毒壅会厌水难纳，溢水气喉呛始发，咽喉肿痛道路狭，甘桔解毒皆妙法。
【注】呛水者，因火盛毒壅会厌门也。盖咽门司纳饮食，一为毒热所壅，则必肿痛，水
不易入，溢于气喉，故气喷出而呛作矣，宜用加味甘桔汤，或加味解毒汤亦可。此证见
于七日前者，俱属恶候。若七日已后，外痘蒸长光润而作呛者，是咽门痘长，壅窒道路
而使然也，至结痂则呛自止。治者当于毒盛之痘，预用清理气道之药，不使热毒侵犯，自
能免此患矣。
加味甘桔汤
牛蒡子（炒） 苦桔梗 生甘草 射干
水煎服。
【方歌】加味甘桔汤最良，痘证呛水效非常，牛蒡子合苦桔梗，甘草射干共煎尝。
加味解毒汤
元参 苦桔梗 麦门冬（去心） 当归尾 赤芍 生地黄 连翘（去心）
牛蒡子（炒、研） 丹皮 红花 甘草（生） 木通
引用灯心，水煎服。
【方歌】加味解毒汤最灵，元参桔梗麦门冬，归芍生地翘牛蒡，丹皮红花草木通。
发痘脾胃被毒侵，口喷秽气不堪闻，毒火燔灼宜速治，加味归宗功效神。
【注】毒火侵炙脾胃，故口出臭味，令人难近。盖出痘全赖脾胃以为根本，今为毒火
侵害，则根本受伤。不急救之，必至脾胃溃烂而成大害。须以归宗汤治之，秽减庶可望生。
归宗汤（方见发热证治）
毒邪壅滞于会厌，导致水液难以吞咽；溢出的水气进入喉部气道，从而引发呛咳。咽喉出现肿痛，使呼吸和吞咽通道变窄，使用甘桔汤（甘草与桔梗组成的方剂）解毒是极为巧妙的方法。
【注】所谓“呛水”，是因为火盛毒壅阻塞了会厌门。因为咽门主管饮食的吞咽，一旦被毒热所壅塞，必然导致肿痛，水液不易进入食道，反而溢出流入气管，所以气体喷出时引发呛咳。适宜使用加味甘桔汤，或者使用加味解毒汤也可以。此证如果在出痘七日前出现，都属于不良征兆。如果是在七日之后，外部痘疹蒸腾生长、光亮润泽却出现呛咳的，这是因为咽门处的痘疹生长，壅塞阻滞了气道所致，等到结痂后呛咳自然停止。治疗者应当在毒邪旺盛的痘疹阶段，预先使用清理气道的药物，防止热毒侵犯，自然能避免这种祸患。
加味甘桔汤
牛蒡子（炒制） 苦桔梗 生甘草 射干
用水煎煮后服用。
【方歌】加味甘桔汤最为优良，治疗痘证呛水效果非凡，牛蒡子配合苦桔梗，甘草与射干共同煎煮品尝。
加味解毒汤
玄参 苦桔梗 麦门冬（去心） 当归尾 赤芍 生地黄 连翘（去心）
牛蒡子（炒制、研碎） 丹皮 红花 甘草（生用） 木通
引用灯心草作为药引，用水煎煮后服用。
【方歌】加味解毒汤最为灵验，玄参、桔梗、麦门冬，当归、芍药、生地、连翘、牛蒡子，丹皮、红花、车前草（注：原诗“草”指代方中最后一味或泛指，此处依方歌习惯及上下文，通常指代方中成分，但方中无车前草，结合方歌“花草木通”，可能指红花、甘草、木通等，此处直译诗句内容），丹皮、红花、甘草、木通。
发痘期间脾胃被毒邪侵袭，口中喷出秽浊之气，气味难闻不堪忍受，毒火燔灼应当迅速治疗，加味归宗汤功效神奇。
【注】毒火侵炙脾胃，所以口中发出臭味，令人难以靠近。因为出痘全赖脾胃作为根本，如今被毒火侵害，则根本受到损伤。如果不紧急救治，必然导致脾胃溃烂而成大害。必须用归宗汤来治疗，待秽浊之气减少，才有望存活。
归宗汤（方剂见发热证治章节）
Toxic pathogens obstruct the epiglottis, making it difficult to swallow water; overflowing water enters the laryngeal airway, thereby initiating choking. The throat becomes swollen and painful, narrowing the passage for respiration and swallowing. Using Ganjie Tang (Licorice and Platycodon Decoction) to resolve toxicity is an excellent method.
