喜泰顺曰∶夫人之声出于肺，清则声清，实则声哑，肺属金。又曰∶金空则鸣，
金实则哑，喉之窍虚，声出而清。惟痘疮之法，或因热毒壅遏而不得发散，或因气
血虚弱而外感风邪，则痰塞肺窍，不能流通，是以音哑。又有痘满咽喉，饮水则呛，
是水能犯气道故也。饮食有渣滓，自能入其门，故呛水而不呛食也。咳嗽则呛，呛
久则哑，必然之理也。是故呛水音哑之证，必兼疮色而定吉凶，若是啼哭咳嗽音哑，痘
色光明却不妨，是证急宜清肺解毒，大用牛蒡子、元参、桔梗、甘草、麦冬等剂，乃是良方。
喜泰顺曰∶痘疮始末，何故寒战切牙。有发热而见此证者，有起发而见此证者，有
行浆而见此证者，有收靥而见此证者，名曰寒战。其病寒也无疑矣。有先战而后寒
者，有先寒而后战者。书云∶七日以前而见此证者属热而凶，七日以后而见此证者
属虚，而亦有可治。吾深历其境，是寒战切牙，其属火也多矣。凡痘色红紫干枯，多
有是证。其寒也，热极生寒，其战也，火
甚则战，石膏、大黄在所宜施。凡痘灰白不红，绽不起发，昏暗顶陷，肌体 白，泄
泻眼开，其寒也，先必毛窍竖立，形如鸡皮，微微而寒，微微而战，是寒也乃气虚
则寒，是战也乃血虚则战，大用参、 、木香、丁、桂之药以助真元。七日以前切牙
者，乃阳明胃经主之，阳明主肌肉，其经走上下齿龈，邪并阳明，故切牙也，又主
胃热，宜清之。七日以后切牙者，乃阳明陷于阴，阴分虚则阳入血道而切牙也，主
血虚，宜补之。是切牙有虚实之分；有轻重之论，大抵必兼痘色而定其虚实，方为
的确。假若七日以后，根红不紧，而且紫艳顶陷火剌，口唇破裂，渴欲饮水，烦躁
闷乱而见此证者，亦为七日后便属虚乎？是以切牙又当闻其声，其声薨薨如咬索者，如
嚼豆者属热，其声蝇蝇如哺绵者属虚。大抵声响而硬，热无疑矣；声低而软，虚无
惑焉。总之见证参详，论痘施治，再无失矣。
喜泰顺说：人的声音产生于肺，肺气清虚则声音清脆，肺气实滞则声音嘶哑，肺在五行中属金。又说：金器中空则鸣响，金器实心则无声，喉部的窍道空虚，声音发出就清脆。只有痘疮的发病机理，有的因为热毒壅盛阻滞而不能发散，有的因为气血虚弱而外感风邪，导致痰液堵塞肺窍，气机不能流通，因此出现声音嘶哑。又有痘疹布满咽喉，喝水时发生呛咳，这是因为水饮侵犯了气道。饮食中有渣滓，反而能进入喉咙，所以只呛水而不呛食物。咳嗽就会引发呛咳，呛咳久了就会导致声音嘶哑，这是必然的道理。因此，对于呛水和声音嘶哑的证候，必须结合痘疹的颜色来判断吉凶。如果是啼哭、咳嗽导致的音哑，且痘色光明润泽，则无大碍；此证急需清肺解毒，大量使用牛蒡子、玄参、桔梗、甘草、麦冬等药物组成的方剂，才是良方。
喜泰顺说：痘疮从开始到结束，为什么会发生寒战和切牙（上下牙齿打架）？有在发热阶段出现此证的，有在起发阶段出现此证的，有在行浆阶段出现此证的，有在收靥阶段出现此证的，这叫做“寒战”。这病属于寒证无疑了。有的先战栗而后发冷，有的先发冷而后战栗。医书说：七日以前出现此证属于热证，预后凶险；七日以后出现此证属于虚证，还有可治的机会。我亲身经历并深入探究过这种情况，发现寒战切牙，大多属于火证。凡是痘色红紫干枯的，多有这种证候。那种寒冷，是热极生寒；那种战栗，是火邪炽盛导致战栗，石膏、大黄是适宜使用的药物。凡是痘色灰白不红，绽开不起发，昏暗顶陷，肌肤苍白，泄泻且眼睛半睁的，那种寒冷，起初必然是毛孔竖立，皮肤形态像鸡皮一样，微微感到寒冷，微微发生战栗，这种寒冷是因为气虚所致，这种战栗是因为血虚所致，应大量使用人参、[此处原文缺字，推测为黄芪或类似补气药]、木香、丁香、肉桂等药物来扶助真元。七日以前出现切牙的，由阳明胃经所主，阳明经主管肌肉，其经脉行走于上下齿龈之间，邪气并入阳明经，所以出现切牙，同时也主胃热，应当清热。七日以后出现切牙的，是阳明邪气陷入阴分，阴分虚弱则阳气进入血道而导致切牙，主因是血虚，应当补益。因此切牙有虚实之分，有轻重之论，大体上必须结合痘色来确定其虚实，才算确切。假如七日以后，痘根红但不紧束，而且颜色紫艳、顶部凹陷如火刺状，口唇破裂，口渴想喝水，烦躁闷乱而出现此证的，难道也算作七日后便属于虚证吗？因此判断切牙还要听其声音，如果声音沉闷如同咬绳索、嚼豆子，属于热证；如果声音细微如同哺食棉絮，属于虚证。大体上声音响亮而坚硬，肯定是热证无疑；声音低微而柔软，肯定不是虚证就是误判（注：原文“虚无惑焉”意为虚证确定无疑）。总之，见证要详细分析，根据痘疹情况施治，就不会有失误了。
Xi Taishun stated: Human voice originates from the Lung. When the Lung Qi is clear, the voice is clear; when the Lung Qi is excess/stagnant, the voice becomes hoarse. The Lung belongs to Metal in the Five Elements. It is also said that an empty metal vessel resonates, while a solid one does not sound; when the orifice of the throat is empty, the voice produced is clear. Regarding the pathology of smallpox (痘疮), hoarseness may occur because heat-toxin is congested and obstructed, preventing dispersion, or because Qi and Blood are deficient, allowing external wind-pathogen to invade, leading to phlegm blocking the Lung orifices and impeding the free flow of Qi. Additionally, if pox covers the throat, drinking water causes choking because water invades the airway. Food with residue can enter the throat naturally, hence one chokes on water but not on food. Coughing induces choking, and prolonged choking inevitably leads to hoarseness; this is a necessary principle. Therefore, for syndromes involving choking on water and hoarseness, one must determine the auspiciousness or inauspiciousness based on the color of the pox. If hoarseness results from crying or coughing, and the pox color is bright and lustrous, it is not serious. This syndrome urgently requires clearing the Lung and resolving toxicity, using large doses of formulas containing Niubangzi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Maidong (Ophiopogonis Radix), which constitutes an excellent prescription.
