Tokishigyakukagoshuyushokyoto is known to be effective when tenderness in the inguinal region is observed during abdominal palpation. This herbal formula was discovered by Keisetsu Otsuka, and since 2016, its mechanism has been gradually elucidated by Katsutoshi Terasawa. The first case was an 85-year-old man who complained of right lower abdominal and right inguinal pain of unknown cause, which occurred six months before the prolapse of a right inguinal hernia. The second case was a 68-year-old man who experienced pain from the left inguinal region to the lower abdomen two years after surgery for a left inguinal hernia. Both cases were difficult to manage with conventional treatments. However, after taking tokishigyakukagoshuyushokyoto, which specifically targeted the tenderness in the inguinal region, both patients experienced significant pain relief.