毒壅会厌水难纳，溢水气喉呛始发，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。若七日已后，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
元参 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，元参桔梗麦门冬，归芍生地翘牛蒡，丹皮红花草木通。
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）
Toxic pathogens obstruct the epiglottis, making it difficult to swallow water; overflowing water enters the laryngeal airway, thereby initiating choking. The throat becomes swollen and painful, narrowing the passage for respiration and swallowing. 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 epiglottis. Since the pharynx governs the ingestion of food and drink, once obstructed by toxic heat, swelling and pain inevitably occur. Water cannot easily enter the esophagus but overflows into the trachea; thus, 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 syndrome appears within seven days after the onset of smallpox/rash, it is considered a ominous sign. However, if choking occurs after seven days, while external pustules are steaming, growing, smooth, and lustrous, it is caused by the growth of pustules in the pharynx obstructing the airway. Once scabs form, the choking will cease naturally. Practitioners should preemptively use herbs that clear the airway during the stage of intense toxic pustules to prevent heat-toxin invasion, thereby avoiding this complication.
Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction)
Bai Fang Zi (Fried) [Arctii Fructus]
Ku Jie Geng [Platcodonis Radix]
Sheng Gan Cao [Raw Glycyrrhizae Radix et Rhizoma]
She Gan [Belamcandae Rhizoma]
Decoct with water and take orally.
[Prescription Verse] Jiawei Ganjie Tang is most excellent, extremely effective for choking in rash diseases. Arctii Fructus combined with Platcodonis Radix, Licorice and Belamcandae Rhizoma decocted together.
Jiawei Jiedu Tang (Modified Detoxification Decoction)
Xuan Shen [Scrophulariae Radix]
Ku Jie Geng [Platcodonis Radix]
Mai Men Dong (Heart Removed) [Ophiopogonis Tuber]
Dang Gui Wei [Tail of Angelicae Sinensis Radix]
Chi Shao [Paeoniae Radix Rubra]
Sheng Di Huang [Rehmanniae Radix Preparata]
Lian Qiao (Heart Removed) [Forsythiae Fructum]
Niu Bang Zi (Fried, Ground) [Arctii Fructus]
Dan Pi [Moutan Cortex]
Hong Hua [Carthami Flos]
Gan Cao (Raw) [Raw Glycyrrhizae Radix et Rhizoma]
Mu Tong [Akebiae Caulis]
Use Deng Xin Cao [Junci Medulla] as a guiding drug, decoct with water and take orally.
[Prescription Verse] Jiawei Jiedu Tang is most efficacious, Xuan Shen, Jie Geng, Mai Men Dong, Dang Gui, Shao Yao, Sheng Di, Lian Qiao, Niu Bang Zi, Dan Pi, Hong Hua, Cao, Mu Tong.
During the eruption of rashes, the spleen and stomach are invaded by toxic pathogens, causing foul breath from the mouth that is unbearable due to its odor. Toxic fire blazing requires rapid treatment; Jiawei Guizong Tang has miraculous efficacy.
[Note] Toxic fire scorches the spleen and stomach, hence foul breath emanates from the mouth, making people reluctant to approach. The eruption of rashes relies entirely on the spleen and stomach as the root foundation. Now, being harmed by toxic fire, the foundation is injured. If not urgently treated, it will inevitably lead to ulceration of the spleen and stomach, causing major harm. One must treat it with Guizong Tang. Only when the foul odor diminishes can survival be hoped for.
Guizong Tang (See prescription in the chapter on Fever Treatment)