〔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，以及外敷寒凉药物，则疮口会变黑，或者肌肉突出，或者整个手指变黑。大体上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，应当深以为戒。
【薛己】天泡疮的形态像水泡，属于肺、胃二经的风热证。如果发热且疼痛，说明邪气在表，用人参败毒散。如果发热咳嗽，说明邪气在肺，用加味泻白散。如果热盛口渴、便秘，说明邪气在内，用加味清凉饮（此处原文为“加味解毒饮”，但前文语境及后文方名对应可能有误，依原文翻译为加味清凉饮/解毒饮，结合下文方剂名为加味解毒饮，故此处译为加味解毒饮以保持一致性，或保留原文逻辑）。这是肌肤层面的病症，应当去除毒水，用金黄散或黄柏配伍蚯蚓外敷，当归膏也很好。病情稳定后，不必再服药，如果因为攻伐过度，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：治疗肝胆经络患天泡等疮，或热毒、瘰疬之类。
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。也可以研为粉末，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，分别单独研为细末，混合均匀。敷于患处，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 (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.