Groin swelling and pain, that is, the condition of swelling and pain at the junction of the thigh root and the abdomen.

This condition is recorded in ancient medical texts as "multiple abscess", "bubo", "bubo", "bubo", "stony nodule", etc.

Hernia is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Summer-Dampness Abscess︰At the initial stage, there is aversion to cold with fever, pain on one side of the groin, but no obvious swelling; subsequently, the affected side becomes diffusely swollen without a distinct head, and the lower limb is flexed and difficult to extend. After about seven days, the swelling gradually becomes apparent, accompanied by persistent high fever. Suppuration typically occurs after about one month. The tongue coating is white and greasy, and the pulse is slippery and rapid. $Multiple abscess due to summerheat-dampness (groin swelling and pain), multiple abscess with remnant toxin (groin swelling and pain), and multiple abscess with blood stasis (groin swelling and pain) are all abscesses occurring deep in the muscles, characterized by diffuse swelling, pain, and normal skin color, with the affected lower limb flexed and difficult to extend. However, their disease causes and treatments differ. **Multiple abscess due to summerheat-dampness (groin swelling and pain)** is mostly caused by exposure to summerheat-dampness during summer and autumn, followed by invasion of cold pathogens lodging between the nutrient and defense levels, leading to internal obstruction of damp-phlegm that spreads between the muscles. Key diagnostic points: initial aversion to cold with fever, worsening swelling and pain during the stage of suppuration, high fever, white and greasy tongue coating, and a slippery, rapid pulse. **Initial stage (first stage)**: Treatment should focus on releasing the exterior with pungent-warm herbs. Schizonepeta and Saposhnikovia Toxin-Vanquishing Powder or Baoan Wanling Dan may be used. As the exterior pathogens gradually resolve, clearing summerheat and resolving dampness is appropriate. The formula may include Soybean Sprouts, Stir-fried Burdock, Stir-fried Gardenia, Fresh Patchouli, Fresh Fortune Eupatorium, Lonicera, Forsythia, Red Peony Root, Dried Tangerine Peel, Red Poria, Raw Coix Seed, Violet, Mulberry Twig, and Talc, combined with Wake-Up Subsiding Pill. If the condition occurs in other seasons, it is caused by damp-phlegm multiple abscesses. Treatment should involve removing Patchouli from the above formula and adding Pinellia and Magnolia Bark to dry dampness and resolve phlegm. **External treatment**: Taiyi Plaster may be applied topically. **Multiple abscess with remnant toxin (groin swelling and pain)** is often caused by prior conditions such as boils and sores, cold-damage disease, or the spread of toxic qi, or by external contraction of wind-cold where residual pathogens remain after exterior resolution, leading to remnant toxins flowing through the channels. Key diagnostic points: sudden onset with fever, thirst, yellow and greasy tongue coating, and a surging, rapid pulse. Severe cases may present with unconsciousness, delirious speech, chest and rib pain, and coughing with bloody phlegm. Treatment should focus on clearing heat and removing toxins, cooling blood, and dispelling stasis. Coptis Detoxification Decoction combined with Rhinoceros Horn and Rehmannia Decoction may be used. If there is no unconsciousness, remove Rhinoceros Horn and add Lonicera, Forsythia, Luffa Vegetable Sponge, and Mulberry Twig. For dysphoria, high fever, and unconsciousness, detoxify and clear the heart by adding Peaceful Palace Bovine Bezoar Pill or Purple Snow Bolus. For coughing with bloody phlegm, resolve phlegm, relieve asthma, clear heat, and stop bleeding by adding Fritillaria Bulb, Mongolian Snakegourd Root, Fresh Bamboo Juice, and Fresh Reed Rhizome. **External treatment**: Same as above. **Multiple abscess with blood stasis (groin swelling and pain)** is caused by overexertion, injury to the sinews and vessels, traumatic injuries, static blood retention, or postpartum lochia stagnation combining with dampness-toxin. Key diagnostic points: mild systemic symptoms at the onset, localized swelling and pain in the groin with slight redness or bruising, mild fever on palpation, purplish-dark tongue texture, and a choppy pulse. Treatment should focus on harmonizing the nutritive level and dispelling stasis. For cases caused by yin injury, dispel stasis to unblock collaterals using Tail of Chinese Angelica, Peach Kernel, Shiny Bugleweed, Red Peony Root, Stephania Tetrandra, Achyranthes Root, Red Bean, Lonicera, Forsythia, Luffa Vegetable Sponge, and Mulberry Twig, combined with Wake-Up Subsiding Pill. For traumatic injury cases, harmonize the nutritive level and expel stasis using a blood-invigorating and stasis-resolving decoction with powdered Sanqi taken orally. For postpartum lochia stagnation, harmonize the nutritive level and unblock stagnation using Tongjing Daozhi Decoction. **External treatment**: Same as above.
