《难经》云∶会厌为吸门，胃为贲门，病痘之人，毒火上熏于肺，灼于胃，肺与胃
之上口，皆有疮而伤矣，水入则呛者，贲门伤则水不得入嗌，入会厌、会厌掩而
不内，故气逆喷出而呛也。食入则吐者，贲门伤则门户隘塞，食物不能直奔于胃，缓则汨汨而下，急则阻而吐
出矣，此其恶候，鲜有生者。其或舌上有疮烂破如蜂窠之状，舌痛强硬，不能为用延纳水谷，亦使水入则呛，食入则
吐，待舌疮平，则安矣。咽以咽物，喉以候气，咽居后而通于胃，喉居前而通于肺，肺无下窍，加橐
然，能受清虚之气，而不受有形之物，喉上有物若悬乳，名曰会厌，凡物入口，则舌抵上 ，舌抵上 则会厌必掩其喉，
故水谷但入咽，而不入喉，若痘生会厌，则木强不利开阖矣，干物间可入咽，而水饮或漏入喉，所以呛也，呛者、
犹云错喉，气须药补，汤药不入，则无补法，故不可治。〔翁〕七日以前痘色红紫而兼此证者，乃火气炎上，热毒壅
塞故也。痘色灰白不起而兼此证者，乃气血虚弱，肺胃受伤故也。二者俱是逆证。七日以后，外痘蒸长光润而有此证者，
是内证亦长，故致如此，外痘结痂，则内证亦靥矣，不治自愈。善治者，当察毒盛之痘于其咽喉干燥之先，而用甘桔汤、
解毒汤加麦冬、栝蒌皮穣、牛蒡子、玄参、荆芥之类，以清气道，不使热毒有犯，则自能免此患矣。袁氏治呛逆歌曰∶
痘中呛逆最凶危，沉香浓汁杏仁推，远把蜂糖多和水，按经煎透滤渣随，欲服晨时加好乳，汤中温热渐调之。余每
详察，痘呛者，乃元气耗铄，枭炎上升，故致呛逆，准恪后方。
人乳一钟，人参一钱，桔梗一钱，枇杷叶三片，共煎，滤渣，服乳。或用沉香磨人乳服者，虽效，总
不若此方之屡见捷也。
《难经》说：会厌是吸门，胃的上口是贲门。患痘疮的人，毒火向上熏蒸肺部，灼烧胃部，肺和胃的上口都长有疮疡而受损。水喝进去就呛咳，是因为贲门受伤，水无法进入咽喉；水流到会厌，会厌闭合阻挡水进入，所以气逆冲上喷出导致呛咳。食物吃下去就呕吐，是因为贲门受伤导致门户狭窄堵塞，食物不能直接顺利进入胃中，缓慢时则汨汨流下，急迫时则受阻而吐出。这是恶候，很少能存活的。如果舌头上有疮烂破溃像蜂巢一样的形状，舌头疼痛僵硬，不能正常使用来接纳水谷，也会使水入则呛，食入则吐，等到舌疮平复，就能安稳了。咽部用来吞咽食物，喉部用来呼吸气息，咽位于后方连通胃，喉位于前方连通肺。肺没有向下的窍道，加上像风箱一样（橐龠），只能接受清虚之气，而不能接受有形之物。喉上方有一物像悬挂的乳房，名叫会厌。凡是食物入口，舌头抵住上颚，舌头抵住上颚就会厌必然封闭喉部，所以水谷只进入咽，而不进入喉。如果痘疮生在会厌处，就会木强不利开阖，干物间或可进入咽，而水饮可能漏入喉，所以发生呛咳。呛咳，就是说错入喉中，气需要药物补益，汤药进不去，就没有补益的方法，所以不可治。〔翁〕七日以前痘色红紫且兼有此证的，是火气炎上，热毒壅塞的缘故。痘色灰白不起且兼有此证的，是气血虚弱，肺胃受伤的缘故。这两种情况都是逆证。七日以后，外见痘疮蒸腾生长、光泽润泽且兼有此证的，是内证也在生长，所以导致这样，外痘结痂，内证也就痊愈了，不用治疗也能自愈。善于治疗的人，应当在察知毒盛之痘在咽喉干燥之前，使用甘桔汤、解毒汤加入麦冬、栝蒌皮瓤、牛蒡子、玄参、荆芥之类的药物，以清气道，不让热毒侵犯，自然能免除这个祸患。袁氏治疗呛逆歌说：痘中呛逆最凶险危急，沉香浓汁配合杏仁推荐，远取蜂糖多加水调和，按照经络煎透过滤掉药渣跟随，想要服用在早晨时加入好乳汁，汤药中温热逐渐调服。我每次详细考察，痘疮呛逆，是元气耗损枯竭，邪火上升，所以导致呛逆，遵循恪定后的方剂。人乳一杯，人参一钱，桔梗一钱，枇杷叶三片，共同煎煮，过滤药渣，服用乳汁。或者用沉香磨入人乳服用，虽然有效，总不如这个方子屡见奇效。
The *Nan Jing* (Classic of Difficult Issues) states: The epiglottis is the "Xi Men" (Suction Gate), and the upper opening of the stomach is the "Ben Men" (Receiving Gate). In patients suffering from smallpox, toxic fire steams upward to affect the lungs and scorches the stomach. Both the lungs and the upper opening of the stomach develop sores and are injured. When water is ingested, choking occurs because injury to the Ben Men prevents water from entering the pharynx; when water reaches the epiglottis, the epiglottis closes to block entry, causing qi to reverse and rush out, resulting in choking. When food is ingested, vomiting occurs because injury to the Ben Men causes narrowing and blockage of the gate, preventing food from passing directly into the stomach; if slow, it trickles down, but if rapid, it is obstructed and vomited out. This is a malignant symptom with few survivors. If there are sores on the tongue that ulcerate and resemble a honeycomb, accompanied by pain and stiffness making the tongue unable to function in receiving food and drink, this also causes choking upon drinking and vomiting upon eating. Recovery will occur once the tongue sores heal. The pharynx is used for swallowing food, while the larynx is used for breathing air. The pharynx is located posteriorly and connects to the stomach, while the larynx