Diagnostic Essentials for Pyemia (Multiple Abscess) in Chinese medicine:
(1) It frequently occurs in the lumbus, hip, posterior aspect of the thigh and iliac fossa.

(2) First of all, muscular pain and diffuse swelling with normal skin color and slightly warm sensation by pressure happen in one area or several areas in the proximal part of the four limbs or body trunk. In about 2–3 days, tumefaction and burning pain become obvious, with palpable mass. Progressively, the tumefaction enlarges and pain is aggravated. In about 2 weeks, the skin in the center of the tumefaction becomes slightly red and warm and feels soft in the center. After rupture, the discharged pus is yellow, white, tenacious and thick, or mixed with blood clots. In another 2 weeks, after the tumefaction diminishes and pain stops, the wound is healed.

(3) If high fever still lingers after the wound is healed or is accompanied bv muscular nain in other areas or palpable mass, mostly it is a secondary infection.

(4) Multiple abscess of the iliac fossa only occurs in one aspect of the iliac fossa. Initially, the infected thigh feels spasmodic and uncomfortable, with difficult walking. After 2 - 3 days, when local pain is aggravated, the thigh shrinks upwards and adducts slightly and is unable to extend straightly. But, the knee joint is still able to extend and flex. If the infected limb is stretched forcefully, it is able to cause serious pain, causing the abdomen protruded forward and the spine curved like a bow. Mter about 7 -10 days, a mass in a long form and hard nature can be palpated with a tenderness in the lilac fossa. It takes about one month for suppuration. Because the position is comparatively deep, the fluctuating sensation is not obvious. Mter it is cured, the infected thigh is still difficult to flex and extend. Only after practice for 1-2 months, can the normal function be restored.

(5) This disease is accompanied by obvious general symptoms. The total count of peripheral leukocyte and neutrophil ratio are obviously enhanced. Bacteria growth can be noticed in blood bacteria culture. Ultrasonic examination is helpful for diagnosis of multiple abscess in the deep position.