天泡疮状如水泡，属肺胃二经风热。若发热 痛邪在表也，用人参败毒散。发热咳嗽，邪在肺也，用加味泻白散。
热渴便秘，邪在内也，用加味清凉饮。此肌肤之症，当去毒水，以金黄散或黄柏、蚯蚓敷之，当归膏亦善，既安不必服
药。若因攻伐过度，元气虚而变生别症者，当参各门治之。
一小儿患此， 赤恶寒发热，大小便赤涩，此邪在表里之间，遂外敷金黄散，内服大连翘饮子，诸症少愈，更加味
解毒散而痊。
一小儿患此， 痛发热，大小便如常，此邪在表也，挑去毒水，敷金黄散，用荆防败毒散治其表，柴芍参苓散安其
里而愈。
一小儿患此，服败毒之剂，喘嗽唇白，此脾肺之气复伤也，先用补中益气汤一剂，诸症悉退，后加桔梗、白芷，二
剂而愈。
一小儿患此，服败毒散，敷寒凉药，呕吐泄泻，犹索败毒散，余佯诺之，却以五味异功散加柴胡、升麻，而吐泻愈；
又用柴芍参苓散而疮痊。
一小儿患此，服败毒之药，腹痛泄泻，余意脾气复伤，宜用五味异功散。不信，仍服败毒之药，后果不食，作呕流
涎，泄泻后重，余先用补中益气汤，次用五味异功散而愈。
一小儿患此，服败毒散，作渴饮汤，余与七味白术散治之。不信，自服败毒之药，前症益甚，更加呕吐不食，来请
治，余曰∶呕吐不食，手足并冷，痰喘气促，唇色皎白，始见虚寒，即当温补，反服攻伐元气之药，虚而又虚，令脾肺
败症已见，莫能为矣。辞之，果不治。
柴芍参苓散 治肝胆经分患天泡等疮，或热毒瘰 之类。
柴胡 芍药 人参 白术 茯苓 陈皮 当归（各五分） 牡丹皮 山栀（炒） 甘草（各三分）
上每服二钱，水煎服。
加味解毒散 治天泡疮，发热作痛。即加味消毒散加金银花、漏芦。
玄参 连翘 升麻 芍药 当归 羌活 生地黄 牛蒡
子（炒。各三钱） 茯苓 甘草（各二钱） 金银花 漏芦（各五钱）
上每服一二钱，水煎服，或用蜜丸。
金黄散 治天泡疮，消毒止痛。
滑石 甘草
上各另为末，和匀敷患处。如泡挑去水敷之，加黄柏尤好。
补中益气汤（方见肌肉不生）
五味异功散（方见用败毒之药）
加味泻白散（即泻白散加山栀、杏仁）
Tianpao Chuang (Blistering Sores) presents with skin lesions resembling blisters. This condition is attributed to Wind-Heat invading the Lung and Stomach meridians. If accompanied by fever and pain, it indicates that the pathogenic factor is in the exterior; Ren Shen Bai Du San (Ginseng Decoction to Overcome Toxins) should be used. If accompanied by fever and cough, it indicates that the pathogenic factor is in the Lungs; Jia Wei Xie Bai San (Modified Powder to Drain White) should be used.
If symptoms include thirst and constipation, it indicates that the pathogenic factor is in the interior; Jia Wei Qing Liang Yin (Modified Cooling Drink) should be used. As this is a disease of the skin and muscles, the toxic fluid within the blisters should be drained. Apply Jin Huang San (Golden Yellow Powder) or a paste made from Huang Bo (Phellodendri Cortex) and Di Long (Earthworm). Dang Gui Gao (Angelica Ointment) is also effective. Once stabilized, internal medication is no longer necessary. If excessive use of purgative or attacking herbs has damaged Yuan Qi (Primary Qi), leading to other complications, treatment should refer to other sections of the text.
A child suffered from this condition, presenting with aversion to cold, fever, and dark, scanty urination. This indicated that the pathogen was between the exterior and interior. External application of Jin Huang San and internal administration of Da Lian Qiao Yin Zi (Large Forsythia Decoction) were used. Symptoms improved slightly, and after adding Jia Wei Jie Du San (Modified Detoxifying Powder), the child recovered.
