毒壅会厌水难纳，溢入气喉呛始发，咽喉肿痛道路狭，甘桔解毒皆妙法。
[注]
呛水者，因火盛毒壅会厌门也，
盖咽门司纳饮食，一为毒热所壅，则必肿痛，水不易入，溢于气喉，
故气喷出而呛作矣，宜用加味甘桔汤，或加味解毒汤亦可，
此证见于七日前者，俱属恶候，
若七日以后，外痘蒸长光润而作呛者，是咽门痘长壅窒道路而使然也，
至结痂则呛自止，治者当于毒盛之痘，预用清理气道之药，
不使热毒侵犯，自能免此患矣。
(加味甘桔汤) 牛蒡子炒 苦桔梗 生甘草 射干 水煎服。
(方歌)
加味甘桔汤最良，痘证呛水效非常，牛蒡子合苦桔梗，甘草射干共煎尝。
(加味解毒汤)
玄参 苦桔梗 麦门冬去心 当归尾 赤芍 生地黄
连翘去心 牛蒡子炒研丹皮 红花甘草生 木通 引用灯心水煎服。
(方歌)
加味解毒汤最灵，玄参桔梗麦门冬，归芍生地翘牛蒡，丹皮红花草木通。
%
痘中杂证
发痘脾胃被毒侵，口喷秽气不堪闻，毒火燔灼宜速治，加味归宗功效神。
[注]
毒火侵炙脾胃，故口出臭味，令人难近，
盖出痘全赖脾胃以为根本，今为毒火侵害，则根本受伤，不急救之，
必至脾胃溃烂而成大害，须以归宗汤治之，秽减庶可望生。
(归宗汤) 方见发热证治。
%
痘中杂证
Toxic pathogens stagnate in the epiglottis, making it difficult to swallow water; if overflowing into the trachea (windpipe), it triggers choking. Swelling and pain in the throat narrow the airway; using Ganjie Tang (Licorice and Platycodon Decoction) to resolve toxicity is an excellent method.
[Note]
"Choking on water" occurs because excessive fire and toxic pathogens obstruct the glottis (epiglottic opening).
Since the pharyngeal gate governs the intake of food and drink, once obstructed by toxic heat, swelling and pain inevitably occur, preventing water from entering easily and causing it to overflow into the trachea.
Consequently, when gas is expelled, choking ensues. It is appropriate to use Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction), or Jiawei Jiedu Tang (Modified Detoxification Decoction) may also be used.
If this condition appears within seven days after the onset of smallpox, it belongs to ominous prognoses.
However, if after seven days, while external pustules are steaming, growing, shining, and smooth, choking occurs, this is caused by the growth of pustules at the pharyngeal gate blocking the passage.
Once scabs form, the choking will naturally cease. The practitioner should, during the stage of severe toxic pustules, preemptively use herbs that clear the airway,
preventing heat and toxins from invading, thereby naturally avoiding this affliction.
(Jiawei Ganjie Tang) Fried Fructus Arctii (Niu Bang Zi), Bitter Radix Platycodi (Ku Jie Geng), Raw Radix Glycyrrhizae (Sheng Gan Cao), Radix Belamcandae (She Gan), decocted in water and taken orally.
(Prescription Verse)
Jiawei Ganjie Tang is the best, extremely effective for choking in smallpox cases,
Fructus Arctii combined with Bitter Radix Platycodi,
Radix Glycyrrhizae and Radix Belamcandae decocted together for consumption.
(Jiawei Jiedu Tang)
Radix Scrophulariae (Xuan Shen), Bitter Radix Platycodi (Ku Jie Geng), Radix Ophiopogonis (Mai Men Dong) with heart removed, Cauda Radix Angelicae Sinensis (Dang Gui Wei), Radix Paeoniae Rubra (Chi Shao), Radix Rehmanniae Preparata (Sheng Di Huang),
Flos Lonicerae Japonicae (Lian Qiao) with heart removed, Fried and ground Fructus Arctii (Niu Bang Zi), Cortex Moutan (Dan Pi), Flos Carthami (Hong Hua), Raw Radix Glycyrrhizae (Sheng Gan Cao), Caulis Akebiae (Mu Tong), decocted in water with Herba Centipedae (Deng Xin Cao) as a guide.
(Prescription Verse)
Jiawei Jiedu Tang is most efficacious, Xuan Shen, Jie Geng, Mai Men Dong,
Dang Gui, Chi Shao, Sheng Di, Lian Qiao, Niu Bang Zi, Dan Pi, Hong Hua, Gan Cao, Mu Tong.
%
Miscellaneous Syndromes in Smallpox
When erupting smallpox, the spleen and stomach are invaded by toxic pathogens, causing foul breath emanating from the mouth which is unbearable; toxic fire blazing requires rapid treatment; Jiawei Guizong Tang possesses miraculous efficacy.
[Note]
Toxic fire invades and scorches the spleen and stomach, hence foul odor emanates from the mouth, making people reluctant to approach.
Because erupting smallpox entirely relies on the spleen and stomach as its foundation, now damaged by toxic fire invasion, if not urgently rescued,
it will inevitably lead to ulceration of the spleen and stomach, causing major harm. One must treat with Guizong Tang; only when the foul odor decreases can survival be hoped for.
(Guizong Tang) See the section on Fever Syndromes for the prescription.
%
Miscellaneous Syndromes in Smallpox