Songfacts®:

• "Hand Of Doom" is about American soldiers returning from the Vietnam War, often injured or traumatized. The song reflects the disoriented feeling that afflicted many of these veterans, who often used drugs to cope. That's reflected in lines like, "drop the acid pill" and "holes are in your skin, caused by deadly pin."
• Running 7:08, "Hand Of Doom" is part of the second Black Sabbath album, Paranoid, a breakthrough for the band with the songs "Iron Man" and "War Pigs."
• Black Sabbath is from the UK and hadn't yet come to America when they wrote this song. Geezer Butler, the band's bass player and lyricist, was inspired by a concert that band played at an American army base in Germany.
  
  "It was a sort of halfway house when soldiers were coming back from Vietnam so they could face family life and ordinary life when they came back to America," he explained to Songfacts. "They'd stop in Germany to decompress. They'd tell me these horrendous stories about being stuck in the mud in Vietnam and how many of them were on heroin. Of course, they didn't tell you that on the news. I just thought I'd write about that."
  
  The UK didn't fight in the Vietnam war, so there weren't a lot of songs by British groups that tackled the subject.
• "Hand Of Doom" was released in 1970 when America was suffering massive casualties in Vietnam. Another track on the album, "War Pigs," also deals with the futility of war and was inspired by the conflict in Vietnam. That one is about the political leaders who orchestrate the wars.
• There's a big change in tempo in the middle of the song as frontman Ozzy Osbourne sings:
  
  You're having a good time baby
  But that won't last
  
  This is the part where the returning soldier gets hooked on drugs, something that happened to the band, and Ozzy in particular, a few years later.
  
  The song takes another turn at the 5-minute mark when it goes quiet and returns with Ozzy's lines:
  
  Now you know the scene
  Your skin starts turning green
  
  This is when addiction has ravaged the soldier. It doesn't end well. The song concludes:
  
  Price of life you cry
  Now you're gonna die
• Geezer Butler named "Hand Of Doom" the most underrated Black Sabbath song, telling Songfacts, "I like Bill's whole drum track on it. It's totally different to what anybody else was doing."
  
  Sabbath's drummer, Bill Ward, had a background in jazz and was exceptionally creative.
• The band played "Hand Of Doom" a lot in their early years before it got bumped for newer material - they issued an album a year from 1971-1973. The song returned to their setlists in 2016 for their The End Tour, which included every original member except drummer Bill Ward, whose health issues kept him from touring.