2. Residual Toxin Migration︰The general symptoms are similar to the previous ones, but the onset is sudden and violent, accompanied by body heat, thirst, yellow and greasy tongue coating, and a surging and rapid pulse. In cases of excessive heat, unconsciousness, delirious speech, chest and hypochondriac pain, cough, wheezing, bloody sputum, and other symptoms may also occur. $Multiple abscess due to summerheat-dampness (groin swelling and pain), multiple abscess with remanent toxin (groin swelling and pain), and multiple abscess with blood stasis (groin swelling and pain)! All are abscesses occurring deep in the muscles, characterized by diffuse swelling and pain, with normal skin color in most cases. The affected lower limb is flexed and difficult to extend, but the disease causes and treatments differ. **Multiple abscess due to summerheat-dampness (groin swelling and pain)** is mostly caused by exposure to summerheat-dampness during the summer and autumn seasons, followed by invasion of cold pathogens, lodging between the nutrient and defense levels, leading to internal obstruction of damp-phlegm, which spreads between the muscles. Key points for pattern identification: At the initial stage, there is aversion to cold with fever; during the stage of suppuration, swelling and pain intensify, accompanied by high fever, white and greasy tongue coating, and a slippery and rapid pulse. In the initial stage [first stage], treatment should focus on releasing the exterior with pungent-warm herbs. Schizonepeta and Saposhnikovia Toxin-Vanquishing Powder or Bao'an Wanling Dan may be used. As the exterior pathogens gradually resolve, clearing summerheat and resolving dampness is appropriate. The prescription may include Soybean Sprout, fried Arctium, fried Gardenia, fresh Patchouli, fresh Fortune Eupatorium, Lonicera, Forsythia, Red Peony Root, Dried Tangerine Peel, Red Poria, raw Coix Seed, Violet, Mulberry Twig, and Talc, combined with Wake-Up Subsiding Pill. If the condition occurs in other seasons, it is caused by damp-phlegm multiple abscess. Treatment should follow the above prescription, removing Patchouli and adding Pinellia and Magnolia Bark to dry dampness and resolve phlegm. External treatment: Taiyi Plaster may be applied topically. **Multiple abscess with remanent toxin (groin swelling and pain)** is mostly caused by prior conditions such as boils and sores, cold-damage disease, or the spread of toxic qi, or external contraction of wind-cold, where residual pathogens remain after exterior dispersion, leading to lingering toxins flowing through the meridians. Key points for pattern identification: Sudden and violent onset, accompanied by body heat, thirst, yellow and greasy tongue coating, and a surging and rapid pulse. In severe cases, unconsciousness, delirious speech, chest and hypochondriac pain, cough, wheezing, and bloody sputum may occur. Treatment should focus on clearing heat and removing toxins, cooling blood, and dispelling stasis. Coptis Detoxification Decoction combined with Rhinoceros Horn and Rehmannia Decoction may be used. If there is no unconsciousness, remove Rhinoceros Horn and add Lonicera, Forsythia, Luffa Vegetable Sponge, Mulberry Twig, etc. If dysphoria, high fever, or unconsciousness appears, toxin removal and heart clearing are appropriate, with the addition of Peaceful Palace Bovine Bezoar Pill or Purple Snow Bolus. If cough, wheezing, and bloody sputum are present, resolving phlegm and relieving asthma, clearing heat, and stopping bleeding are indicated. Additional herbs such as Fritillaria Bulb, Mongolian Snakegourd Root, fresh Bamboo Juice, and fresh Reed Rhizome may be added. External treatment is the same as the previous condition. **Multiple abscess with blood stasis (groin swelling and pain)** is caused by excessive fatigue, injury to the sinews and vessels, traumatic injury, static blood retention, or postpartum lochia stagnation, where static blood combines with dampness-toxin. Key points for pattern identification: At the initial stage, systemic symptoms are not obvious. There is a painful lump in the groin area, with slightly red or bluish-purple skin, mild fever upon touch, purple-dark tongue texture, and a choppy pulse. Treatment should focus on harmonizing the nutrient aspect and dispelling stasis. For cases caused by yin injury, dispelling stasis to unblock collaterals is appropriate. The prescription may include Tail of Chinese Angelica, Peach Kernel, Shiny Bugleweed, Red Peony Root, Stephania Tetrandra, Achyranthes Root, Red Bean, Lonicera, Forsythia, Luffa Vegetable Sponge, and Mulberry Twig, combined with Wake-Up Subsiding Pill. For cases caused by traumatic injury, harmonizing the nutrient aspect and expelling stasis is appropriate. The prescription may include Invigorating Blood and Resolving Stasis Decoction with Sanqi powder taken orally. For cases caused by lochia stagnation, harmonizing the nutrient aspect and unblocking stagnation is appropriate. Tongjing Daozhi Decoction may be used. External treatment is the same as the previous conditions.
