Abstract： Hand-foot syndrome （HFS）， also known as palmoplantar dysesthesia or acral erythema， is a cutaneous toxic reaction induced by anticancer drugs. Its main clinical manifestations include hypoesthesia，numbness， tingling， burning pain， and even skin fissures， desquamation， and bleeding on the palms and soles. In traditional Chinese medicine（ TCM），it falls under the category of bi syndrome. The concept of "new diseases enter the meridians， chronic diseases enter the collaterals，" proposed by YE Tianshi，is a crucial principle in differentiating and treating bi syndrome. Applying this concept to HFS involves specific treatment strategies：for new diseases entering the meridians， use acrid-aromatic herbs to disperse obstruction； for constrained meridians transforming into heat， use sweet-cold herbs to clear and resolve； for chronic diseases entering the collaterals， use acrid-moist herbs to gently attack， supporting the healthy qi and eliminating pathogenic factors while considering deficiency and excess syndromes. Additionally， insect drugs are employed to search and eliminate pathogens from the meridians and collaterals. This approach provides significant guidance for the precise clinical treatment of HFS.