[Note] "Choking on water" occurs because excessive fire and toxic pathogens obstruct the epiglottis. Since the pharynx governs the ingestion of food and drink, once obstructed by toxic heat, swelling and pain inevitably occur. Water cannot easily enter the esophagus but overflows into the trachea; thus, when gas is expelled, choking ensues. It is appropriate to use Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction), or Jiawei Jiedu Tang (Modified Detoxification Decoction) may also be used. If this syndrome appears within seven days after the onset of smallpox/rash, it is considered a ominous sign. However, if choking occurs after seven days, while external pustules are steaming, growing, smooth, and lustrous, it is caused by the growth of pustules in the pharynx obstructing the airway. Once scabs form, the choking will cease naturally. Practitioners should preemptively use herbs that clear the airway during the stage of intense toxic pustules to prevent heat-toxin invasion, thereby avoiding this complication.
Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction)
Bai Fang Zi (Fried) [Arctii Fructus]
Ku Jie Geng [Platcodonis Radix]
Sheng Gan Cao [Raw Glycyrrhizae Radix et Rhizoma]
She Gan [Belamcandae Rhizoma]
Decoct with water and take orally.
[Prescription Verse] Jiawei Ganjie Tang is most excellent, extremely effective for choking in rash diseases. Arctii Fructus combined with Platcodonis Radix, Licorice and Belamcandae Rhizoma decocted together.
Jiawei Jiedu Tang (Modified Detoxification Decoction)
Xuan Shen [Scrophulariae Radix]
Ku Jie Geng [Platcodonis Radix]
Mai Men Dong (Heart Removed) [Ophiopogonis Tuber]
Dang Gui Wei [Tail of Angelicae Sinensis Radix]
Chi Shao [Paeoniae Radix Rubra]
Sheng Di Huang [Rehmanniae Radix Preparata]
Lian Qiao (Heart Removed) [Forsythiae Fructum]
Niu Bang Zi (Fried, Ground) [Arctii Fructus]
Dan Pi [Moutan Cortex]
Hong Hua [Carthami Flos]
Gan Cao (Raw) [Raw Glycyrrhizae Radix et Rhizoma]
Mu Tong [Akebiae Caulis]
Use Deng Xin Cao [Junci Medulla] as a guiding drug, decoct with water and take orally.
[Prescription Verse] Jiawei Jiedu Tang is most efficacious, Xuan Shen, Jie Geng, Mai Men Dong, Dang Gui, Shao Yao, Sheng Di, Lian Qiao, Niu Bang Zi, Dan Pi, Hong Hua, Cao, Mu Tong.
During the eruption of rashes, the spleen and stomach are invaded by toxic pathogens, causing foul breath from the mouth that is unbearable due to its odor. Toxic fire blazing requires rapid treatment; Jiawei Guizong Tang has miraculous efficacy.
[Note] Toxic fire scorches the spleen and stomach, hence foul breath emanates from the mouth, making people reluctant to approach. The eruption of rashes relies entirely on the spleen and stomach as the root foundation. Now, being harmed by toxic fire, the foundation is injured. If not urgently treated, it will inevitably lead to ulceration of the spleen and stomach, causing major harm. One must treat it with Guizong Tang. Only when the foul odor diminishes can survival be hoped for.
Guizong Tang (See prescription in the chapter on Fever Treatment)