Library

Heavenly Snake Poison (Tianshe Du)

Wang Kentang stated: Heavenly Snake Poison, also known as Heavenly Snake Head, can occur on any finger. It is a type of red knot toxin characterized by swelling, pain, and pus formation. Upon ulceration, it splits open with lips resembling a snake's head, hence the name. It is also called "Fa Zhi" (Finger Eruption), caused by accumulated heat in the Pericardium Meridian of Hand-Jueyin. Even if it presents with blackness, stubborn numbness, or ulceration leading to finger loss, it is not fatal. (*Zhunsheng*)

Chen Shigong stated: Heavenly Snake Poison is equivalent to Snake-Head Ding (Snake-Head Carbuncle). It arises from reckless movement of Heart Fire attacking and injecting into the area. The fingertip swells like a snake's head, becoming red, swollen, and painful, with extreme pain radiating to the heart. In severe cases, alternating chills and fever occur, with swelling and pain flaring upwards. At the initial stage, moxibustion is suitable, covered with Chan Su Bing Gao (Toad Venom Cake Plaster). (*Zhengzong*)

Feng Luzhan stated: Heavenly Snake Head refers to toxic sores on the fingers, arising according to their respective meridians. The pain is extremely severe. One must examine the affected meridian and administer detoxifying and blood-nourishing herbs, supplemented by guide drugs to direct the action to the specific meridian. (*Jinnang*)

Dou Hanqing stated: If pus has not yet matured in this condition, one must not cut it open with a knife or probe it with a needle; otherwise, the flesh will protrude and become difficult to treat.

Hu Gongbi stated: In prolonged cases of Heavenly Snake Head, bone may be expelled. If the lesion appears purple-black at the onset, it is invariably fatal. The finger must be amputated for treatment to proceed. The treatment method is the same as that for Tuo Ju (Gangrene of the Extremities). (*Qingnang*)

Wang Shengzhi stated: The three Yin and three Yang meridians of the hand have varying amounts of Qi and Blood. Lesions occurring on the ten fingers are named Dun Ju. If they ulcerate and discharge pus after four to five days and can be punctured, the patient will survive. If they do not ulcerate, lack pus, or show blackness spreading past the joint, it is an incurable fatal condition. (*Lili*)

Wang Kentang stated: Gangrene arising on the tips of the five fingers is named Dun Ju, resulting from accumulated heat in the Zang-Fu organs. Treatment must not be delayed. (*Zhunsheng*)

He further stated: When gangrene erupts on the tip of the thumb, it begins as a small point like millet, gradually enlarging to the size of a bean, plum, or peach. The color may be green, purple, yellow, white, or black intermittently. Symptoms may include itching, numbness without pain, or excruciating pain penetrating the heart. This is called Diao Ju, belonging to accumulated toxins in the Lung Meridian of Hand-Taiyin. If the toxin is excessive, amputation of the finger is advisable. If bloody pus is obtained upon puncturing within four days, the patient survives; if black or white discharge occurs, death ensues. If toxins attack the heart causing vomiting, anorexia, and abdominal distension, or if bleeding occurs from the gum margins, death is inevitable. (*Zhunsheng*)

Zhu Danxi stated: Snake-Head Ding located at the tip of the finger is hard with a distinct head, common to all ten fingers. It originates from the tendons and bones, with deep roots and heavy toxicity. Initially presenting as small blisters, it is characterized by purple discoloration, pain, and hardness resembling a Ding carbuncle.

Wang Kentang stated: Heavenly Snake Poison, located at the tip of the finger, presents as stifling swelling without a distinct head, common to all ten fingers. It originates from the muscles, and its toxicity is slightly milder. Although each finger has its dedicated meridian, these lesions often arise from the fire of the Spleen Meridian combined with other factors. Since the fingers are areas where skin and flesh are thin, moxibustion is contraindicated, as is early incision. Mistaken moxibustion or premature incision can cause skin rupture and muscle eversion, doubling the pain and preventing rapid healing. Caution is essential.

He further stated: Diao Ju arises on the thumb due to accumulated heat in the Lung Meridian. It starts like a millet grain or bean, gradually swelling to the size of a plum, with green-purple discoloration, numbness, and pain/itching penetrating the heart. Puncturing on the sixth day yielding thick pus and fresh blood is auspicious; yielding black blood is dangerous. If black necrosis spreads without pain, it is named Duan Zhi (Severed Finger) and is considered a adverse prognosis. It should be treated according to the methods for foot gangrene.

Gu Shicheng stated: For any finger suffering from Heavenly Snake Poison, if internal pus has formed causing distending pain, use a needle to drain it. One must always prick from below upwards. Never prick from top to bottom, otherwise the toxin will transmit to the lower segment causing ulceration. This is colloquially referred to as "poking the snake's head, causing the snake to shrink downwards."

He further stated: After a fingertip ulcerates, one must strictly avoid lifting heavy objects. If force is applied during work, the flesh will evert, making rapid healing difficult. Similarly, after toe ulcers form, walking must be avoided, or similar complications will arise.

He further stated: Workers whose finger skin is thick and rough often experience situations where pus becomes distended and urgent but cannot penetrate naturally, leading to suppuration of the entire hand. For such individuals, one must use a needle to pricking/draining pus from the fingertip upwards. Do not prick downwards. Mistaken downward pricking often causes toxin flow to the lower segment, leading to finger loss. This must be known.

He further stated: After ulceration, old skin must be trimmed away to prevent it from harboring toxic fluids that could damage healthy flesh.

He further stated: I often see cases where pricking was neglected until pus over-distended, resulting in nail loss and flesh rot leaving only tendons and bones. Applying Yu Hong Gao (Jade Red Ointment) promotes tissue regeneration. However, fingertips often fail to regenerate skin, remaining receded as before. Adding Pearl Powder (Zhenzhu Mo) to Sheng Ji San (Generate Flesh Powder) allows the skin to grow and heal. The same method applies to toes.

When treating fingers or toes where the ulcerated appearance resembles a cicada slough, Gu Shicheng advised using sharp scissors to remove dead skin before applying medication. Otherwise, pus fluid trapped under the skin will remain un-dried. Even with the use of Zhenzhu San (Pearl Powder), hoping for resolution, it is akin to scratching an itch through a boot—rapid healing is impossible.