舌乃心苗五内通，毒火一犯先见形，赤紫黑肿并舒弄，总以清热犀角平。
【注】舌为心苗，内通五脏，毒热举发，舌先受之，或赤或紫或黑或肿，舒舌，弄舌，
种种不一，要皆热留于心而使然也。治宜清热为主，以加味犀角汤治之。
加味犀角汤
荆芥 防风 牛蒡子（炒） 生甘草 桔梗 升麻 犀角 麦冬（去心） 栀子 黄连
石膏（ ）
水煎服。
【方歌】加味犀角能散热，荆防牛蒡同甘桔，升麻犀角麦门冬，栀子黄连石膏捷。
咽喉之地司出入，毒火冲炽痛难堪，内用甘桔利咽剂，外吹牛黄散即安。
【注】咽者，饮食之道；喉者，呼吸之门，乃最紧要之处。若痘毒不能发越于外，火热
壅塞膈间，上冲咽喉，则或肿痛、或哑呛，甚而不能呼吸，饮食难入。速用加味甘桔汤治
之。或用加减利咽解毒汤，外用牛黄散吹入肿处。
加味甘桔汤（方见失音）
利咽解毒汤
防风 山豆根 麦冬（去心） 牛蒡子（炒） 黑参 苦桔梗 生甘草 绿豆
水煎服。
【方歌】利咽解毒用防风，山豆根与麦门冬，牛蒡黑参苦桔梗，甘草绿豆共煎浓。
牛黄散
川黄连（生） 黄柏（生） 薄荷（各八分） 雄黄 火硝 青黛（各二分半） 牛黄
冰片 硼砂 朱砂（各一分）
共为细末，每用少许，吹患处。
舌是心的外候，与五脏相通，痘毒火热之邪侵犯时，首先会在舌头上显现症状。若见舌色红赤、紫暗、发黑或肿胀，以及伸舌、弄舌等表现，总应以清热凉血、平息热毒为主。
【注】舌为心之外候，内连五脏，当痘毒热邪发作时，舌头最先受到侵害，表现为舌色红、紫、黑或肿胀，以及伸舌、弄舌等症状，各种表现不一，但根本原因都是热邪留滞于心所致。治疗应以清热为主，使用加味犀角汤进行治疗。
加味犀角汤
荆芥 防风 牛蒡子（炒） 生甘草 桔梗 升麻 犀角 麦冬（去心） 栀子 黄连 石膏
水煎服。
【方歌】加味犀角汤能疏散热邪，荆芥、防风、牛蒡子配合甘草和桔梗，升麻、犀角、麦门冬，加上栀子、黄连和石膏，疗效迅速。
咽喉部位主管呼吸与饮食的出入，痘毒火热之邪上冲炽盛，疼痛难以忍受。内服甘桔利咽剂，外用牛黄散吹入患处即可安宁。
【注】咽是饮食通过的通道；喉是呼吸的门户，这是人体最紧要的部位。如果痘毒不能向外透发，火热之邪壅塞在胸膈之间，向上冲逆至咽喉，就会导致咽喉肿痛、声音嘶哑呛咳，严重时甚至无法呼吸，饮食难以下咽。应迅速使用加味甘桔汤治疗。也可以使用加减利咽解毒汤，并外用牛黄散吹入肿胀处。
加味甘桔汤（方剂见“失音”章节）
利咽解毒汤
防风 山豆根 麦冬（去心） 牛蒡子（炒） 黑参 苦桔梗 生甘草 绿豆
水煎服。
【方歌】利咽解毒使用防风，搭配山豆根与麦门冬，牛蒡子、黑参、苦桔梗，再加上甘草和绿豆共同煎煮浓汁。
牛黄散
川黄连（生） 黄柏（生） 薄荷（各八分） 雄黄 火硝 青黛（各二分半） 牛黄 冰片 硼砂 朱砂（各一分）
共研为细末，每次取少许，吹敷于患处。
The tongue is the sprout of the Heart and connects with the five Zang organs. When toxin-heat invades, manifestations first appear on the tongue. Redness, purpleness, blackening, swelling, protrusion, and fanning of the tongue are all best treated by clearing heat and using rhinoceros horn (Xijiao) to calm the condition.
[Note] The tongue is the sprout of the Heart and internally connects with the five Zang organs. When toxin-heat erupts, the tongue is affected first, presenting as red, purple, black, or swollen, or showing protrusion and fanning movements. These various manifestations are all caused by heat lingering in the Heart. Treatment should primarily focus on clearing heat, using Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction).
Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction)
Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Niubangzi (Arctii Fructus, stir-fried), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Shengma (Cimicifugae Rhizoma), Xijiao (Rhinocerotis Cornu), Maidong (Ophiopogonis Radix, heart removed), Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Shigao (Gypsum Fibrosum).
Decoct in water and take orally.
[Fangge] Jiawei Xijiao Tang disperses heat; Jingjie, Fangfeng, Niubangzi combined with Gancao and Jiegeng; Shengma, Xijiao, and Maidong; Zhizi, Huanglian, and Shigao act swiftly.
The throat and pharynx govern the entry and exit of air and food. When toxin-fire rushes upward and blazes fiercely, pain becomes unbearable. Internally, use Ganjie Wanjie Ji (Licorice and Platycodon Throat-Soothing Formula); externally, apply Niuhuang San (Calculus Bovis Powder) for immediate relief.
[Note] The pharynx (Yan) is the pathway for food and drink; the larynx (Hou) is the gate for respiration. This is a most critical area. If the pox-toxin cannot vent outward, fire-heat obstructs the diaphragm and rushes upward to the throat, it may cause swelling and pain, hoarseness, or choking, and in severe cases, difficulty breathing and inability to swallow food or drink. Quickly treat with Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction). Alternatively, use Jiajian Liyan Jiedu Tang (Modified Throat-Soothing and Toxin-Clearing Decoction), and externally apply Niuhuang San (Calculus Bovis Powder) to the swollen area.
Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction) (See formula under "Hoarseness")
Liyan Jiedu Tang (Throat-Soothing and Toxin-Clearing Decoction)
Fangfeng (Saposhnikoviae Radix), Shandougen (Sophorae Tonkinensis Radix), Maidong (Ophiopogonis Radix, heart removed), Niubangzi (Arctii Fructus, stir-fried), Heishen (Scrophulariae Radix, processed), Ku Jiegeng (Bitter Platycodonis Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Lüdou (Phaseoli Radiatus Semen).
Decoct in water and take orally.
[Fangge] For soothing the throat and clearing toxins, use Fangfeng; combine with Shandougen and Maidong; Niubangzi, Heishen, and Ku Jiegeng; decoct together with Gancao and Lüdou to make a concentrated liquid.
Niuhuang San (Calculus Bovis Powder)
Chuan Huanglian (Raw Coptidis Rhizoma), Huangbai (Phellodendri Cortex, raw), Bohe (Menthae Haplocalycis Herba) (each 8 fen); Xionghuang (Realgar), Huoxiao (Saltpeter), Qingdai (Indigo Naturalis) (each 2.5 fen); Niuhuang (Calculus Bovis), Bingpian (Borneolum Syntheticum), Pengsha (Borax), Zhusha (Cinnabaris) (each 1 fen).
Grind into a fine powder. Use a small amount each time, insufflated onto the affected area.