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Tianpao Chuang (Blistering Eruption) is attributed to a deficiency of Yuan Qi (Original Qi), allowing pathogenic factors to invade; it can also be contracted through transmission. The pathology primarily involves the Liver and Kidney meridians, hence lesions often manifest on the lower body. Some patients experience bone and joint pain prior to onset, while others develop lesions first followed by pain. In the initial stage, if the pulse is floating and rapid, the pathogen is in the Spleen and Lung meridians; treat initially with Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) to release the exterior. If the pulse is wiry and rapid, the pathogen is in the Liver and Gallbladder meridians; treat initially with Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to clear and resolve heat. If the pulse is deep and rapid, the pathogen is in the Zang-Fu organs; treat initially with Neishu Huanglian Tang (Internal-Draining Coptis Decoction) to unblock and guide out pathogens. Subsequently, use Huanji Xiaodu San (Skin-Rejuvenating Toxin-Resolving Powder) as the main formula. After recovery, there will be no further risk of bone and joint pain. If the sores are convex, red, and painful, it indicates intense heat-toxin. If the sores are slightly painful, the toxin is subsiding. If the sores are white and do not form scabs, it indicates Yang Qi deficiency. If the sores are red but do not form scabs, it indicates Yin Blood deficiency. If itching occurs with a floating and deficient pulse, it signifies that Qi cannot nourish mutually; if itching occurs with a floating and rapid pulse, it signifies that Blood cannot nourish mutually. Itching between the buttocks and back or in the neck indicates Bladder Yin deficiency. Itching in the scrotum or inner thighs indicates Liver meridian Blood deficiency. Itching in the scrotum accompanied by a heavy, dragging sensation indicates Liver meridian Yin deficiency with damp-heat. Frequent urination with scanty, reddish urine indicates Liver meridian Yin deficiency. Frequent urination with scanty, whitish urine indicates Spleen and Lung Qi deficiency. Itching in the face and eyes, or redness after scratching, indicates conflict with external pathogens. Itching in the glabella or hair loss indicates dryness of Liver and Gallbladder Blood. Reduced appetite and desire for food, dry mouth desiring warm drinks indicate Stomach Qi deficiency. Indigestion and loose stools indicate Spleen Qi deficiency. Diarrhea occurring in the early morning or at night indicates Spleen and Kidney deficiency. If treatment is incorrect, complications such as eye damage leading to blindness, rotting of the penis, and limb contracture may occur. In such cases, use Jiwei Lushan Wan (Nine-Ingredient Aloe Pill) to clear Liver fire; Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to generate Kidney water; Juanbi Jiedu San (Bi-Syndrome-Removing Toxin-Resolving Powder) to nourish Blood and dispel pathogens; recovery is still possible. However, if mercury-containing powders (Qingfen) etc. are mistakenly used, the condition becomes difficult to treat.

A scholar suffered from the aforementioned condition, initially experiencing itching and discharge from the penis, followed by small eruptions in the scrotum, inner thighs, lower abdomen, hypochondrium, and arms, some dry with pus-filled crusts. He had mistakenly taken wind-dispelling medicines. I stated: This condition belongs to the Liver and Gallbladder meridians. The left Guan position pulse is wiry, and the left Chi position pulse is floating and rapid, indicating insufficient Kidney Water causing deficient heat to transmit to the Liver. The right Guan position pulse is floating and slow, indicating weak Spleen and Stomach Qi. A wiry sensation upon palpation indicates Liver Wood overacting on Spleen Earth. Treatment was based on Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), supplemented with Huanji Xiaodu San (Skin-Rejuvenating Toxin-Resolving Powder), resulting in recovery.

Another scholar suffered from the aforementioned condition with red, painful sores and constipation with hard stool. After taking wind-dispelling and toxin-resolving medicines, he developed tongue pain, dry mouth, and a floating, rapid pulse, indicating unresolved pathogenic factors. Later, the sores gradually turned white; subsequently, he recovered using Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix).

Another patient took toxin-attacking medicines, resulting in convex, red, painful sores, limb fatigue, aversion to cold, fever, and a floating, deficient pulse. This indicated that Yuan Qi (Original Qi) was re-injured while pathogens remained excess. Treatment with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) resulted in recovery after two doses.

A scholar mistakenly took wind-dispelling and toxin-resolving medicines, further injuring his Yuan Qi (Original Qi). Due to excessive labor, he experienced internal heat, dry mouth, and gum pain. The right Guan position pulse was surging, rapid, and deficient, indicating Spleen and Stomach injury with stirring of fire. He recovered using Qingwei San (Stomach-Clearing Powder) and similar formulas.

Jinshi Liu Huafu suffered from this condition for several months. Using Qingfen (Calomel) and Zhusha (Cinnabar) caused nodules about two inches in size to form on the head, face, back, and buttocks. After ulceration, his physical form and Qi became depleted, presenting with alternating chills and fever, dry mouth, dry tongue, cracked lips, dribbling urination, surping phlegm-saliva, and reduced appetite. This indicated Spleen and Stomach injury, weakness of all Zang-Fu organs, and stirring of deficient fire. Initially, when urination was not clear and phlegm-saliva did not stop, he recovered using Jiawei Bawei Wan (Modified Eight-Ingredient Pill).

A scholar suffered from this condition with facial itching, forming either granules or patches, sometimes with discharge. Both Spleen and Lung pulses were surging and rapid, indicating injury by Wind pathogens. He initially recovered using Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins). Later, he experienced whole-body itching with internal heat and dry mouth, recovering with the addition of Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).

A merchant developed whole-body eruptions after every instance of labor or eating. After taking wind-dispelling and toxin-resolving agents, nodules like peaches or chestnuts formed on the face, chest, back, arms, and hypochondrium, appearing concave. External application of Danggui Gao (Angelica Ointment) was used. Internally, he took Buyin Bazhen Tang (Nourish Yin Eight-Treasures Decoction) with Bibai (Dioscoreae Hypoglaucae Rhizoma) 5 qian, combined with Huanji Xiaodu San (Skin-Rejuvenating Toxin-Resolving Powder) added with Gegen (Puerariae Lobatae Radix) and Goutenggou (Uncariae Ramulus cum Uncis) each 1 qian. After more than twenty doses, various symptoms gradually receded. Continuing with the previous medicines as the main regimen and supplementing with regulatory agents, his Qi and Blood recovered, and the sores healed after more than two months.