当喉攒聚名锁项，毒结咽喉命必虽，音哑声呛食难入，清金攻毒是良煎。
[注]
颈项者，咽当喉之管籥也，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，汤水虽下，多致不救，
用清金攻毒饮庶或望生。
(清金攻毒饮) 牛蒡子炒研 甘草生 苦枯梗 玄参 枳壳炒 僵蚕炒
前胡 荆芥穗 大黄 山查 蝉退 山豆根 引加灯心水煎服。
(方歌)
清金攻毒饮如神，牛蒡甘桔合玄参，枳壳彊蚕前胡穗，大黄山查蝉豆根。
%
披肩两肩痘成攒，上下阻塞毒透难，清解热毒汤投证，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，此毒气不松，上下阻塞也，
以清热解毒汤主之，大便秘秘者，以归宗汤主之。
(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，坚硬必胜汤可活。
[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。
(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。
%
当喉部痘疹密集聚集时称为“锁项”，若毒邪结聚于咽喉，患者性命必危；此时声音嘶哑、饮水呛咳、食物难以下咽，采用清金攻毒饮是良好的治疗方案。
[注]
颈项部位，是咽喉的管窍所在。此处痘疹密集聚集，称为“锁项”。
如果不紧急治疗，等到毒邪攻冲咽喉，必然引发肿痛，导致声音嘶哑、饮水呛咳，即使汤水勉强咽下，大多难以救治，
使用清金攻毒饮或许还有一线生机。
（清金攻毒饮）牛蒡子炒后研碎，甘草生用，桔梗，玄参，枳壳炒，僵蚕炒，
前胡，荆芥穗，大黄，山楂，蝉蜕，山豆根。煎服时加灯心草为引，用水煎服。
（方歌）
清金攻毒饮效果如神，牛蒡子、甘草、桔梗合用玄参，枳壳、僵蚕、前胡、荆芥穗，大黄、山楂、蝉蜕、山豆根。
双肩痘疹粘连成团，上下阻塞，毒邪难以透发，应投用清热解毒汤对症施治，若伴有便秘，则以归宗汤为首选。
[注]
双肩的痘疹粘连成团，颜色赤紫晦暗，称为“披肩”，这是毒气郁结不舒，上下阻塞所致，
以清热解毒汤为主治方剂，大便秘结不通者，以归宗汤为主治方剂。
（清热解毒汤）方剂见“见点证治”章节。
（归宗汤）方剂见“发热证治”章节。
背部出痘不宜过多，若遇到痘疹密集聚集，则预后不良，生命垂危。若痘根松软，可用燕脂膏外贴；若痘质坚硬，必胜汤可救活。
[注]
大凡毒邪发于背部的，多关乎生死，至于出痘，更贵在稀疏，
若背部痘疹密集粘连，称为“聚背”，此时应当辨别痘根的紧松程度，
痘根松软者，毒邪尚且活动，内服松肌通圣散，外用燕脂膏贴敷。
痘根紧硬者，因毒邪固结、血液凝滞，急用必胜汤治疗，但这也是死中求活的一种方法罢了。
（松肌通圣散）方剂见“蒙头证治”章节。
（燕脂膏）方剂见“蒙□证治”章节。
（必胜汤）方剂见“见点证治”章节。
When the smallpox lesions cluster densely at the throat, it is called "Locking of the Neck" (Suo Xiang). If toxic heat consolidates in the pharynx and larynx, life is inevitably endangered; symptoms include hoarseness, choking upon swallowing, and difficulty ingesting food. Qingjin Gongdu Yin (Clear Metal and Attack Toxin Decoction) is an excellent prescription for this condition.
[Note]
The neck region serves as the aperture for the pharynx and larynx. When smallpox lesions cluster densely in this area, it is termed "Locking of the Neck."
If not treated urgently, when the toxin attacks the pharynx and larynx, it will inevitably cause swelling and pain, leading to hoarseness and choking. Even if liquids are forced down, rescue is rarely successful.
Using Qingjin Gongdu Yin (Clear Metal and Attack Toxin Decoction) may offer a slim hope of survival.
(Qingjin Gongdu Yin / Clear Metal and Attack Toxin Decoction): Fructus Arctii (Niubangzi), stir-baked and crushed; Radix Glycyrrhizae (Gancao), raw; Radix Platycodonis (Jiegeng); Radix Scrophulariae (Xuanshen); Fructus Aurantii (Zhiqiao), stir-baked; Bombyx Batryticatus (Jiangcan), stir-baked;
Radix Peucedani (Qianhu); Ramulus Cinnamomi (Jingjie Sui); Radix et Rhizoma Rhei (Dahuang); Fructus Crataegi (Shanzha); Periostracum Cicadae (Chantui); Radix Sophorae Tonkinensis (Shandougen). Add Juncus effusus (Dengxincao) as a guide herb, decoct with water, and take orally.
(Verse Formula)
Qingjin Gongdu Yin works like magic, combining Arctii, Glycyrrhizae, Platycodon, and Scrophularia; Aurantii, Bombyx, Peucedani, and Cinnamoni ramuli; Rheum, Crataegi, Periostracum Cicadae, and Sophorae Tonkinensis roots.
Smallpox lesions on both shoulders adhere into clusters, causing upper and lower blockage and hindering the eruption of toxins. One should administer Qingjie Redu Tang (Clear Heat and Resolve Toxin Decoction) according to the syndrome; if constipation is present, Guizong Tang (Return to Origin Decoction) is the primary choice.
[Note]
When smallpox lesions on both shoulders adhere into clusters, appearing dark red or purplish and dull, it is called "Draping Shoulders" (Pi Jian). This indicates that toxic qi is stagnant and blocked above and below.
Treat primarily with Qingjie Redu Tang (Clear Heat and Resolve Toxin Decoction). For cases with severe constipation, treat primarily with Guizong Tang (Return to Origin Decoction).
(Qingjie Redu Tang / Clear Heat and Resolve Toxin Decoction): See the section on "Treatment of Symptoms upon Appearance" (Jiandian Zhengzhi).
(Guizong Tang / Return to Origin Decoction): See the section on "Treatment of Fever" (Fare Zhengzhi).
It is unfavorable for excessive smallpox lesions to appear on the back. If they cluster densely, the prognosis is poor, and life is precarious. If the base of the lesion is loose, apply Yanzhi Gao (Carmine Ointment) externally; if the lesion is hard, Biseng Tang (Victory Over Death Decoction) can save the patient.
[Note]
Generally, toxins erupting on the back are critical regarding life and death. Regarding smallpox, sparsity is highly desirable.
If smallpox lesions on the back cluster and adhere, it is called "Gathering on the Back" (Ju Bei). One must distinguish whether the base of the lesion is tight or loose.
If the base is loose, the toxin is still active; internally administer Songji Tongsheng San (Loosen Muscle and Unblock Holy Powder) and externally apply Yanzhi Gao (Carmine Ointment).
If the base is tight and hard, due to toxin consolidation and blood stasis, urgently treat with Biseng Tang (Victory Over Death Decoction). However, this is merely one method to seek survival amidst death.
(Songji Tongsheng San / Loosen Muscle and Unblock Holy Powder): See the section on "Treatment of Head Covering Symptoms" (Mengtou Zhengzhi).
(Yanzhi Gao / Carmine Ointment): See the section on "Treatment of [Masked] Symptoms" (Meng [?] Zhengzhi).
(Biseng Tang / Victory Over Death Decoction): See the section on "Treatment of Symptoms upon Appearance" (Jiandian Zhengzhi).