Another child suffered from this condition, experiencing pain and fever, with normal bowel movements and urination. This indicated that the pathogen was in the exterior. The blisters were pricked to drain the fluid, followed by external application of Jin Huang San. Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) was used to treat the exterior, and Chai Shao Shen Ling San (Bupleurum, Peony, Ginseng, and Poria Powder) was used to stabilize the interior, leading to recovery.
A third child suffered from this condition but developed wheezing, coughing, and pale lips after taking detoxifying herbs. This indicated a further injury to the Qi of the Spleen and Lungs. One dose of Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi) was administered first, resolving all symptoms. Subsequently, Jie Geng (Platycodonis Radix) and Bai Zhi (Angelicae Dahuricae Radix) were added, and the child recovered after two doses.
A fourth child suffered from this condition, taking Jing Fang Bai Du San and applying cold-natured topical medicines, resulting in vomiting and diarrhea. The family still requested detoxifying herbs. I feigned agreement but instead prescribed Wu Wei Yi Gong San (Five-Ingredient Powder for Extraordinary Efficacy) with added Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma). Vomiting and diarrhea ceased; subsequently, Chai Shao Shen Ling San was used to cure the sores.
A fifth child suffered from this condition and experienced abdominal pain and diarrhea after taking detoxifying herbs. I surmised that the Spleen Qi had been injured again and recommended Wu Wei Yi Gong San. The family did not believe this and continued administering detoxifying herbs. Consequently, the child lost appetite, vomited with salivation, and suffered from diarrhea with tenesmus. I first used Bu Zhong Yi Qi Tang, followed by Wu Wei Yi Gong San, leading to recovery.
A sixth child suffered from this condition and developed thirst after taking Jing Fang Bai Du San. I prescribed Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder). The family did not believe this and self-administered detoxifying herbs, worsening previous symptoms. Vomiting and anorexia ensued. Upon consultation, I stated: "Vomiting, anorexia, cold extremities, phlegm-wheezing, rapid breathing, and bright white lips indicate deficiency-cold. Immediate warming and tonification are required. Instead, you administered herbs that attack and damage Yuan Qi, causing deficiency upon deficiency. Now signs of Spleen and Lung failure are evident; nothing can be done." I declined treatment, and indeed, the child could not be saved.
Chai Shao Shen Ling San (Bupleurum, Peony, Ginseng, and Poria Powder): Treats Tianpao Chuang and similar sores affecting the Liver and Gallbladder meridians, or conditions such as heat-toxin Luo Li (Scrofula).
Ingredients: Chai Hu (5 fen), Shao Yao (5 fen), Ren Shen (5 fen), Bai Zhu (5 fen), Fu Ling (5 fen), Chen Pi (5 fen), Dang Gui (5 fen), Mu Dan Pi (3 fen), Shan Zhi fried (3 fen), Gan Cao (3 fen).
Usage: Take 2 qian per dose, decoct in water and drink.
Jia Wei Jie Du San (Modified Detoxifying Powder): Treats Tianpao Chuang with fever and pain. It is Jia Wei Xiao Du San (Modified Disinfecting Powder) plus Jin Yin Hua (Lonicerae Japonicae Flos) and Lou Lu (Euphorbiae Humifusae Herba).
Ingredients: Xuan Shen (3 qian), Lian Qiao (3 qian), Sheng Ma (3 qian), Shao Yao (3 qian), Dang Gui (3 qian), Qiang Huo (3 qian), Sheng Di Huang (3 qian), Niu Bang Zi fried (3 qian), Fu Ling (2 qian), Gan Cao (2 qian), Jin Yin Hua (5 qian), Lou Lu (5 qian).
Usage: Take 1-2 qian per dose, decoct in water and drink, or form into honey pills.
Jin Huang San (Golden Yellow Powder): Treats Tianpao Chuang, dispelling toxins and relieving pain.
Ingredients: Hua Shi (Talcum), Gan Cao (Licorice Root).
Usage: Grind each separately into fine powder, mix evenly, and apply topically to the affected area. If applied after pricking the blister and draining fluid, adding Huang Bo is even better.
Bu Zhong Yi Qi Tang (See formula under 'Muscles Not Regenerating')
Wu Wei Yi Gong San (See formula under 'Use of Detoxifying Herbs')
Jia Wei Xie Bai San (Xie Bai San plus Shan Zhi and Xing Ren)