初起，鲜蟹捣烂敷之，其毒可散。
王肯堂曰∶手心毒， 赤肿痛，俗名病穿掌，又曰穿窟天蛇，又名贫子盂。若
偏于掌边者，名穿边天蛇，又名穿埂天蛇，亦名 痈。此手厥阴心包经劳宫穴，乃积热所致。（《准绳》）
\r手心毒\p04-a41a126.bmp\r
李氏曰∶手心毒，一名擎珠毒。
陈远公曰∶有手心中忽红肿高突变成一疽，疼痛非常，日夜无间，世所谓擎疽
也。此证多是冤家相寻，内外治疗，往往不能收功，有流血至死者，似乎不必治也。
然有证无方，安见吾道之大乎！苟能告解怨艾，安在不可救。此疽虽是冤孽，亦因
病患有火热之毒，乘机窃发，消火热之毒，何不可奏功耶！但火热非起于一旦，而解
毒难于小剂。盖毒成于热，热起于火，火之有余，终是水之不足，不大料以滋水，惟
小剂以灭火，安得取胜乎！必大用补水之剂，少佐解毒之味，则自愈耳。释擎汤∶元
参一两，金银花二两，生地一两，当归一两，紫花地丁五钱，贝母二钱。水煎，二
剂疼止，已溃者又服四剂，未溃者又服一剂，无不全愈。愈后仍须告解，则无后患，
否则恐变生他证，非方之过也。此方滋水以治火，补正以解毒，自居于无过之地，又何拟议哉。（《冰鉴》）
陈实功曰∶手心毒，一名穿板疔，又名擎珠，又名瘭疽，乃心火热毒也。是于
五心痛不可忍，其疮如泡，色如血赤，外形虽小，内有热毒发于心窠者，难治；发
于手足心者，可疗。如在手掌心敷药，当从手腕敷起；如在足心，须从脚胫骨四围
敷住，以截血路，免毒上攻。（《正宗》）
胡公弼曰∶右手心毒，乃太阳、阳明二经受证，气流足厥阴经。左手心毒，乃
少阴、太阳二经受证，气流足太阴、阳明经。或因七情内伤，气血凝滞，亦能患此。（《青囊》）
初起时，将鲜螃蟹捣烂外敷患处，其毒邪即可消散。
王肯堂说：手心毒，表现为局部红肿疼痛，俗称“病穿掌”，又称“穿窟天蛇”，又名“贫子盂”。如果病灶偏向手掌边缘的，称为“穿边天蛇”，又称“穿埂天蛇”，也叫做“痈”。此病发生在手厥阴心包经的劳宫穴（位于手掌中心），是由积热所致。（出自《医宗必读·准绳》）
陈远公说：有人手心突然红肿高突，形成一疽，疼痛剧烈，日夜不停，世人称之为“擎疽”。此证多因冤家相寻引起，内外治疗往往难以见效，甚至有流血至死的案例，似乎不必治疗。然而有证无方，怎能体现中医之道的大度与包容！若能告解怨艾（忏悔和解），何尝不能救治？此疽虽是冤孽所致，但也因患者体内有火热之毒，乘机发作。消除火热之毒，为何不能奏效呢！只是火热之毒并非一朝一夕形成，而解毒非小剂量所能胜任。因为毒由热成，热由火起，火的有余，终究是因为水的不足。若不大量用药以滋补肾水，仅用小剂量来灭火，怎能取胜！必须大剂量使用补水之剂，少量佐以解毒之药，则疾病自愈。释擎汤组成：玄参一两，金银花二两，生地黄一两，当归一两，紫花地丁五钱，贝母二钱。水煎服，服用两剂后疼痛停止，已经溃破者再服四剂，未溃破者再服一剂，无不痊愈。痊愈后仍须告解，则无后患，否则恐怕变生其他证候，这不是药方的过错。（出自《石室秘录·冰鉴》）
陈实功说：手心毒，一名“穿板疔”，又名“擎珠”，又名“瘭疽”（biāo jū，一种急性化脓性感染），属于心火热毒。这种病让人心痛难忍，疮疡如泡，颜色赤红如血，外形虽小，但内有热毒发于心窠（心脏内部或深层）者，难治；发于手足心者，可治疗。如果在手掌心敷药，应当从手腕处开始敷起；如果在足心，必须从脚胫骨四周敷住，以截断血路，避免毒邪上攻。（出自《外科正宗》）
胡公弼说：右手心毒，是太阳经、阳明经受邪所致，气机流注于足厥阴肝经。左手心毒，是少阴经、太阳经受邪所致，气机流注于足太阴脾经、阳明胃经。也可能因七情内伤，导致气血凝滞，从而患此病。（出自《青囊秘传》）
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*)