th century.)
Its colour will then slightly reduce the effect of the sun’s rays, and being cotton it will be light to wear and will absorb and easily evaporate your perspiration. If you have a fabric that’s better than cotton, please let us know!
When outside, wear a sun-hat, preferably vented, so that any passing breeze can remove hot air. Make sure it is light-coloured or white. A scarf over your head can be almost as good.
You may find that wearing even a non-vented light-coloured hat is better than no hat, because the trapped air, although hot, doesn’t change its temperature much and is cooler than not wearing a hat.
Also, be aware that although hot during the day, sometimes the air gets cold at night. Wear something! The human body can cope with only a limited range of temperatures.
Beware breezes on a hot day, when you are hot or perspiring heavily. They are a source of Wind, which in Chinese medicine is regarded as being one of the most invasive and dangerous of the external causes of disease.
At the time, that gentle breeze feels great. Only later, when you get the headache and chill, may you regret it. If you must expose flesh to the wind, keep your abdomen and back covered, and let bare legs and lower arms cool you. Otherwise you could end up with an attack of what in Chinese medicine is called Wind-Cold or Wind-Heat.
At night during a heatwave it is usually better to wear something rather than nothing. A light cotton sheet may be all you need, but have more bedclothes available because at 3am or 4am the air may cool suddenly. Also, sheets are one way to discourage flying biting insects from enjoying your company.
If there is stagnant water near you, get a mosquito net. (Stagnant water could be in just an old flower-pot or gutter protected from the sun. Mosquitoes need very little of it to breed.)
Get rid of stagnant water! Especially during a heatwave! Mosquitoes love heatwaves!
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In terms of Chinese medicine, Heat warms and dries the fluids of your body. This leads to Yin deficiency. Usually Yin deficiency creeps up on you as you age, or after an inflammatory disease or high fever or, for some, if you overwork mentally for too long.
With Heat exhaustion as from a Heatwave, it comes faster. Severe Dryness and Yin deficiency drain your resources and can kill as the Heat penetrates down through your Four defensive Levels – see Heatstroke, below.
Do realise that, if symptoms appear of disease at these four levels (for symptoms click the link) you need treatment. This is almost certainly not a do-it-yourself situation: you’re past that stage.
So Heat Stroke is when great Heat over-warms your blood and rises up in your blood to your brain, causing a kind of epileptic seizure. You may briefly become manic but more usually you lose touch with reality and start seeing illusions. Physically there may be convulsions. With children and the elderly this can happen fast – take care!
Heat exhaustion is usually slower. Heat depletes your yin resources and you get weaker. It can happen with continual sweating when the ambient temperature exceeds 35C with high humidity. For perspiration to work normally, your sweat needs to evaporate but if the environment is too damp, as in high humidity, it cannot evaporate. So it doesn’t cool you and you overheat, even though your metabolism is desperately trying to cool you. Indeed, the work it puts in can become heating in itself. Hence, hyperthermia.
The same thing happens to people, often trying to get fit or lose weight, who exercise too vigorously for too long in scuba diving or ‘wet’ suits. These are made to prevent cold entering and – depending on the type – trap water between the suit and the skin. That water heats up nearly to body temperature and keeps the swimmer warm even in deep cold water. But if worn to exercise vigorously, your perspiration can’t evaporate, so you overheat. I know of a number of people who have died from this. For more on choosing a wet-suit, click here.
I’m not really aiming this page at super-fit athletes who may survive in situations that would destroy the rest of us. Athletes – like tennis players who have fought each other for hours on very hot days – may use ice-baths to cool down, but I do not recommend this for ordinary people suffering from HeatWave, Heatstroke or Heat Exhaustion.
Even for super fit athletes in those situations, I think Chinese medicine might warn against ice baths because they are a source of Cold (and Damp).
Well, obviously, you say!
But Cold is regarded in Chinese medicine as being a Yin source of energy. Yin things don’t always work fast, in fact they very often work slowly. So, especially in warm weather, Cold doesn’t necessarily produce its symptoms immediately.
It might start appearing as ongoing tightness or sore stiffness, perhaps during the next or a subsequent spell of damp or cold weather. Then, one day, you find you have what Western medicine diagnoses as arthritis.
To illustrate what I mean, let me make up a story.
