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The *Nan Jing* (Classic of Difficult Issues) states: The epiglottis is the "Xi Men" (Inlet Gate), and the upper opening of the stomach is the "Ben Men" (Receiving Gate). In patients suffering from smallpox, toxic fire steams upward to affect the Lung and scorches the Stomach. Both the Lung and the upper opening of the Stomach suffer from sores and damage. When water enters, choking occurs because the Ben Men is damaged, preventing water from entering the pharynx; when water reaches the epiglottis, the epiglottis covers the glottis to prevent entry, causing Qi to reverse and rush out, resulting in choking. When food enters, vomiting occurs because the damaged Ben Men causes a narrow and blocked passage; food cannot go directly into the Stomach quickly. If slow, it trickles down; if rapid, it is obstructed and vomited out. This is a malignant sign, with few survivors. If there are sores on the tongue that ulcerate like a honeycomb, accompanied by tongue pain and stiffness, rendering it unable to accept food and fluids, this also causes choking upon drinking and vomiting upon eating. The condition will stabilize once the tongue sores heal. The pharynx is used for swallowing, while the larynx is used for breathing. The pharynx is located posteriorly and connects to the Stomach; the larynx is located anteriorly and connects to the Lung. The Lung has no lower orifice and relies on the bellows-like mechanism (*Tuoyue*) to receive pure and empty Qi, but not tangible substances. Above the larynx lies an organ resembling a hanging nipple, called the epiglottis. Whenever food enters the mouth, the tongue presses against the hard palate; pressing the tongue against the hard palate causes the epiglottis to cover the larynx. Thus, food and drink enter the pharynx but not the larynx. If smallpox lesions occur on the epiglottis, the wood element becomes rigid, impairing opening and closing functions. Dry food may occasionally enter the pharynx, but liquids may leak into the larynx, causing choking. Choking implies misdirection into the larynx. Qi requires medicinal tonification; if decoctions cannot be taken, there is no method for tonification, making the condition untreatable. [Weng] If, before the seventh day, the smallpox rash is red-purple and accompanied by this syndrome, it is due to flaming fire rising and heat-toxin obstruction. If the rash is grayish-white, flat, and accompanied by this syndrome, it is due to deficiency of Qi and Blood and injury to the Lung and Stomach. Both are adverse syndromes. After the seventh day, if the external rash is steaming, growing, smooth, and glossy, accompanied by this syndrome, it indicates that internal pathology is also resolving; thus, when the external rash scabs, the internal pathology will resolve as well, and the disease will heal spontaneously without treatment. A skilled practitioner should observe toxic-rash cases before the onset of dryness and soreness in the throat and use Gan Jie Tang (Licorice and Platycodon Decoction) or Jie Du Tang (Detoxification Decoction) added with Maidong (Ophiopogon Tuber), Gualou Pi Rang (Trichosanthes Peel Pith), Niubangzi (Arctium Fruit), Xuanshen (Scrophularia Root), and Jingjie (Schizonepeta Spike), to clear the airway and prevent heat-toxin invasion, thereby avoiding this complication naturally. Yuan’s song on treating choking and reversal states: "Choking and reversal in smallpox are most fierce and critical; thick decoction of Chenxiang (Aquilaria Wood) and Xingren (Apricot Seed) are recommended; mix far with much bee honey and water; decoct thoroughly according to meridians, filter dregs, and follow; for morning administration, add good breast milk; warm the decoction gradually." Upon my detailed examination, choking in smallpox is caused by depletion of Yuan Qi (Original Qi) and rising of evil fire. Therefore, I follow the later prescription: One cup of human milk, one qian of Renshen (Ginseng Radix), one qian of Jiegeng (Platycodon Root), and three leaves of Pipaye (Loquat Leaf), decocted together, filtered, and taken with milk. Alternatively, grinding Chenxiang into human milk for consumption is effective, but never as frequently successful as this formula.