Bell's Palsy - Wind-Heat Attacking the Collaterals Pattern

TCM differentiation and treatment for Bell's palsy with

Bell's Palsy · Wind-Heat Attacking the Collaterals Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head


Pattern Overview

Wind-Heat Attacking the Collaterals is a pattern in acute Bell's palsy,

characterized by **facial nerve inflammation (HSV-1 reactivation),

sudden facial paralysis, facial heat pain, fever, and sore throat**. The

core pathogenesis is **invasion of Wind-Heat pathogens into the facial

collaterals**, causing viral-induced neuroinflammation, nerve damage,

and facial paralysis.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

pain, fever |

Associated Symptoms

|

Tongue and Pulse

and rapid pulse |

Pathogenesis

|

Etiology

Wind-Heat invasion |


Acupuncture Point Prescription

Point Location Function
Fengchi (GB20)

sternocleidomastoid and trapezius | Disperses Wind-Heat and clears the

head |

Hegu (LI4)

metacarpals | Disperses Wind and unblocks collaterals |

Quchi (LI11) Lateral end of the elbow crease

detoxifies |

Dicang (ST4) About 0.4 cun lateral to the corner of the mouth

Treats deviation of the mouth |

Jiache (ST6)

zygomatic arch, about 1 cun anterior to the angle of the mandible |

Treats facial paralysis |

Yifeng (TE17)

mastoid process and the mandible | Treats ear pain and facial paralysis

|

Clinical Recommendation: Filament needle, even method; during the

acute phase, use gentle technique. May combine with Dazhui pricking to

enhance Heat clearing.


Herbal Formula

Base Formula: Qian Zheng San (牵正散) + Yin Qiao San (银翘散)

Composition:

White Aconite (Bai Fu Zi), Bombyx Batryticatus (Jiang Can), Scorpion

(Quan Xie), Lonicera (Jin Yin Hua), Forsythia (Lian Qiao), Mint (Bo He),

Isatis (Ban Lan Gen), Licorice (Gan Cao)

Action: Disperses Wind-Heat, clears toxins, unblocks collaterals,

and corrects facial deviation.

Modifications

Associated Symptoms Additions/Subtractions
Severe facial heat pain

generate fluids |

Ear pain Add Chuan Xiong, Chai Hu to disperse Wind and stop pain
Sore throat

sore throat |

Headache Add Ju Hua, Man Jing Zi to disperse Wind and clear Heat
Herpetic lesions Add Long Dan Cao, Ze Xie to clear Damp-Heat

Western Mechanism Reference

Facial nerve inflammation following HSV-1 reactivation, with

viral-induced neuroinflammation and nerve damage. Wind-Heat Attacking

the Collaterals corresponds to Bell's palsy associated with HSV-1

reactivation, where viral replication and neuroinflammation contribute

to facial nerve damage.


References

1. Internal Medicine of TCM - Facial Paralysis with Wind-Heat Attacking

Collaterals.

2. Zang-Fu Pattern Differentiation: Wind-Heat → Clearing Pathway.

3. WHO. (2023). Neurological health. World Health Organization.


Explore More

Personalized herbal protocols and acupressure tools for facial nerve

health.

research papers and clinical case studies on TCM neurology.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.