疹毒热甚上攻喉，肿痛难堪实可忧，表邪元参升麻用，裹热凉膈消毒求。
[注]
疹毒热盛，上攻咽喉轻则肿痛，甚则汤水难下，最为可虑，
表邪郁遏，疹毒不能发舒于外，致咽喉作痛者，元参升麻汤主之，
里热壅盛，或疹已发于外，而咽喉作痛，以凉膈消毒饮主之
(元参升麻汤) 荆芥 防风 升麻 牛蒡子炒研 元参 生甘草 水煎服。
(方歌)
表郁疹毒喉肿痛，急服元参升麻汤，荆芥防风升麻蒡，元参甘草水煎尝。
(凉膈消毒饮) 荆芥穗 防风 连翘去心 薄荷叶 黄芩 生栀子
生甘草 牛蒡子炒研 芒硝 大黄生 引用灯心，水煎服。
(方歌)
里热喉痛昔难当，凉膈消毒饮最良，荆防翘薄芩栀草，牛蒡芒硝生大黄。
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疹毒声哑肺热壅，元参升麻大有功，已发加减凉膈散，没后儿茶音即清。
[注]
失音者，乃热毒闭壅肺窍而然也，疹初失音者，元参升麻汤主之，
疹已发而失音者，加减凉膈散主之，疹没后哑者，儿茶散主之。
(元参升麻汤) 方见喉痛
(加减凉膈散) 薄荷叶 生栀子 元参 连翘去心 生甘草 苦桔梗
麦冬去心 牛蒡研炒 黄芩 水煎服。
(方歌)
加减凉膈治失音，薄荷栀子共元参，连翘甘草苦桔梗，麦冬牛蒡与黄芩。
(儿茶散) 硼砂二钱 孩儿茶五钱 共为细末，凉水一盏，调药一匙服之。
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疹毒热势炽盛，向上攻冲咽喉，导致咽喉红肿疼痛难以忍受，确实令人担忧。若因表邪郁闭所致，宜用玄参升麻汤；若因内裹之热所致，宜求治于凉膈消毒饮。
[注]
疹毒热势亢盛，向上攻冲咽喉，轻则出现肿痛，重则连汤水都难以咽下，最为令人忧虑。若是表邪郁遏，致使疹毒不能向外透发舒展，从而导致咽喉作痛者，以元参升麻汤为主治方剂。若是里热壅盛，或者疹毒已经发于体表之外，但咽喉仍然作痛者，以凉膈消毒饮为主治方剂。
（元参升麻汤）荆芥、防风、升麻、牛蒡子（炒后研碎）、玄参、生甘草，用水煎服。
（方歌）
表郁疹毒喉肿痛，急服元参升麻汤，荆芥防风升麻蒡，元参甘草水煎尝。
（凉膈消毒饮）荆芥穗、防风、连翘（去心）、薄荷叶、黄芩、生栀子、生甘草、牛蒡子（炒后研碎）、芒硝、大黄（生用），引用灯心草为引，用水煎服。
（方歌）
里热喉痛昔难当，凉膈消毒饮最良，荆防翘薄芩栀草，牛蒡芒硝生大黄。
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疹毒导致声音嘶哑，乃肺热壅盛所致，玄参升麻汤大有功效。若疹毒已发出，可用加减凉膈散；若疹毒已消退，可用儿茶散，声音即可清亮。
[注]
失音（声音嘶哑或丧失），是由于热毒闭阻壅塞肺窍而造成的。疹初起时出现失音的，以元参升麻汤为主治方剂；疹毒已经发出但仍出现失音的，以加减凉膈散为主治方剂；疹毒消退后出现声音嘶哑的，以儿茶散为主治方剂。
（加减凉膈散）薄荷叶、生栀子、玄参、连翘（去心）、生甘草、苦桔梗、麦冬（去心）、牛蒡子（研碎炒制）、黄芩，用水煎服。
The heat toxicity of the rash is severe and attacks upward to the throat, causing unbearable swelling and pain, which is indeed a cause for concern. If caused by exterior pathogenic factors, Yuanshen Shengma Decoction (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) should be used; if caused by internal entrapment of heat, Liangge Xiaodu Yin (Cooling the Diaphragm and Detoxifying Drink) should be sought.
[Note]
When the heat toxicity of the rash is excessive and attacks upward to the throat, it causes mild swelling and pain in the early stage, or even difficulty in swallowing soup and water in severe cases, which is most worrying. If exterior pathogens are constrained, preventing the rash toxicity from venting outward, thereby causing throat pain, Yuanshen Shengma Decoction (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is the primary formula. If interior heat is congested and abundant, or if the rash has already erupted externally but throat pain persists, Liangge Xiaodu Yin (Cooling the Diaphragm and Detoxifying Drink) is the primary formula.
(Yuanshen Shengma Decoction) Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Niubangzi (Arctii Fructus, stir-baked and crushed), Yuanshen (Scrophulariae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take orally.
(Decoction Song)
Exterior constraint with rash toxicity causes throat swelling and pain,
Urgently take Yuanshen Shengma Decoction.
Jingjie, Fangfeng, Shengma, and Niubang,
Yuanshen and Gancao, decoct in water and taste.
(Liangge Xiaodu Yin) Jingjiesui (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus, heart removed), Boheye (Menthae Haplocalycis Folium), Huangqin (Scutellariae Radix), Sheng Zhizi (Gardeniae Fructus), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Niubangzi (Arctii Fructus, stir-baked and crushed), Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma, raw). Use Dengxincao (Junci Medulla) as a guide, decoct in water and take orally.
(Decoction Song)
Interior heat causing throat pain was once hard to bear,
Liangge Xiaodu Yin is the best remedy.
Jing, Fang, Qiao, Bo, Qin, Zhi, Cao,
Niubang, Mangxiao, and raw Dahuang.
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Rash toxicity leading to hoarseness is due to lung heat congestion; Yuanshen Shengma Decoction (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is highly effective. If the rash has already erupted, use Jiajian Liangge San (Modified Cooling the Diaphragm Powder); if the rash has subsided, use Ercha San (Child's Tea Powder), and the voice will become clear.
[Note]
Hoarseness (loss of voice) results from heat toxicity blocking and congesting the orifices of the lungs. When hoarseness occurs at the initial stage of the rash, Yuanshen Shengma Decoction (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is the primary formula. When hoarseness persists after the rash has erupted, Jiajian Liangge San (Modified Cooling the Diaphragm Powder) is the primary formula. When hoarseness occurs after the rash has subsided, Ercha San (Child's Tea Powder) is the primary formula.
(Yuanshen Shengma Decoction) See the "Throat Pain" section for the formula.
(Jiajian Liangge San) Boheye (Menthae Haplocalycis Folium), Sheng Zhizi (Gardeniae Fructus), Yuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus, heart removed), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Ku Jiegeng (Platycodonis Radix), Maidong (Ophiopogonis Tuber, heart removed), Niubang (Arctii Fructus, crushed and stir-baked), Huangqin (Scutellariae Radix). Decoct in water and take orally.
(Decoction Song)
Jiajian Liangge treats hoarseness,
Bohe and Zhizi together with Yuanshen.
Lianqiao, Gancao, and Ku Jiegeng,
Maodong, Niubang, and Huangqin.
(Ercha San) Pengsha (Borax) 2 qian, Haiercha (Stelechocarpus Burr) 5 qian. Grind together into a fine powder. Take one spoonful of the medicine mixed with one cup of cool water.
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