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Zhu Danxi stated: Wrist carbuncle (Wanshou Yong) arises on the outer side of the wrist, belonging to the Three Yang Meridians of the Hand. It is formed by the coagulation of wind, fire, dampness, and toxin pathogens. This area is where the skin and flesh are thin and shallow. If it lingers for a long time without suppurating and ulcerating, or presents with diffuse swelling and flat collapse; once ulcerated, if it rots and exposes bone, it is considered a adverse condition (Ni), difficult to heal. If it is swollen and hard, red but not rotting, and produces multiple heads, it is named Drumstick Madness (Guchui Feng), also known as Wrist Carbuncle (Wanshou Ju).

Dui Ju arises on the inner side of the wrist, between the transverse crease posteriorly and the anterior tip of the radial artery, also known as Pulse Carbuncle (Mai Ju). Initially, it presents with chills, fever, swelling, and pain, with pain radiating through the arm, making movement inconvenient. This is the gate of Metal of the Lung. If the ulceration is deep, Lung Qi will be severely depleted, which is a critical prognosis. Both of the above conditions should be treated according to the principles for Ding Ju (Ting Ju).

Hand Back Carbuncle (Shou Fa Bei) arises at the Zhuxu (Zhongzhu, SI3) and Yemen (Yemen, TE2) acupoints on the back of the hand, belonging to the Triple Energizer Meridian of the Hand-Shaoyang. If it arises at the center of Laogong (Laogong, PC8), it belongs to the Pericardium Meridian of the Hand-Jueyin. It is caused by wind-heat pathogens multiplying each other, leading to stagnation and coagulation of Qi and Blood. Initially, it resembles thorns, accompanied by aversion to cold, fear of heat, dizziness, stuffiness, itching, pain, vomiting, and retching, followed by high swelling over the entire back of the hand. Later, toxins gather to form sores, penetrating deeply to the bone. Rapid suppuration and ulceration indicate a favorable course (Shun); diffuse swelling and hardness with delayed ulceration indicate Ju (Carbuncle). Another type presents initially as a single high-swelling nodule that rots within two days, which belongs to Damp-Fire. Initially, Jingfang Baidu San (Jingfang Decoction for Overcoming Toxins) should be used, followed by Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) or Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). (If the entire back of the hand is eroded, Zhenzhu San (Pearl Powder) must be applied, and Baiyu Gao (White Jade Ointment) pasted to promote healing.)

Palm Toxicity (Shouxin Du), also known as Qingzhu Du or Biao Ju, is caused by the coagulation of Damp-Fire toxin pathogens in the Heart Meridian of the Hand-Shaoyin and the Pericardium Meridian of the Hand-Jueyin. The sore resembles a blister, colored crimson like blood. Although small externally, the internal toxin is excessive, causing severe pain without relief day or night. This condition often fails to heal and can lead to death from hemorrhage. The treatment method must employ formulas that greatly nourish Yin fluids, assisted by detoxifying herbs such as Dideng (Viola Herba), Yinhua (Lonicerae Japonicae Flos), Yuan Shen (Scrophulariae Radix), Sheng Di (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Dan Pi (Moutan Cortex), and Bei Mu (Fritillariae Bulbus).

Tray Ding (Tuopan Ding) arises in the center of the palm, governed by the Pericardium Meridian and the Heart Meridian of the Hand. It is caused by blazing Heart Fire forcing blood to move recklessly, Liver Wind stirring, and toxins dispersing to the four limbs. Combined with excessive worry and thought, and immoderation in alcohol and sexual activity, the toxin flows into the bone marrow and invades Laogong. Laogong is the meridian pathway of the Heart, hence the toxin generates there. Initially, it becomes hard and forms blisters; if the blisters are bright, they should be punctured. Treatment uses Yinhua Jiedu Tang (Honeysuckle Detoxification Decoction).