〔薛〕手指头生疮，俗名天蛇毒，然五指各有经络，拇指属手太阴肺经，食指属
手阳明大肠经，中指属手厥阴心包络经，无名指属手少阳三焦经，小指属手少阴心
经。亦有患于足者，足趺属肝胆胃三经，大指属肝脾二经，次指属胆经，小指属膀
胱经，各当随经而治。其致患之由，或因胃中积热所发，或因乳母膏梁浓味所致，
或因湿热下流，或因风毒外中，大率多由所禀足三阴之经虚，故邪得以入之也。其
初患肿痛者，先用仙方活命饮，次用托里消毒散。元气下陷，重坠作痛，久而不溃
者，用补中益气汤。若服败毒散，及敷寒凉之剂，则疮口变黑，或 肉突出，或指
皆黑，大抵手足为气血难到之处，手属于胃，足属于脾，不可损其真气。丹溪以臀
居僻位，尚言气血罕到，况肢末乎，故寒凉克伐之药，所宜深戒者也。
〔薛〕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。
此肌肤之证，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，元气虚而变生别证者，当参各门治之。
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。
加味解毒饮 治天泡疮，发热作痛。
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。或为末，蜜丸亦可。
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。
【薛己】手指头生疮，俗称天蛇毒。然而五指各有其所属经络：拇指属于手太阴肺经，食指属于手阳明大肠经，中指属于手厥阴心包络经，无名指属于手少阳三焦经，小指属于手少阴心经。也有发生在足部的，足背属于肝、胆、胃三条经络，大脚趾属于肝、脾两条经络，第二趾属于胆经，小脚趾属于膀胱经，治疗时应当根据所属经络进行辨证施治。导致患病的原因，有的是因为胃中积热引发，有的是因为乳母食用膏粱厚味所致，有的是因为湿热下注，有的是因为风毒外袭，大体上多是由于禀赋不足导致足三阴经虚弱，所以邪气得以侵入。初起出现肿痛者，先用仙方活命饮，接着用托里消毒散。若元气下陷，感觉沉重坠痛，且久不溃破者，用补中益气汤。如果服用败毒散及外敷寒凉药物，则疮口会变黑，或者肌肉突出，或者整个手指变黑。大致来说，手足是气血难以到达的地方，手部归属于胃，足部归属于脾，不可损伤其真气。朱丹溪认为臀部处于偏僻位置，尚且说气血很少到达，何况四肢末端呢？因此寒凉克伐的药物，是应该深加戒忌的。
【薛己】天泡疮的症状像水泡一样，属于肺、胃二经的风热证。如果伴有发热和疼痛，说明邪气在表，用人参败毒散。如果伴有发热和咳嗽，说明邪气在肺，用加味泻白散。如果伴有热渴和大便秘结，说明邪气在内，用加味清凉饮。这是肌肤表面的病症，应当去除毒水，用金黄散或黄柏配伍蚯蚓外敷，当归膏效果也很好。病情稳定后，不必再服药；如果因攻伐过度导致元气虚弱而变生其他证候，应当参考各门类的方法进行治疗。
柴芍参苓散：治疗肝胆经分发生的天泡等疮，或热毒、瘰疬之类的病症。
组成：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）。
用法：以上药材，每次服用二钱，加水煎服。
加味解毒饮：治疗天泡疮，发热作痛。
组成：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）。
用法：以上药材，每次服用一二钱，加水煎服。也可以研为细末，用蜜制成丸剂服用亦可。
金黄散：治疗天泡疮，消毒止痛。
组成：滑石、甘草。
用法：以上药材分别研为细末，混合均匀。外敷患处，如果有水泡，挑破去水后敷药。加入黄柏效果更好。
[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, the index finger to the Hand-Yangming Large Intestine Meridian, the middle finger to the Hand-Jueyin Pericardium Meridian, the ring finger to the Hand-Shaoyang Sanjiao Meridian, and the little finger to the Hand-Shaoyin Heart Meridian. There are also cases occurring on the feet; the dorsum of the foot belongs to the Liver, Gallbladder, and Stomach meridians, the big 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 specific meridian involved. The causes of this condition include heat accumulation in the Stomach, dietary factors such as rich foods consumed by the nursing mother, downward flow of damp-heat, or external invasion of wind-toxin. Generally, it is mostly 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 (Interior-Supporting Toxin-Expelling Powder). If Qi and Yang sink causing heavy, dragging pain and prolonged failure to suppurate, Buzhong Yiqi Tang (Middle-Warming Qi-Supplementing Decoction) is indicated. If Baidu San (Toxin-Resisting Powder) or cold-cooling topical agents are used, the sore may turn black, tissue may protrude, or the entire finger may become black. Generally, the hands and feet are areas where Qi and Blood have difficulty reaching; the hands relate to the Stomach and the feet to the Spleen, so one must not damage the True Qi. Danxi stated that even the buttocks, being in a remote location, receive scarce Qi and Blood, let alone the extremities. Therefore, cold and cooling drugs that deplete are strictly to be avoided.
[Xue Ji] Tianpao Chuang (Blistering Disease) presents with lesions resembling blisters and is attributed to Wind-Heat in the Lung and Stomach meridians. If accompanied by fever and pain, the pathogen is at the exterior; Renshen Baicu San (Ginseng Toxin-Resisting Powder) is used. If accompanied by fever and cough, the pathogen is in the Lung; Jiawei Xiebai San (Modified Draining-Lung Powder) is used. If accompanied by heat-thirst and constipation, the pathogen is internal; Jiawei Qingliang Yin (Modified Cooling-Decoction) is used. As this is a skin-level condition, toxic fluids should be drained using Jinhuang San (Golden Yellow Powder) or a topical application of Huangbai (Phellodendron Bark) combined with earthworms; Danggui Gao (Angelica Ointment) is also effective. Once stabilized, oral medication is unnecessary. If excessive purgation leads to Qi deficiency and secondary complications, treatment should follow the guidelines for respective categories.
Chaishao Shenling San (Bupleurum, Peony, Ginseng, and Poria Powder): Treats Tianpao and similar sores arising from the Liver and Gallbladder meridians, or conditions involving heat-toxin and scrofula.
Ingredients: Chaihu (Bupleuri Radix), Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix) (each 5 fen); Mudanpi (Moutan Cortex), Zhizi (Gardeniae Fructus, stir-fried), Gancao (Licorice Radix) (each 3 fen).
Usage: Take 2 qian per dose, decoct in water and drink.
Jiawei Jiedu Yin (Modified Toxin-Resolving Decoction): Treats Tianpao Chuang with fever and pain.
Ingredients: Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Shengma (Cimicifugae Rhizoma), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), Qianghuo (Notopterygii Rhizoma et Radix), Shengdihuang (Rehmanniae Radix Preparata), Niubangzi (Arctii Fructus, stir-fried) (each 3 qian); Fuling (Poria), Gancao (Licorice Radix) (each 2 qian); Jinyinhua (Lonicerae Japonicae Flos), Loulu (Leontopodium Herba) (each 5 qian).
Usage: Take 1–2 qian per dose, decoct in water and drink. Alternatively, grind into powder and form pills with honey.
Jinhuang San (Golden Yellow Powder): Treats Tianpao Chuang, dispels toxin and relieves pain.
Ingredients: Huashi (Talcum), Gancao (Licorice Radix).
Usage: Grind each ingredient separately into fine powder and mix evenly. Apply topically to the affected area. If blisters are present, puncture them to drain fluid before applying. Adding Huangbai (Phellodendri Cortex) is particularly beneficial.