They sent therefore and gathered together all the lords of the Philistines, and they said, Send away the ark of the God of Israel, and let it go again to its own place, that it not kill us and our people. For there was a deadly confusion throughout all the city; the hand of God was very heavy there.
The Hebrew word translated "broke out" occurs only here in the Old Testament (1 Samuel 5:9). The Septuagint translators interpreted it accurately as "groin." These tumors were apparently most prominent in the groin area, hence the English translation "hemorrhoids." Tumors in the groin are a symptom of bubonic plague. Since the Philistines associated mice with this plague (1 Samuel 6:4-5), and mice carry bubonic plague, it seems clear that the hand of Yahweh sent this particular affliction on them.