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The *Nan Jing* (Classic of Difficult Issues) states: The epiglottis is the "Xi Men" (Suction 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 lungs and scorches the stomach. Both the lungs and the upper opening of the stomach develop sores and are injured. When water is ingested, choking occurs because injury to the Ben Men prevents water from entering the pharynx; when water reaches the epiglottis, the epiglottis closes to block entry, causing qi to reverse and rush out, resulting in choking. When food is ingested, vomiting occurs because injury to the Ben Men causes narrowing and blockage of the gate, preventing food from passing directly into the stomach; if slow, it trickles down, but if rapid, it is obstructed and vomited out. This is a malignant symptom with few survivors. If there are sores on the tongue that ulcerate and resemble a honeycomb, accompanied by pain and stiffness making the tongue unable to function in receiving food and drink, this also causes choking upon drinking and vomiting upon eating. Recovery will occur once the tongue sores heal. The pharynx is used for swallowing food, while the larynx is used for breathing air. The pharynx is located posteriorly and connects to the stomach, while the larynx is located anteriorly and connects to the lungs. The lungs have no lower orifices and function like bellows, accepting only clear and empty qi, not tangible substances. Above the larynx lies an organ resembling a hanging breast, called the epiglottis. When anything enters the mouth, the tongue presses against the palate; pressing the palate causes the epiglottis to cover the larynx. Thus, food and water enter the pharynx but not the larynx. If smallpox lesions occur on the epiglottis, its flexibility for opening and closing is impaired. Dry matter may occasionally enter the pharynx, but liquids may leak into the larynx, causing choking. Choking implies misdirection into the larynx. Qi requires medicinal supplementation; if decoctions cannot be taken, there is no method for supplementation, rendering the condition untreatable. [Weng] If red-purple smallpox appears within seven days accompanied by these symptoms, it is due to flaming fire rising and heat-toxin stagnation. If grayish-white, non-elevated smallpox appears accompanied by these symptoms, it is due to deficiency of qi and blood and injury to the lungs and stomach. Both are adverse conditions. After seven days, if external smallpox is steaming, growing, smooth, and glossy accompanied by these symptoms, it indicates internal lesions are also healing; thus, when external scabs form, internal lesions resolve as well, and the condition heals spontaneously without treatment. A skilled practitioner should observe toxic, abundant smallpox before the onset of dry throat and use Gan Jie Tang (Licorice and Platycodon Decoction) or Jie Du Tang (Detoxification Decoction) added with Maidong (Ophiopogon Root), Gualou Pi Rang (Trichosanthes Peel Pith), Niubangzi (Arctium Fruit), Xuanshen (Scrophularia Root), and Jingjie (Schizonepeta Herb) to clear the respiratory tract, preventing heat-toxin invasion, thereby avoiding this affliction. Yuan’s Song on Treating Choking and Regurgitation states: Smallpox-induced choking and regurgitation are most fierce and critical; thick decoction of Chenxiang (Aquilaria Wood) and Xingren (Apricot Seed) are recommended; take Fengtang (Bee Honey) mixed with much water; decoct thoroughly according to meridians, filter dregs, and follow up; for administration in the morning, add good human milk; warm the decoction gradually before mixing. Upon my detailed examination, smallpox-induced choking results from depletion of primordial qi and rising of evil fire. I adhere to the following prescription: one cup of Renru (Human Milk), one qian of Renshen (Ginseng Root), one qian of Jiegeng (Platycodon Root), and three leaves of Pipaye (Loquat Leaf), decocted together, filtered, and taken with the milk. Alternatively, grinding Chenxiang (Aquilaria Wood) into Renru (Human Milk) for consumption is effective, but generally not as frequently successful as this formula.