3. Static Blood Stasis︰In the early stage, systemic symptoms are not obvious. There is swelling and pain in the groin forming a mass, with slightly red or purplish skin, and mild fever upon touch. The affected lower limb is flexed and difficult to extend. The tongue texture is dark purple, and the pulse is choppy. **Multiple abscess due to summerheat-dampness with groin swelling and pain**, **multiple abscess with remnant toxin with groin swelling and pain**, and **multiple abscess with blood stasis with groin swelling and pain** are all abscesses occurring deep in the muscles, characterized by diffuse swelling, pain, and often normal skin color, with the affected lower limb flexed and difficult to extend. However, their disease causes and treatments differ. **Multiple abscess due to summerheat-dampness with groin swelling and pain** is mostly caused by exposure to summerheat-dampness during summer and autumn, followed by invasion of cold pathogens, lodging between the nutrient and defense levels, leading to internal obstruction of damp-phlegm that spreads between the muscles. Key diagnostic points: In the early stage, there is aversion to cold with fever; during the suppuration stage, swelling and pain intensify, accompanied by high fever, a white and greasy tongue coating, and a slippery, rapid pulse. **Initial stage [first stage]**: Treatment should focus on releasing the exterior with pungent-warm herbs. Schizonepeta and Saposhnikovia Toxin-Vanquishing Powder or Bao'an Wanling Dan can be used. As the exterior pathogens gradually resolve, the focus should shift to clearing summerheat and resolving dampness. The formula may include Soybean Sprout, stir-fried Arctium, stir-fried Gardenia, fresh Patchouli, fresh Fortune Eupatorium, Lonicera, Forsythia, Red Peony Root, Dried Tangerine Peel, Red Poria, raw Coix Seed, Viola, Mulberry Twig, and Talc, combined with Wake-Up Subsiding Pill. If the condition occurs in other seasons, it is caused by damp-phlegm multiple abscess. The treatment should follow the above formula but remove Patchouli and add Pinellia and Magnolia Bark to dry dampness and resolve phlegm. **External treatment**: Taiyi Plaster can be applied topically. **Multiple abscess with remnant toxin with groin swelling and pain** is often caused by prior boils and sores, cold-damage disease, or the spread of toxic qi, or external contraction of wind-cold, where residual pathogens remain after exterior release, leading to remnant toxins flowing through the meridians. Key diagnostic points: Sudden onset with fever, thirst, a yellow and greasy tongue coating, and a surging, rapid pulse. Severe cases may present with unconsciousness, delirious speech, chest and rib pain, cough, wheezing, and bloody phlegm. Treatment should focus on clearing heat and removing toxins, cooling blood, and dispelling stasis. Coptis Detoxification Decoction combined with Rhinoceros Horn and Rehmannia Decoction can be used. If there is no unconsciousness, remove Rhinoceros Horn and add Lonicera, Forsythia, Luffa Vegetable Sponge, and Mulberry Twig. If dysphoria, high fever, or unconsciousness occurs, focus on removing toxins and clearing the heart, adding Peaceful Palace Bovine Bezoar Pill or Purple Snow Bolus. For cough, wheezing, and bloody phlegm, resolve phlegm and relieve asthma, clear heat, and stop bleeding by adding Fritillaria Bulb, Mongolian Snakegourd Root, fresh Bamboo Juice, and fresh Reed Rhizome. **External treatment**: Same as above. **Multiple abscess with blood stasis with groin swelling and pain** is caused by overexertion, injury to the sinews and vessels, traumatic injury, stagnant blood retention, or postpartum lochia stagnation, where static blood combines with dampness-toxin. Key diagnostic points: In the early stage, systemic symptoms are not obvious. There is swelling and pain in the groin forming a mass, with slightly red or purplish skin, mild fever upon touch, a