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[Xue Ji] Sores on the fingertips are commonly known as "Tianshe Du" (Heavenly Snake Poison). However, each of the five fingers has its own meridian: the thumb belongs to the Hand-Taiyin Lung Meridian (Shǒu Tàiyīn Fèi Jīng), the index finger to the Hand-Yangming Large Intestine Meridian (Shǒu Yángmíng Dàcháng Jīng), the middle finger to the Hand-Jueyin Pericardium Meridian (Shǒu Juéyīn Xīnbāo Luò Jīng), the ring finger to the Hand-Shaoyang Sanjiao Meridian (Shǒu Shàoyáng Sānjiāo Jīng), and the little finger to the Hand-Shaoyin Heart Meridian (Shǒu Shàoyīn Xīn Jīng). There are also cases occurring on the feet; the dorsum of the foot belongs to the Liver, Gallbladder, and Stomach meridians, the great toe to the Liver and Spleen meridians, the second toe to the Gallbladder meridian, and the little toe to the Bladder meridian. Treatment should be conducted according to the affected meridian. The causes of this disease include heat accumulation in the Stomach, dietary factors such as rich food consumed by the nursing mother, downward flow of damp-heat, or external invasion of wind-toxin. Generally, it is due to deficiency in the Foot-Taiyin meridians from congenital endowment, allowing pathogens to enter. For initial swelling and pain, Xianfang Huoming Yin (Immortal Life Elixir) is used first, followed by Tuoli Xiaodu San (Supporting Interior and Detoxifying Powder). If Qi and Yang sink causing heavy, dragging pain and failure to ulcerate over time, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. If Baidu San (Defeat Toxin Powder) is taken, or cold-natured agents are applied externally, the sore may turn black, flesh may protrude, or the entire finger may become black. Generally, the hands and feet are areas where Qi and Blood rarely reach. The hands relate to the Stomach, and the feet relate to the Spleen; one must not damage the True Qi. Danxi stated that even the buttocks, being in a remote location, have scarce Qi and Blood, let alone the extremities. Therefore, cold and purgative medicines should be strictly avoided.

[Xue Ji] Tianpao Chuang (Blistering Disease) presents like water blisters and belongs to Wind-Heat in the Lung and Stomach meridians. If accompanied by fever and pain, the pathogen is at the exterior; Ren Shen Baidu San (Ginseng and Toxin-Expelling Powder) is used. If accompanied by fever and cough, the pathogen is in the Lung; Jiawei Xiebai San (Modified Draining White Powder) is used. If accompanied by heat, thirst, and constipation, the pathogen is internal; Jiawei Jiedu Yin (Modified Detoxifying Decoction) is used. As this is a skin manifestation, toxic fluid should be drained, applying Jinhuang San (Golden Yellow Powder) or Huangbai (Phellodendri Cortex) combined with Earthworms topically; Danggui Gao (Angelica Ointment) is also effective. Once stabilized, no further oral medication is needed. If excessive purging leads to deficiency of Yuan Qi and the emergence of other syndromes, treatment should refer to respective categories.

Chai Shao Shen Ling San (Bupleurum, Peony, Ginseng, and Poria Powder): Treats Tianpao and similar sores affecting the Liver and Gallbladder meridians, or heat-toxin and scrofula.
Ingredients: Chai Hu (Bupleuri Radix), Shao Yao (Paeoniae Radix Alba), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium), Dang Gui (Angelicae Sinensis Radix) (each 5 fen); Mu Dan Pi (Moutan Cortex), Shan Zhi (Gardeniae Fructus, stir-fried), Gan Cao (Licorice Radix et Rhizoma) (each 3 fen).
Usage: Grind into powder. Take 2 qian per dose, decoct in water and drink.

Jiawei Jiedu Yin (Modified Detoxifying Decoction): Treats Tianpao Chuang with fever and pain.
Ingredients: Xuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Sheng Ma (Cimicifugae Rhizoma), Shao Yao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Sheng Di Huang (Rehmanniae Radix Preparata), Niu Bang Zi (Arctii Fructus, stir-fried) (each 3 qian); Fu Ling (Poria), Gan Cao (Licorice Radix et Rhizoma) (each 2 qian); Jin Yin Hua (Lonicerae Japonicae Flos), Lou Lu (Leuzeae Rhizoma) (each 5 qian).
Usage: Take 1-2 qian per dose, decoct in water and drink. Alternatively, grind into powder and make honey pills.

Jinhuang San (Golden Yellow Powder): Treats Tianpao Chuang, dispels toxin and relieves pain.
Ingredients: Hua Shi (Talcum), Gan Cao (Licorice Radix et Rhizoma).
Usage: Grind each separately into fine powder and mix evenly. Apply to the affected area. If blisters are present, puncture them, drain the fluid, and then apply the powder. Adding Huangbai (Phellodendri Cortex) is particularly effective.