Let’s suppose you and I decide to play tennis together. Now you may be old, or young, fit or otherwise, but I’m well over 70 and not very good at tennis. Although I keep moderately free of illness and ‘look after’ myself, I don’t really claim to be the amazingly healthy person I would like to believe you think I am!
So, you’ve chosen to play tennis with me at midday in the middle of summer in the middle of the Sahara desert.
It’s going to be hot, with no clouds to prevent an instant sunburn.
And you’re keen on tennis and fitter than me. You play a hard game.
How long shall I last? The beating sun, the waves of heat, the shimmering sands, the sizzling wind, the weight of the tennis racket and – well, I’m tired before we’ve started.
After 5 minutes I’m floored. To say I’m hot is an understatement. I’m thirsty and boiling and exhausted. I might feel dizzy, even faint. I may be behaving oddly. Of course I’m sweating, and I’m probably irritated with myself, with you and your whole stupid idea.
My body is working like crazy to cool me down, and rather unsuccessfully. I’m perspiring heavily, I’m red in the face. And don’t forget I’m tired.
But you’re not such a bad type. You’ve brought your own private aircraft with its wonderful air-conditioning, attentive staff and cool drinks.
I stagger into it. And you invite me to take a shower. On purpose you’ve arranged for the water to be ice-cold. And you’ve arranged for a chilled drink to be placed, ready, in the shower cubicle.
(It’s probably got alcohol in it, and, given that I’m not thinking straight by now, I might quite like the idea, but let’s not go there for the moment!)
So I’m standing under the ice-cold shower and half-way through I reach out for the ice-cold drink.
You hear a thump. You rush in. What do you find?
I’m curled up in a tight ball on the floor, shivering. Suddenly, I’ve become ice-cold.
But it’s still a boiling hot day, and even though the aircraft has the air-conditioning full on, the interior of the aircraft is pretty hot.
What happened, and what to do?
Well, what happened is that the (stupid) game of tennis had made my yang energy go into hyper-drive, moving my yin (the fluids) round my body. Those yin fluids were rapidly becoming exhausted with my exertions, my perspiration and the desperate need to keep cool.
I was already exhausted, remember? So I was getting through my yang energy pretty fast.
The Yang energy, pumping the Yin fluids round, depends on the Yin fluids for fuel. So Yang was hyper and Yin was exhausted. No wonder I was suffering from Heat Exhaustion.
And then, silly me, I took in too much Yin: the ice-cold shower and finally the ice-cold drink. Probably one or the other might have been all right, but together, they cooled down both the exterior and the interior of my body.
Although these are Yin fluids I’ve swallowed, they have not had time to turn into Blood, which is what my body uses to nourish and cool itself. So it’s like a big lump of ice inside, or you might almost say, on top of me.
My Yang energy, the pump, was already labouring to cool me down. Now it’s suddenly got to deal with a huge ‘lump’ of Yin, being the cold shower on the outside and the cold drink on the inside.
It’s too much! Suddenly you’ve quenched the little (Yang) fire there was still in me. So there I am, suffering from an invasion of Cold on the hottest day of the year in the middle of the Sahara desert!
How to treat heat stroke? I’ll tell you. You should turn off the air-conditioning, cover me in a warm blanket (I suppose your aircraft has one?) and give me a little warm fluid to drink – if I can take it. Preferably you’ll make me a warm herb tea perhaps with raw ginger in it. (Ginger is a great herb for helping your Stomach energy work better.)
Don’t give me alcohol, which although initially warming and probably full of calories has a secondary action which is cooling – certainly not what I need!
You might even give me a warm, not hot, bean bag or hot water bottle. Notice where I put this – almost certainly over my abdomen, which I then curl round – that foetal position again.
Then you keep a careful eye on me, I hope for several hours. You make sure I don’t get dehydrated. If you don’t have drinks with electrolytes to replace the fluids I’ve lost, give me water with salt and sugar in it. Don’t offer me lots of food until my energy recovers.
Heat exhaustion treatment? To cool down, (and this applies not just during a heatwave) use tepid or even very slightly warm water.
Dab it behind your knees, on and under your arms, round your neck, on your forehead. If the atmosphere is very damp or moist, even this won’t help much because it won’t evaporate, but try a little.
Unless you are young and/or vigorous, don’t jump into an ice-cold shower or bath. Your body will eventually react by warming you up: better to use a tepid shower, then wipe or dab yourself dry.