dark purple tongue texture, and a choppy pulse. Treatment should focus on harmonizing the nutrient level and dispelling stasis. For cases caused by yin damage, dispel stasis to unblock collaterals using Tail of Chinese Angelica, Peach Kernel, Shiny Bugleweed, Red Peony Root, Stephania Tetrandra, Achyranthes Root, Red Bean, Lonicera, Forsythia, Luffa Vegetable Sponge, and Mulberry Twig, combined with Wake-Up Subsiding Pill. For cases caused by traumatic injury, harmonize the nutrient level and expel stasis using a blood-invigorating and stasis-resolving decoction with Sanqi powder taken orally. For cases caused by lochia stagnation, harmonize the nutrient level and unblock stagnation using Tongjing Daozhi Decoction. **External treatment**: Same as above.
4. Congealing Cold and Qi Stagnation︰Initially, a subcutaneous node appears on one side of the groin, resembling a peach, plum, or chicken egg in size. It gradually enlarges, becoming as hard as stone, with unchanged skin color, causing tendon pain. It is difficult to resolve or ulcerate, and even after ulceration, it is hard to heal. The tongue coating is thin and white, and the pulse is deep. This condition is mostly caused by the deep invasion of cold pathogens, obstructing the flow of yang qi and leading to poor blood circulation, resulting in the congealing of static blood. Key diagnostic points: a groin mass as hard as stone, unchanged skin color without signs of inflammation, and tendon pain. For those with a robust constitution, the treatment should focus on dissipating cold to relieve pain, harmonizing the nutrient and resolving stasis. Myrrh pills can be used. For prolonged cases with a weak constitution, the approach should be warming and tonifying qi and blood, and Ten Major Tonics Decoction can be employed. External treatment: moxibustion with ginger (or garlic) slices.
5. Heat Toxin Accumulation︰Initially, there is sudden swelling and discomfort in one side of the groin, smooth and soft without a head, quickly forming a painful lump, with visible redness or no redness on the skin. Later, it gradually expands, becoming highly swollen and hard. Mild cases may have no systemic symptoms, while severe cases may present with {|###|}aversion to cold with fever{|###|}, {|###|}headache{|###|}, nausea, {|###|}tongue coating{|###|} yellow and greasy, and a surging, rapid pulse. After 7 to 14 days, the swelling becomes more prominent, pain intensifies (like being pecked by a chicken), and systemic {|###|}fever{|###|} persists. If the area feels fluctuant upon pressure, it indicates pus formation. This condition is mostly caused by the accumulation of {|###|}dampness-heat fire toxin{|###|}, leading to {|###|}disharmony between nutrient and defensive qi{|###|}, meridian blockage, and stagnation of qi and blood. Key diagnostic points: Sudden swelling and discomfort in the groin, smooth and soft without a head, rapid lump formation, burning pain on the skin, high swelling and hardness, {|###|}aversion to cold with fever{|###|}, {|###|}headache{|###|}, nausea, {|###|}tongue coating{|###|} yellow and greasy, and a surging, rapid pulse. Treatment should focus on {|###|}clearing heat and removing toxin{|###|}, harmonizing the nutrient aspect, and {|###|}resolving dampness{|###|}. Modified Coptis Detoxification Decoction combined with Immortal Formula Life-Saving Decoction can be used. External treatment: Golden Yellow Powder or Jade Dew Powder may be applied.

bubble_chart Documentation

1. Waike Zhengzong．Chapter 32 of "bubo bubo": "The fish stool, the left is bubo, the right is bubo. ... It is the swelling that occurs between the seams of the two hips." "At the beginning, the swelling is not red, with mild fever, walking is slightly convenient, and there is no alternation of cold and heat, which is mild. Once it becomes red, swollen, painful, feverish, and painful, it is difficult to move, especially at night, which is easy."