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At the initial stage, crush fresh crabs and apply them externally to the affected area; the toxicity can be dissipated.

Wang Kentang stated: Hand palm carbuncle (Shǒuxīn dú) presents with redness, swelling, and pain. It is commonly known as "Bìng chuān zhǎng" (Disease Penetrating Palm), also called "Chuān kū tiān shé" (Heavenly Snake Piercing Caves), or alternatively "Pín zǐ yú" (Poor Man's Bowl). If the lesion is located on the edge of the palm, it is named "Chuān biān tiān shé" (Heavenly Snake Piercing Edge) or "Chuān gěng tiān shé" (Heavenly Snake Piercing Ridge), and is also referred to as a furuncle (yōng, 痈). This condition occurs at Laogong (Lp8, Acupoint of Pericardium Meridian of Hand-Jueyin), which is caused by accumulated heat. (From *Zhunsheng*)

Li Shi stated: Hand palm carbuncle is also known as "Qíng zhū dú" (Holding Pearl Toxicity).

Chen Yuan Gong stated: In some cases, the center of the hand suddenly becomes red, swollen, and protruding, forming a carbuncle with severe pain that persists day and night without interruption. The world calls this "Qíng jū" (Holding Carbuncle). This syndrome is often attributed to enmity or grudges. Internal and external treatments often fail to achieve success, and there are cases of death due to bleeding, suggesting that treatment might seem unnecessary. However, having symptoms but no formulas, how can we demonstrate the greatness of our medical path! If one can confess and repent for grievances, why is it not curable? Although this carbuncle may stem from karmic retribution, it is also because the patient harbors fire-heat toxicity within, which erupts opportunistically. Eliminating the fire-heat toxicity, why would it not yield results! The issue is that fire-heat does not arise overnight, and detoxification cannot be achieved with small doses. Since toxicity forms from heat, and heat arises from fire, the excess of fire ultimately stems from the insufficiency of water. Without using large doses to nourish water, relying only on small doses to extinguish fire, how can victory be assured! One must use large doses of water-nourishing formulas, supplemented with small amounts of detoxifying herbs, and the disease will heal itself. Shijing Decoction (Shì Qíng Tāng): Xuan Shen (Radix Scrophulariae) 1 liang, Jin Yin Hua (Flos Lonicerae) 2 liang, Sheng Di Huang (Radix Rehmanniae Preparata) 1 liang, Dang Gui (Radix Angelicae Sinensis) 1 liang, Zi Hua Di Ding (Herba Violae) 5 qian, Bei Mu (Bulbus Fritillariae Cirrhosae) 2 qian. Decoct in water. After two doses, pain stops. For those already ulcerated, take four more doses; for those not yet ulcerated, take one more dose. All will recover completely. After recovery, confession and repentance are still required to prevent future complications; otherwise, other syndromes may develop, which is not the fault of the formula. This formula nourishes water to treat fire and supplements righteousness to detoxify, placing itself in a position of non-error, leaving no room for debate. (From *Bingjian*)

Chen Shigong stated: Hand palm carbuncle is also known as "Chuān bǎn dīng" (Board-Piercing Hard Chancre), "Qíng zhū" (Holding Pearl), or "Biāo jū" (Phagedenic Carbuncle), which belongs to heart fire-heat toxicity. This condition causes unbearable heart pain. The sore resembles a blister, with a color like blood-red. Although the external appearance is small, if the internal heat toxicity originates from the heart cavity (Xīn kē), it is difficult to treat; if it occurs on the palms or soles, it is treatable. When applying medicine to the palm, application should start from the wrist; when applied to the sole, it must be applied around the shin bone to block the blood flow and prevent the toxicity from ascending. (From *Zhengzong*)

Hu Gongbi stated: Right hand palm carbuncle involves evidence from the Taiyang and Yangming meridians, with qi flowing into the Foot Jueyin Liver Meridian. Left hand palm carbuncle involves evidence from the Shaoyin and Taiyang meridians, with qi flowing into the Foot Taiyin Spleen Meridian and Yangming Stomach Meridian. It may also be caused by internal injury from the seven emotions, leading to stagnation of qi and blood. (From *Qingnang*)