当喉攒聚名锁项，毒结咽喉命必难，音哑声呛食难入，清金攻毒是良煎。
【注】颈项者，咽喉之 管也。此处痘出攒聚，名曰锁项。若不急治，迨毒攻咽喉，必发为肿痛，音哑
声呛，汤水难下，多致不救。急用清金攻毒饮，庶或望生。
\r锁项图\p03-b24a11.bmp\r
清金攻毒饮
牛蒡子（炒、研） 甘草（生） 苦桔梗 元参 枳壳（麸炒） 僵蚕（炒） 前胡 荆芥穗
大黄 山楂 蝉蜕 山豆根
引加灯心，水煎服。
【方歌】清金攻毒饮如神，牛蒡甘桔合元参，枳壳僵蚕前胡穗，大黄山楂蝉豆根。
披肩两肩痘成攒，上下阻塞毒透难，清热解毒汤投证，便秘归宗又为先。
【注】两肩之痘粘连成攒，其色赤紫滞黯，名曰披肩。此毒瓦斯不松，上下阻塞也，以清
热解毒汤主之。大便秘者，以归宗汤主之。
\r披肩图\p03-b24a12.bmp\r
清热解毒汤（方见见点证治）
归宗汤（方见发热证治）
背间出痘不宜多，若逢攒聚命蹉跎，根松松肌燕脂贴，紧硬必胜汤可活。
【注】大凡毒发于背者，多关生死，至于出痘，更贵稀疏。若背间攒聚粘连者，名曰
聚背。而亦当辨根脚之紧松。根松者，毒尚活动，内服松肌通圣散，外用燕脂膏贴之；根
紧硬者，因毒锢血凝，急用必胜汤治之，然亦死中求活之一法耳。
\r聚背图\p03-b24a13.bmp\r
松肌通圣散（方见蒙头证治）
燕脂膏（方见蒙 证治）
必胜汤（方见见点证治）
When pustules gather at the throat, it is named "Locking of the Neck" (Suo Xiang). If toxic heat knots in the pharynx and larynx, life is inevitably difficult to save. Symptoms include hoarseness, choking cough, and difficulty swallowing food. Clearing Metal (Lung) and attacking toxicity is the best decoction.
[Note] The neck and nape are the passages connecting to the pharynx and larynx. When pustules here gather densely, it is called "Locking of the Neck." If not treated urgently, when toxic heat attacks the pharynx and larynx, swelling and pain will inevitably occur, leading to hoarseness, choking cough, and inability to swallow liquids or solids, often resulting in death. Urgently use Qingjin Gongdu Yin (Clear Metal Attack Toxicity Decoction), perhaps there is a chance for survival.
Qingjin Gongdu Yin (Clear Metal Attack Toxicity Decoction)
Babaozi (Fructus Arctii, stir-fried and ground) Gancao (Radix Glycyrrhizae, raw) Kujiegeng (Radix Platycodi) Yuanshen (Radix Scrophulariae) Zhike (Pericarpium Citri Reticulatae, bran-fried) Jiangcan (Bombyx Batryticatus, stir-fried) Qianhu (Radix Peucedani) Jingjiesui (Herba Schizonepetae) Dahuang (Radix et Rhizoma Rhei) Shanzha (Fructus Crataegi) Chantui (Periostracum Cicadae) Shandougen (Radix Sophorae Tonkinensis)
Guiding herb: Dengxincao (Papyrus Clubrush Spikelet). Decoct with water and take orally.
[Prescription Song] Qingjin Gongdu Yin works miraculously, Babaozi, Gancao, Jiegeng combined with Yuanshen; Zhike, Jiangcan, Qianhu, and Jingjiesui; Dahuang, Shanzha, Chantui, and Shandougen.
Pustules on both shoulders gather into clumps, blocking up and down, making it difficult for toxic heat to vent outward. One should administer Qingre Jiedu Tang (Clear Heat Detoxify Decoction) according to the syndrome. If constipation is present, Guizong Tang is the primary choice.
[Note] Pustules on both shoulders adhere and cluster together, appearing red-purple, stagnant, and dull. This is named "Draping Shoulders" (Pi Jian). This indicates that toxic qi is not loose, causing blockage above and below. Treat primarily with Qingre Jiedu Tang (Clear Heat Detoxify Decoction). For severe constipation, treat with Guizong Tang.
Backrest (Bei Jian)
Pustules appearing on the back should not be numerous. If they encounter clustering, life is jeopardized. If the root is loose, apply Yanzhi Gao (Carmine Paste); if tight and hard, Bisheng Tang can save life.
[Note] Generally, when toxic heat erupts on the back, it concerns life and death. Regarding the eruption of pustules, sparsity is highly valued. If pustules on the back cluster and adhere, it is named "Gathering on the Back" (Ju Bei). One must also distinguish whether the root base is loose or tight. If the root is loose, the toxic heat is still active; internally administer Songji Tongsheng San (Loosen Muscle Pass the Holy Powder), and externally apply Yanzhi Gao. If the root is tight and hard, it is due to toxic heat imprisonment and blood coagulation; urgently use Bisheng Tang (Invincible Decoction) for treatment. However, this is merely one method of seeking life amidst death.
Songji Tongsheng San (See Prescriptions for Meng Tou Syndrome Treatment)
Yanzhi Gao (See Prescriptions for Meng Syndrome Treatment)
Bisheng Tang (See Prescriptions for Jian Dian Syndrome Treatment)