Redness and swelling on one or both sides of a woman's vulva, accompanied by distending pain, and even the formation of pus, is called vulvar abscess. The annotated Furen Liangfang refers to it as "swelling of vulva in women."

bubble_chart Pattern Analysis

1. Dampness-heat︰Swelling of the vulva with no or slight redness, grade I pain, and excessive leucorrhea or epigastric stuffiness and poor appetite. The tongue coating is normal or white and greasy, and the pulse manifestation is normal or soggy and rapid. $Swelling of the vulva due to dampness predominating over heat and swelling of the vulva due to heat predominating over dampness! Both are caused by dampness-heat pouring down the vaginal orifice. Due to the difference in the degree of "dampness" and "heat," the severity of dampness-heat symptoms and accompanying symptoms also vary. In cases where dampness predominates over heat, the main symptom is local swelling, with no or slight redness of the skin, possibly accompanied by grade I pain and excessive leucorrhea. The treatment should focus on draining dampness and clearing heat, using Sheng Yi Ren Yin (Coix Seed Decoction) as the prescription. For external use, apply Peaceful Ointment locally or use a decoction of 30g mirabilite and 30g Portulaca oleracea for fumigation and washing. In cases where heat predominates over dampness, the main symptoms are local redness, swelling, heat, and pain, difficulty in movement, excessive yellowish leukorrhea, and dark urine. The treatment should focus on clearing heat and draining dampness, using Gentian Liver-Draining Decoction combined with Five-Ingredient Toxin-Eliminating Decoction with modifications. For external use, apply Jin Huang San (Golden Yellow Powder) locally or use a decoction of 30g mirabilite, 15g raw Rhubarb Rhizome, 10g Phellodendron Bark, and 30g Purslane Herb for fumigation and washing. If pus has formed, the treatment should focus on expelling the internal to drain pus, clearing heat and draining dampness, using Pus-Draining Powder combined with Two Wonderful Herbs Powder.
2. Heat Predominating over Dampness︰Swelling, redness, heat, and pain in the vulva, difficulty in movement, aggravated pain when sitting, copious yellowish leukorrhea, and dark urine. The tongue coating is yellow and greasy, and the pulse is wiry and rapid. $Vulvar abscess with dampness predominating over heat and vulvar abscess with heat predominating over dampness! Both are caused by dampness-heat pouring down the vaginal orifice. Due to the varying degrees of "dampness" and "heat," the severity and accompanying symptoms of dampness-heat differ. In cases where dampness predominates over heat, the main symptom is localized swelling, with the skin appearing non-red or slightly red, possibly accompanied by grade I pain and copious leukorrhea. Treatment should focus on draining dampness and clearing heat, using the Raw Coix Seed Decoction, with external application of Peaceful Ointment, or a decoction of 30g mirabilite and 30g purslane for fumigation and washing. In cases where heat predominates over dampness, the main symptoms are localized redness, swelling, heat, and pain, difficulty in movement, copious yellowish leukorrhea, and dark urine. Treatment should focus on clearing heat and draining dampness, using Gentian Liver-Draining Decoction combined with Five-Ingredient Toxin-Eliminating Decoction with modifications, and external application of Golden Yellow Powder, or a decoction of 30g mirabilite, 15g raw rhubarb rhizome, 10g phellodendron bark, and 30g purslane herb for fumigation and washing. If pus has already formed, the treatment should focus on expelling the internal to drain pus, clearing heat, and draining dampness, using Pus-Draining Powder combined with Two Wonderful Herbs Powder.

bubble_chart Documentation

1. Jiyin Gangmu．Postpartum Section: "For swelling and pain of the vulva that does not close, Peripatetic PowderTen Major Tonics Decoction；for swelling that subsides but does not close, Middle-Tonifying Qi-Replenishing Decoction；for swelling and pain, add Gardenia and Peony Bark. For damp itching, bleeding, and pain, caused by excessive worry, Returning to Spleen Decoction add Bupleurum, Gardenia, Peony Bark, Peony Root, and raw Liquorice Root. For ulceration, Peripatetic Powder."