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The throat and pharynx govern the ascending and descending of respiratory Qi, serving as the central pivot for the movement of Qi throughout the body. If toxic pathogens cannot disperse smoothly, they will accumulate here, causing swelling, pain, and obstruction, making it difficult to swallow water or food; life and death then hang in the balance, a situation that is deeply alarming. For treatment, whether at the beginning or end of the disease, Ganjie Tang (Licorice and Platycodon Decoction) added with Ophiopogonis Radix (Maidong), Arctii Fructus (Niubangzi), Scrophulariae Radix (Xuanshen), and Apricot Seed (Xingren) is suitable. Alternatively, Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction) or the Ganjie Tang from *Ba Cui Fang* can be used. If heat is severe and pain is intense, Li Dongyuan's Liangge San (Cool the Diaphragm Powder) added with Arctii Fructus (Niubangzi) is appropriate. One may also combine Ganjie Tang with Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity), adding Gypsum (Shigao), Akebia Caulis (Mutong), Arctii Fructus (Niubangzi), Sophorae Tonkinensis Radix et Cortex (Shandougen), and Belamcandae Rhizoma (Shegan), while externally applying Yuyaochi (Jade Key) powder. In cases of sore throat accompanied by constipation, Sishun Qingliang Yin (Four-Obedience Cooling Drink) should be administered to unblock the bowels. The above syndromes and treatments are applicable only if the patient can consume meat and other warm-natured foods; otherwise, these cold-natured formulas should not be used. If there is heat in the Upper Jiao but not in the Lower Jiao, or if the patient has poor appetite, only Jiawei Ganjie Tang should be used, taken slowly by swallowing, without Arctii Fructus (Niubangzi), lest its cold nature damage the Spleen.

1. Sore throat and swelling: This symptom often occurs in patients with smallpox (痘疮). However, appearance within seven days of onset is considered a adverse sign (Ni Zheng), whereas appearance after seven days is generally harmless. This occurs because during the stage of eruption and suppuration, both external and internal pustules swell, causing airway congestion and edema. This is a manifestation of the smallpox itself, not the toxicity of Hou Bi (acute pharyngitis). Once the external pustules crust over, the internal symptoms will naturally resolve, requiring no specific treatment. Xu stated: For sore throat and swelling preventing eating and drinking, internally administer Jiawei Ganjie Tang. Examine the largest pustules on the body; this indicates connected toxicity. It is suitable to ignite a rush wick dipped in sesame oil and quickly touch (cuì) the affected area; one application brings cure. Alternatively, puncture the pustule manually and apply Dou Ding San (Pustule Cancer Powder).

Chen stated: For high fever, hard stools, mouth and tongue ulcers, and sore throat and swelling, these indicate incomplete resolution of toxin from sores. Siwei Shegan Niuzi Tang (Four-Ingredient Belamcanda and Arctus Decoction) is suitable. If ineffective, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is appropriate.

1. Tongue protrusion and rolling in smallpox: This indicates Heat in the Spleen. Mild cases are treated with Daochi San (Guide Out Redness Powder); severe cases with Xiehuang San (Drain Yellow Powder).

1. The lips and mouth connect with the Zang-Fu organs. Therefore, when internal Heat-Toxin erupts, the mouth and tongue are injured first. With severe toxicity, the mouth and tongue may turn purple, white, or black, and the tongue may swell. These are all manifestations of Excess Heat. Internally, Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) added with Gypsum (Shigao), Arctii Fructus (Niubangzi), Akebia Caulis (Mutong), and Rehmanniae Radix Preparata (Shengdi) is suitable, or Li Dongyuan’s Liangge San (Cool the Diaphragm Powder). If stools are dry and bound, Liangge San from *Ju Fang* (Tai Ping Hui Min He Ji Ju Fang) is appropriate, with external application of Yuyaochi (Jade Key) powder. For mouth and tongue ulcers (Gan Chuang), Chui Kou Dan (Blow Mouth Pill) or Yinyang San (Yin-Yang Powder) can be applied.

1. Swollen and ulcerated gums forming Gan Chuang (mouth cancer/ulcers): This is caused by Heat-Toxin attacking inward from the Yangming Stomach channel. It is rapidly fatal. Ganlu Yin (Sweet Dew Drink) is the primary treatment. Externally, wash with a strong decoction of old tea leaves and Chinese chive root. Use a feather brush to remove necrotic tissue until fresh blood appears, then apply Shenshou Dan (Divine Grant Pill) or Cha Ya San (Teeth Rubbing Powder), three times daily. Mian Jian San (Silkworm Cocoon Powder) is also acceptable. If the ulceration extends into the throat, blow Mian Jian San into the throat using a small bamboo tube. Even if teeth fall out and lips perforate, medication can effect a cure. However, treatment is only viable if yellow-white pus is present. If the color resembles dried sauce, the flesh is foul and rotting, and the decay progresses by one fen daily, it is incurable.

1. Foul-smelling gum ulcers with rapid breathing and intense heat, white coating extending to the lips, fetid odor like rotting meat, purulent bloody diarrhea, abdominal distension and pain: This indicates Stomach Deficiency with internal attack of toxins, leading to gastric ulceration. Red spots appearing on the Shan Gen (root of the nose) indicate internal attack of Gan Toxin manifesting at the Shan Gen, which is also a sign of gastric ulceration. Both conditions are incurable.

1. After the subsidence of rash diseases, if gum ulceration and profuse epistaxis occur, these are signs of blood loss. Ju Fang’s Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Gardenia Fruit (Shanzhi), Akebia Caulis (Mutong), Scrophulariae Radix (Xuanshen), and Scutellariae Radix (Huangqin) is suitable to promote urination, directing Heat-Toxin downward. Externally, treat with Shenshou Dan (Divine Grant Pill). Do not delay. If the Gan Chuang is white, it indicates gastric ulceration, which is an incurable condition.