Xi Taishun stated: Why do cold shivering (寒战) and teeth grinding/clenching (切牙) occur throughout the course of smallpox? This syndrome may appear during the fever stage, the eruption stage, the pustule formation stage, or the crusting stage; it is called "cold shivering." Undoubtedly, this disease belongs to Cold. Some experience shivering first followed by coldness, while others feel cold first followed by shivering. Medical texts state that if this syndrome appears before the seventh day, it belongs to Heat and indicates a poor prognosis; if it appears after the seventh day, it belongs to Deficiency and is still treatable. Having deeply experienced and investigated this condition, I found that cold shivering and teeth grinding are mostly due to Fire. In cases where the pox color is red-purple and dry/withered, this syndrome is common. The "cold" here is extreme heat generating cold symptoms; the "shivering" is caused by excessive fire, making Shigao (Gypsum Fibrosum) and Dahuang (Rhei Radix et Rhizoma) appropriate treatments. In cases where the pox color is grayish-white without redness, fails to erupt, is dull with depressed tops, the skin is pale white, accompanied by diarrhea and half-open eyes, the "cold" initially manifests as standing hair follicles and skin resembling chicken skin, with slight coldness and slight shivering. This cold is due to Qi deficiency, and this shivering is due to Blood deficiency. One should heavily use herbs such as Renshen (Ginseng Radix et Rhizoma), [text missing, likely Huangqi], Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos), and Guirou (Cinnamomi Cortex) to support the True Yuan (True Origin). Teeth grinding occurring before the seventh day is governed by the Yangming Stomach Meridian. The Yangming meridian governs muscles and runs through the upper and lower gums; when pathogenic factors merge into the Yangming meridian, teeth grinding occurs. It also indicates Stomach Heat, which should be cleared. Teeth grinding occurring after the seventh day indicates Yangming pathogen sinking into the Yin aspect; Yin deficiency allows Yang to enter the blood vessels causing teeth grinding, primarily due to Blood deficiency, requiring tonification. Thus, teeth grinding has distinctions of Excess and Deficiency, and severity. Generally, one must combine the observation of pox color to determine Excess or Deficiency accurately. For instance, if after the seventh day, the pox base is red but loose, the color is purple-bright, the top is depressed like fire thorns, lips are cracked, there is thirst, irritability, and confusion, can this still be considered a Deficiency syndrome simply because it is after the seventh day? Therefore, when evaluating teeth grinding, one must listen to the sound. A muffled sound like biting a rope or chewing beans indicates Heat; a faint sound like feeding cotton indicates Deficiency. Generally, a loud and hard sound confirms Heat beyond doubt; a low and soft sound confirms Deficiency without hesitation. In summary, by carefully analyzing the manifestations and treating according to the state of the pox, errors will be avoided.