is located anteriorly and connects to the lungs. The lungs have no lower orifices and function like bellows, accepting only clear and empty qi, not tangible substances. Above the larynx lies an organ resembling a hanging breast, called the epiglottis. When anything enters the mouth, the tongue presses against the palate; pressing the palate causes the epiglottis to cover the larynx. Thus, food and water enter the pharynx but not the larynx. If smallpox lesions occur on the epiglottis, its flexibility for opening and closing is impaired. Dry matter may occasionally enter the pharynx, but liquids may leak into the larynx, causing choking. Choking implies misdirection into the larynx. Qi requires medicinal supplementation; if decoctions cannot be taken, there is no method for supplementation, rendering the condition untreatable. [Weng] If red-purple smallpox appears within seven days accompanied by these symptoms, it is due to flaming fire rising and heat-toxin stagnation. If grayish-white, non-elevated smallpox appears accompanied by these symptoms, it is due to deficiency of qi and blood and injury to the lungs and stomach. Both are adverse conditions. After seven days, if external smallpox is steaming, growing, smooth, and glossy accompanied by these symptoms, it indicates internal lesions are also healing; thus, when external scabs form, internal lesions resolve as well, and the condition heals spontaneously without treatment. A skilled practitioner should observe toxic, abundant smallpox before the onset of dry throat and use Gan Jie Tang (Licorice and Platycodon Decoction) or Jie Du Tang (Detoxification Decoction) added with Maidong (Ophiopogon Root), Gualou Pi Rang (Trichosanthes Peel Pith), Niubangzi (Arctium Fruit), Xuanshen (Scrophularia Root), and Jingjie (Schizonepeta Herb) to clear the respiratory tract, preventing heat-toxin invasion, thereby avoiding this affliction. Yuan’s Song on Treating Choking and Regurgitation states: Smallpox-induced choking and regurgitation are most fierce and critical; thick decoction of Chenxiang (Aquilaria Wood) and Xingren (Apricot Seed) are recommended; take Fengtang (Bee Honey) mixed with much water; decoct thoroughly according to meridians, filter dregs, and follow up; for administration in the morning, add good human milk; warm the decoction gradually before mixing. Upon my detailed examination, smallpox-induced choking results from depletion of primordial qi and rising of evil fire. I adhere to the following prescription: one cup of Renru (Human Milk), one qian of Renshen (Ginseng Root), one qian of Jiegeng (Platycodon Root), and three leaves of Pipaye (Loquat Leaf), decocted together, filtered, and taken with the milk. Alternatively, grinding Chenxiang (Aquilaria Wood) into Renru (Human Milk) for consumption is effective, but generally not as frequently successful as this formula.