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Facial paralysis (Kou Yan Xie), commonly treated by lay physicians indiscriminately with syndromes of wind-stroke involving dizziness and tremors, is often medicated with formulas such as Lingbao Dan, Zhibao Dan, Xuming Tang, Qingxin Wan, and Yizi Jifeng Wuxi Tiedan Wan. Although these prescriptions claim to treat this disease, why do patients fail to recover? This is because practitioners know the orifices but not the meridians, or know the meridians but not the Qi dynamics.

What is meant by "knowing the orifices but not the meridians"? The human head has seven orifices, analogous to the sun, moon, five planets, and seven celestial bodies in the sky. Thus, the liver opens into the eyes; the eyes are the external manifestation of the liver. The lungs open into the nose; the nose is the external manifestation of the lungs. The heart opens into the tongue; however, since the tongue itself lacks an orifice, the heart combines with the kidneys and lodges its orifice in the ears. Therefore, both the ears and the tongue serve as external manifestations of the heart. Lay physicians merely associate eye diseases with the liver, mouth diseases with the spleen, ear diseases with the kidneys, and tongue diseases with the heart, adhering rigidly without variation. They fail to realize that the inner upper and lower eyelids are where the Foot-Taiyang Bladder Meridian and Foot-Yangming Stomach Meridian originate; the outer canthus is where the Foot-Shaoyang Gallbladder Meridian originates and the Hand-Shaoyang Sanjiao Meridian reaches; the left and right sides of the nose are flanked by the Foot-Yangming Stomach Meridian and Hand-Yangming Large Intestine Meridian; and the left and right sides of the mouth are also circled by these two meridians. Therefore, when diseases affect the seven orifices, they cannot be attributed solely to the five zang organs but must be attributed to the six yang meridians. I say: This is why lay physicians know the orifices but not the meridians.

What is meant by "knowing the meridians but not the Qi"? Among the millions discussing herbal prescriptions, few truly understand the origins, destinations, courses, loops, intersections, confluences, passages, acupoints, affiliations, collaterals, superior and inferior directions, parallel paths, distributions, scatterings, knots, winds, connections, ties, constraints, similarities, and distinctions of the twelve primary meridians. Such individuals are rare. Most simply cling to the twelve meridians as the root of disease, categorizing Yang meridians as heat and Yin meridians as cold, then searching for herbs in the *Bencao* (Materia Medica) and formulas on their shelves. Is it surprising that the disease does not heal? As stated in the *Ling Shu* (Spiritual Pivot): "Spasms of the tendons of the Foot-Yangming and Hand-Taiyang meridians cause deviation of the mouth and eyes." These are the locations of the twelve meridians and the sites of pathology, not the pathogenic factors themselves. The true pathogenic factors are the Six Qi of heaven: Wind, Summer-heat, Dryness, Dampness, Fire, and Cold. Thus, lay physicians know the meridians but not the Qi.

So, which meridian and which Qi are involved in facial paralysis? The Foot-Taiyang and Foot-Yangming meridians affect both the left and right eyes. The Foot-Yangming and Hand-Yangming meridians affect both the left and right corners of the mouth. These constitute two pathways. The *Ling Shu* further states: "When the tendons of the Foot-Yangming Meridian are diseased, affecting the cheek tendons, cold causes spasms pulling the mouth, while heat causes flaccidity and inability to contract, resulting in deviation." If the left side is cold and the right side hot, the left becomes spastic and the right flaccid; if the right is cold and the left hot, the right becomes spastic and the left flaccid. Therefore, left-sided deviation indicates left cold and right heat; right-sided deviation indicates right cold and left heat. One should not directly use pungent-hot agents for cold, as treating left-side cold with heat would force heat to the right, and vice versa, preventing the smooth circulation of Yang Qi. Moreover, Wind belongs to Wood (Jia/Yi). The mouth and eyes belong to the Yangming Stomach Earth. When Wind attacks parasitically, it causes deviation.

Why do only the mouth and eyes suffer from deviation among the seven orifices, while the ears and nose do not? Movement generates Wind, stillness extinguishes Wind; this is the constant principle of heaven and earth. Examining the *I Ching* (Book of Changes), there are correspondences: Zhen and Xun trigrams govern movement (Wood); Kun and Gen trigrams govern stillness (Earth). The Guan (View) hexagram relates to vision. Vision is the function of the eyes. The upper eyelid blinks (movement/Wind), while the lower eyelid does not (stillness/Earth). Hence, Guan has Xun above and Kun below. The Yi (Nourishment) hexagram relates to nourishment. Nourishment is the function of the mouth. The lower jaw chews (movement/Wind), while the upper jaw remains still (stillness/Earth). Hence, Yi has Gen above and Zhen below. Since the mouth and eyes are constantly moving, Wind arises. Since the ears and nose are relatively still, Wind does not settle. Note that although the eyes deviate, the eye sockets do not; although the mouth deviates, the mandible (Fu Che) does not. This clearly shows the meridians are diseased, not the orifices. Furthermore, the eyes have the "Wind Wheel" (cornea/pupil), and the lips have the "Flying Gate" (oral opening).

I have treated this condition without using common folk medicines, not to deliberately oppose society like a square peg in a round hole. Passing through Yingzhou, a magistrate suffered from this. His eye deviation was treated with moxibustion at Chengqi (ST1); his mouth deviation was treated with moxibustion at Dicang (ST4), both effective. If ineffective, Renying (ST9) should be moxibusted. This is due to Qi deficiency allowing Wind invasion, trapping true Qi, so moxibustion is indicated. The *Nei Jing* states: "Use moxibustion for sinking/collapsed Qi." This explains the immediate recovery. Later, passing through Dongqi, a man suffered from this. His pulse was rapid, taut like a drawn bowstring, strong and excess. He had strong teeth and abundant Qi, differing from the magistrate, indicating a conflict of Wind and Fire. I prescribed Chengqi Tang (Gut-Purging Decoction) 6 liang, decocted in 4 sheng of water to yield 3 sheng, divided into four doses, taken warm. He defecated 40-50 times, expelling basins of waste. Then I used bitter emetics and detoxifying herbs to regulate the ascending and descending of Water and Fire. He recovered within ten days. The *Mai Jue* says: "Heat generates Wind." Such cases are not merely caused by Wind entering through window cracks but by inherent Wind-Fire interaction. Fire overacting controls Metal; Metal deficiency allows Wood to flourish; Wood flourishing generates Wind. For the patient in Dongqi, moistening and purging were appropriate. After heavy purgation, restoring appetite and resolving stagnation was key. The *Ling Shu* mentions applying horse fat and cinnamon wine externally, but this treats only the exterior, not the interior root. Modern practitioners who ignore the root and rely solely on drinking hot water see no cures. Were the previous uses of Ginger, Aconite, Aconite (Wutou), Cinnamon, Magnetite, and Sulfur correct or incorrect?