Finger swelling and pain refers to the condition of swollen and painful fingers, mostly belonging to boil and sore diseases, such as snake-head whitlow (felon), nail corner boil, snake-back boil, snake-eye whitlow (paronychia), spiral boil and sore, interphalangeal boil, and dai zhi, all of which are signs of fire toxin. Conditions like carbuncle on the thumb and blister carbuncle on other fingers fall under the category of digital gangrene.

bubble_chart Pattern Analysis

1. Zang-fu Fire Toxin︰Initially, the finger becomes numb and painful, followed by redness, swelling, and pain, with most cases being headless and fewer having a head. The swelling gradually expands, accompanied by severe throbbing pain, and chronic lymphadenitis can be palpated in the elbow and armpit. At this stage, systemic symptoms gradually appear, such as aversion to cold with fever, reduced appetite, and restless sleep. This is caused by the congealing of zang-fu organs fire toxin and the attack of heat toxin on the fingers. It is an excess heat pattern, with a relatively short course, often seen in individuals with yang exuberance. Key points for differentiation: initially, the finger is numb and itchy, followed by scorching heat and pain that radiates to the heart. The swelling gradually expands, accompanied by severe throbbing pain, and chronic lymphadenitis can be palpated in the elbow and armpit, along with systemic symptoms. Treatment should focus on clearing heat and removing toxin. For internal use, modified Five-Ingredient Toxin-Eliminating Decoction combined with Coptis Detoxification Decoction can be taken. For external treatment, Golden Yellow Powder can be applied topically.
2. External Contraction of Pathogenic Toxin︰At the initial stage, there is redness, heat, swelling, and pain beside the fingernail, which gradually expands as pus forms. Generally, there are no systemic symptoms. It is mostly caused by injuries to the skin and flesh from nail trimming, or punctures by needles, bamboo, wood, fish bones, etc., leading to infection by toxic qi. Key points for pattern identification: At the onset, there is redness, heat, and pain beside the fingernail, gradually expanding, usually without systemic symptoms. Treatment should focus on {|###|}clearing heat and removing toxin{|###|}, and {|###|}Five-Ingredient Toxin-Eliminating Decoction{|###|} can be used. For cases where pus has formed, apply Pus-Draining Powder externally as described above.
3. Accumulation of Fire Toxin︰It is commonly seen in individuals with a history of digital gangrene. Initially, the fingers turn pale, feel cold, and experience numbness and pain (the pain is more pronounced during activity and subsides with rest). Over time, the surrounding skin becomes swollen and cyanotic, with burning pain that worsens at night. The course of the disease is relatively long. The causes of the condition are generally:
   1. prolonged exposure to cold-dampness, leading to cold congealing and obstruction of the collaterals, resulting in poor blood circulation, internal stagnation of yang qi, and the transformation of long-standing cold-dampness into heat;
   2. excessive consumption of rich, fatty, spicy, or fried foods, leading to internal generation of fire toxin;
   3. overuse of warming and tonifying kidney yang medications, or excessive sexual activity, causing pathogenic fire to damage yin, resulting in water deficiency and inability to restrain fire. Key diagnostic points: swollen and cyanotic fingers, burning pain that worsens at night. Treatment should focus on unblocking the collaterals, promoting blood circulation, nourishing yin and clearing heat. Digital gangrene No. 2 can be used. For external treatment, peaceful ointment may be applied.

bubble_chart Documentation

1. Yizong Jinjian Waike Xinfa Key Points. Hand Section: "Snake-head whitlow (felon) is characterized by purplish swelling, hardness, and pain; Tian snake toxin causes dull swelling and redness. Both conditions are associated with spleen meridian fire, and the specific meridian involved can be identified by the finger affected. ... Snake-eye whitlow (paronychia) occurs beside the nail, and is later called snake-back boil; interphalangeal boil occurs in the middle joint bone; snake belly refers to the fish-belly shape inside the finger; mud-loach boil causes swelling throughout the finger, with heat, redness, and pain radiating to the elbow and arm. The specific meridian involved can be identified by the finger affected, and all are caused by zang-fu organs fire toxin. ... Dai finger often occurs on the nail body, with initial swelling, heat, and pain reaching the heart. Mild cases result in slight pus, while severe cases lead to nail loss, caused by Jingmai blood heat."
2. Waike Dacheng. Hand Section: "Tiao carbuncle occurs on the thumb; if it occurs on the tip of another finger, it is also called Biao carbuncle or Dun carbuncle. Initially, it appears like foxtail millet or a bean, gradually enlarging to the size of a peach or plum, with cyanosis, numbness, and itching pain that penetrates to the heart, all caused by lung meridian heat accumulation. It should be lanced on the fourth day; those with pus survive, while those with black blood die. If it is black without pus and painless, it is also called broken finger. Treatment should involve amputation, similar to digital gangrene."