And, although you may think me crazy, don’t keep swilling down water. If you are neither weakened by disease nor elderly, your body will probably tell you when it needs moisture. (Though not always, I grant you, so it’s hard to generalise on this.) Too much fluid strains not just your Stomach Yang but also you Kidney Yang. Read Kidney Yang deficiency for more on this.
So drink when thirsty, or when the colour of your urine remains yellow through the day. (This is assuming you aren’t taking food or vitamins – like Vit B – that turns your urine dark or yellow.) And when you drink, don’t down it all in huge gulps! Sip it a little at a time. Doing it that way introduces yin gradually without overwhelming your Stomach energy.
Besides dark urine, there are many other symptoms of dehydration, heat exhaustion and heatstroke, not just during heatwaves, of course, including
If you notice many of these symptoms in someone else, you should:
If you find someone who has had no fluids for some days and is dying from lack of moisture, don’t swill a bucket of water down their parched throats.
Get a sponge or piece of flannel, moisten it with water and dab it on their lips. Repeat doing this until they can easily lick their lips. Then let them have a tiny amount of water in their mouths, perhaps just a teaspoonful. After they’ve managed to absorb this, repeat again and again, letting them rest between sips.
Eventually they will be able to drink a few drops.
If you’ve ever found a cloth that has completely dried out, at first it may actually resist absorbing water. If you try to bend it, it will break because it has ‘set hard’. That’s like someone in this condition. By dabbing on water you gradually do the equivalent of moistening the cloth which eventually becomes properly absorbent.
Don’t rush this. It can take longer than you think.
Heatstroke is the same as sunstroke and is potentially a serious medical emergency. So take it seriously. Your body stops being able to cool itself down, and the Heat penetrates into your vital inner organs, and even your brain.
Read about what happens as Heat penetrates inside your Four Level defences according to Chinese medicine. (Warning! It’s a bit technical, but some people are really interested in this sort of thing.)
By then, all the systems nature put in place to keep your body working properly have started going wrong.
Seek medical help – or find an acupuncturist!
The explanation in Chinese medicine for Heat cramps is this. They occur when, from heat exposure, probably with perspiration, your body loses moisture. In other words you can get this when exercising heavily in hot air.
Your Blood becomes depleted – probably in both water and salt and other electrolytes. Yin is cooling, relaxing and moisturising. Without sufficient yin your muscles and tendons tighten up, giving muscle spasms. They can be dangerous because until you replace the depleted yin, there is no way your body can mend itself. So these spasms can be extremely painful and last longer than calf cramps at night.
Heat cramps occur more often in people who are unfit for the level of exercise in heat that they are taking. So they are more likely to happen early in the season before your body becomes conditioned to heavy exertion in the heat.
As these are caused by yin deficiency, all the processes that replete yin can help.
Although the symptoms are much the same, watch out! Heat Exhaustion in kids can develop much faster than you think.
Why – in Chinese medicine – is this?
Heat exhaustion in kids, and let’s not forget heat stroke symptoms in kids, happen fast because children have comparatively small bodies. Our bodies are yin, which houses our shen mind: yang.
When born, babies are, in effect, small bundles of yin containing lots of yang. Or at least, that’s what you hope. That yang manifests itself in that first yell!
Healthy children are active, noisy, restless, troublesome: very yang! They need the comfortable stability of home and its rules to learn how to live – yin.
Meantime their bodies have too much yang.
With small amounts of yin, they overheat easily. So, being already yang, they succumb to excess heat more easily than most adults. And it happens fast.
One moment you’ve got healthy, inquisitive, noisy bothersome children. They’re outside, running around, heating up. They might forget to drink the lemonade you left out. Or maybe they got stuck up a tree in the sun.
Anyway, suddenly they go pale, act funny, start sweating heavily and faint.
Quick. For heat exhaustion and heat stroke in kids, act fast.
Why? Small bodies get ill fast and get well fast – usually!
If not, they need medical help. (Which would do what? Probably do what you’re doing, but attached to all sorts of instruments and with intravenous drip of electrolytes.)
Heatwaves impose extra burdens on your body.
Check my collection of books:
Master Tung’s acupuncture is a hidden treasure, lost to China but recovered in Taiwan from where it spread round the world.
Knee pain has five main causes. It’s certainly worth trying acupuncture before you resort to surgery!
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