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When the smallpox lesions cluster densely at the throat, it is called "Locking of the Neck" (Suo Xiang). If toxic heat consolidates in the pharynx and larynx, life is inevitably endangered; symptoms include hoarseness, choking upon swallowing, and difficulty ingesting food. Qingjin Gongdu Yin (Clear Metal and Attack Toxin Decoction) is an excellent prescription for this condition.

[Note]
The neck region serves as the aperture for the pharynx and larynx. When smallpox lesions cluster densely in this area, it is termed "Locking of the Neck."
If not treated urgently, when the toxin attacks the pharynx and larynx, it will inevitably cause swelling and pain, leading to hoarseness and choking. Even if liquids are forced down, rescue is rarely successful.
Using Qingjin Gongdu Yin (Clear Metal and Attack Toxin Decoction) may offer a slim hope of survival.
(Qingjin Gongdu Yin / Clear Metal and Attack Toxin Decoction): Fructus Arctii (Niubangzi), stir-baked and crushed; Radix Glycyrrhizae (Gancao), raw; Radix Platycodonis (Jiegeng); Radix Scrophulariae (Xuanshen); Fructus Aurantii (Zhiqiao), stir-baked; Bombyx Batryticatus (Jiangcan), stir-baked;
Radix Peucedani (Qianhu); Ramulus Cinnamomi (Jingjie Sui); Radix et Rhizoma Rhei (Dahuang); Fructus Crataegi (Shanzha); Periostracum Cicadae (Chantui); Radix Sophorae Tonkinensis (Shandougen). Add Juncus effusus (Dengxincao) as a guide herb, decoct with water, and take orally.
(Verse Formula)
Qingjin Gongdu Yin works like magic, combining Arctii, Glycyrrhizae, Platycodon, and Scrophularia; Aurantii, Bombyx, Peucedani, and Cinnamoni ramuli; Rheum, Crataegi, Periostracum Cicadae, and Sophorae Tonkinensis roots.

Smallpox lesions on both shoulders adhere into clusters, causing upper and lower blockage and hindering the eruption of toxins. One should administer Qingjie Redu Tang (Clear Heat and Resolve Toxin Decoction) according to the syndrome; if constipation is present, Guizong Tang (Return to Origin Decoction) is the primary choice.

[Note]
When smallpox lesions on both shoulders adhere into clusters, appearing dark red or purplish and dull, it is called "Draping Shoulders" (Pi Jian). This indicates that toxic qi is stagnant and blocked above and below.
Treat primarily with Qingjie Redu Tang (Clear Heat and Resolve Toxin Decoction). For cases with severe constipation, treat primarily with Guizong Tang (Return to Origin Decoction).
(Qingjie Redu Tang / Clear Heat and Resolve Toxin Decoction): See the section on "Treatment of Symptoms upon Appearance" (Jiandian Zhengzhi).
(Guizong Tang / Return to Origin Decoction): See the section on "Treatment of Fever" (Fare Zhengzhi).

It is unfavorable for excessive smallpox lesions to appear on the back. If they cluster densely, the prognosis is poor, and life is precarious. If the base of the lesion is loose, apply Yanzhi Gao (Carmine Ointment) externally; if the lesion is hard, Biseng Tang (Victory Over Death Decoction) can save the patient.

[Note]
Generally, toxins erupting on the back are critical regarding life and death. Regarding smallpox, sparsity is highly desirable.
If smallpox lesions on the back cluster and adhere, it is called "Gathering on the Back" (Ju Bei). One must distinguish whether the base of the lesion is tight or loose.
If the base is loose, the toxin is still active; internally administer Songji Tongsheng San (Loosen Muscle and Unblock Holy Powder) and externally apply Yanzhi Gao (Carmine Ointment).
If the base is tight and hard, due to toxin consolidation and blood stasis, urgently treat with Biseng Tang (Victory Over Death Decoction). However, this is merely one method to seek survival amidst death.
(Songji Tongsheng San / Loosen Muscle and Unblock Holy Powder): See the section on "Treatment of Head Covering Symptoms" (Mengtou Zhengzhi).
(Yanzhi Gao / Carmine Ointment): See the section on "Treatment of [Masked] Symptoms" (Meng [?] Zhengzhi).
(Biseng Tang / Victory Over Death Decoction): See the section on "Treatment of Symptoms upon Appearance" (Jiandian Zhengzhi).