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It is asked: Regarding hemiplegia, the ancients discussed wind, fire, dampness, and phlegm. Various schools have analyzed and refuted these theories layer by layer; do these views have evidence to rely upon? I say: Take Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), chapter on Wind-Stroke, which states that wind-stroke causes headache and body pain, fever and aversion to cold, dry retching and spontaneous sweating. The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) discusses wind-cold causing nasal congestion and sneezing, cough with heavy voice, and clear nasal discharge. The chapter on wind-stroke itself also states: "The disease of wind should cause hemiplegia." Now I ask, what kind of wind, and what method of invasion, causes headache and body pain, fever and aversion to cold, dry retching and spontaneous sweating? What kind of wind, and what method of invasion, causes nasal congestion and sneezing, cough with heavy voice, and clear nasal discharge? What kind of wind, and what method of invasion, causes hemiplegia? If hemiplegia were indeed caused by wind pathogen, wind invading the human body must enter from the skin into the meridians, and there must be symptoms indicating progression from exterior to interior that can be verified. I have treated this condition many times; at the onset, there were no exterior symptoms such as fever and aversion to cold, headache and body pain, eye pain and dry nose, or alternating chills and fever. Since there are no exterior symptoms, it is known that hemiplegia is not caused by wind pathogen invasion. Furthermore, the theories of wind, fire, dampness, and phlegm proposed by others are even more vague. If it were wind, fire, dampness, or phlegm, whether invading from outside or originating from inside, it must affect the meridians. What the meridians store is nothing but Qi and Blood. If Qi and Blood are obstructed by wind, fire, dampness, or phlegm, there must be pain symptoms. Pain symptoms indicate Bi syndrome (a condition characterized by pain, numbness, heaviness, and limited movement of limbs and joints), not hemiplegia. Hemiplegia has no pain symptoms. I have treated this condition most frequently in my life and have never seen anyone develop hemiplegia due to body pain from Bi syndrome. Reflecting on this, it is again not caused by wind, fire, dampness, or phlegm.

It is asked: You state that hemiplegia originates from the depletion of Yuan Qi (Original Qi). Why does the disease manifest only when Yuan Qi is depleted by half? I wish to hear your explanation. I say: When Yuan Qi declines, there is a lack of strength; when Yuan Qi is exhausted, death occurs. If there is ten units of Yuan Qi, and two units are depleted, leaving eight units, each half of the body still retains four units, so there is no disease. If five units are depleted, leaving five units, each half of the body retains only two and a half units. At this time, although hemiplegia has not yet occurred, there are already symptoms of Qi deficiency. Because there is no pain or itching, people do not perceive it themselves. Once Yuan Qi is depleted, the meridians naturally become empty. In these empty spaces, it is inevitable that Qi will shift to one side. For example, if the two and a half units of Qi in the right half of the body shift to the left, the right half of the body will have no Qi; if the two and a half units of Qi in the left half of the body shift to the right, the left half of the body will have no Qi. Without Qi, movement is impossible. This inability to move is called hemiplegia. "Bu Sui" (not following) means not obeying human command. For instance, during sleep, the shifting of Qi is imperceptible to the person; they simply find they cannot turn over upon waking. Only upon waking does the person feel the Qi in the affected half flowing towards the unaffected half, a sensation more pronounced than the sound of water waves. When sitting, the shifting causes the body to tilt; when walking, the lack of Qi in one half leads to falling. People claim that hemiplegia is caused by falling, but little do they know that it is not the fall that causes hemiplegia, but rather the depletion of Qi.