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Hand Back Carbuncle initially presents with a shape resembling thorns, caused by the stagnation of wind, fire, qi, and dampness in the three Yang meridians. If the lesion is hard and ulcerates to damage tendons and bones, it is dangerous; if it is high-swollen and ulcerates rapidly, it is easy to heal.

[Note] This condition arises on the back of the hand, belonging to the three Hand-Yang meridians, formed by the stagnation of wind-fire and dampness. Initially, the shape resembles thorns, gradually becoming painful. If it is high-swollen with vibrant red color and heat, it rapidly ulcerates into an abscess (Yong); if it is diffusely swollen and hard, without redness or heat, and ulcerates slowly, it becomes a carbuncle (Ju). Regardless of its form or size, if the ulceration is deep enough to expose tendons and bones, it is difficult to cure. Initially, Qianghuo San (Notopterygium Powder) should be taken to induce sweating, followed by Neishu Huanglian Tang (Internal Draining Coptis Decoction) to clear heat. All other internal and external treatments follow the records in the Abscess Ulcer and Ulcerated Ulcer sections.

Qianghuo San
Qianghuo (Notopterygii Rhizoma et Radix), Danggui (Angelicae Sinensis Radix) (each 2 qian), Duhuo (Angelicae Pubescentis Radix), Wuyao (Linderae Radix), Weilingxian (Salaciae Chinensis Caulis) (each 1.5 qian), Shengma (Cimicifugae Rhizoma), Qianhu (Peucedani Radix), Jingjie (Schizonepetae Spica), Jiegeng (Platycodonis Radix) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, raw, 0.5 qian), Rougui (Cinnamomi Cortex, 0.3 qian).
Decoct with one cup of wine and one cup of water until one cup remains. Take far from meals.

[Prescription Song] Qianghuo San treats Hand Back Carbuncle, dispels dampness and induces sweat to chase away wind; Shengma, Qianhu, Duhuo, Jingjie, Danggui, and Gancao are included, while Wuyao, Weilingxian, Jiegeng, and Rougui follow.
Neishu Huanglian Tang (see Abscess Ulcer section)

Palm Toxin manifests as red swelling and pain, belonging to the Pericardium Meridian, formed by accumulated heat. If it occurs on the side of the palm, it is named Chuanzhang Poison. Initially, inducing sweating is appropriate, followed by clearing heat.

[Note] This condition arises in the center of the palm, presenting with red swelling and pain, belonging to the Laogong Acupoint of the Pericardium Meridian, formed by accumulated heat. If it occurs on the side of the palm, it is named Chuanzhang Poison, also known as Chuangheng Poison or Ding Yong. The initial treatment is the same as for Hand Back Carbuncle; all other treatments follow the records in the Abscess Ulcer and Ulcerated Ulcer sections.

(Attached: Hegu Ding)
Kou Tiger Carbuncle arises at the Hegu Acupoint, belonging to the Large Intestine Meridian, formed by the stagnation of heat and dampness. A deep-rooted lesion is a Ding (Hard Chancre); a large one is a Ju (Carbuncle). Hardness and numbness/pain indicate the need for sweating and acupuncture for clarity.

[Note] This condition arises at the Hegu Acupoint, located between the metacarpal bones of the thumb and index finger, belonging to the Large Intestine Meridian, formed by the coagulation of damp-heat. Also known as Yacha Poison or Baixie Poison. Initially, it resembles a bean, diffusely enlarged with bluish-purple color, numb, painful, and hard, named Kou Tiger Carbuncle; if it initially presents as small yellow millet grains with itching, heat, and pain, with a deep root and red lines attacking towards the axilla, it is named Hegu Ding. Whether Ding or Ju, initially Qianghuo San should be taken to induce sweating, and Neishu Huanglian Tang to clear heat. For Ju, when pus is mature, use needles to drain it; other treatments follow the Abscess Ulcer and Ulcerated Ulcer sections. For Ding, at the onset, pick out the root of the Ding; if there are red threads, use a needle to cut them off at the end of the red thread. Other treatments follow the Ding section.

Qianghuo San (see Hand Back Carbuncle)
Neishu Huanglian Tang (see Abscess Ulcer section)