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It is asked: If hemiplegia (hemiplegia) is not caused by wind, why does facial deviation (facial paralysis/deviation) occur? I say: The ancients named it "deviation" because they were not careful enough in clinical examination. Facial deviation is not actually a true deviation; it occurs because the affected half of the face lacks Qi. Without Qi, the muscles on that side shrink and contract. One eye lacks strength to open fully, causing the outer corner to pull downward; one side of the mouth lacks strength to open, causing the corner to pull upward. These upper and lower contractions together create the appearance of deviation at first glance, but it is not a true left-right deviation. In my clinical experience, for patients with left-sided hemiplegia, the deviation is mostly on the right side; for those with right-sided hemiplegia, the deviation is mostly on the left side. This principle is puzzling and cannot be verified in existing books. Why? Because the meridians of the left half of the body ascend to the head and face traveling on the right side, while the meridians of the right half of the body ascend to the head and face traveling on the left side, reflecting the principle of cross-interaction. I dare not state this as a definitive conclusion, but await scholars to examine it carefully and supplement it later.

It is further asked: Is facial deviation entirely due to lack of Qi in half the face? I say: The previous discussion referred specifically to cases accompanied by hemiplegia. If a robust person suffers from facial deviation without hemiplegia, they can be cured with a single dose of herbs that unblock the meridians and disperse wind. This effect cannot be achieved by the formulas used for treating hemiplegia.

It is asked: Is the fluid flowing from the corner of the mouth phlegm-fluid retention (phlegm-rheum)? I say: In treating this condition, I observed that the fluid was clear water, not thick phlegm. Clearly, it is due to Qi deficiency failing to consolidate and hold fluids. By correlating with other symptoms, salivation (sialorrhea) undoubtedly belongs to Qi deficiency.

It is asked: When suffering from hemiplegia accompanied by dry stool, the ancients called it "wind-dryness," implying the disease involves both wind and fire. Is there any truth to this? I say: If it were wind and fire, using herbs to disperse wind, clear heat/fire, and moisten dryness would resolve the issue; once the stool passes, the wind disperses and fire clears, so dryness should not persist. I have seen practitioners mistakenly use purgative herbs (purgatives) for this condition, resulting in even worse dryness after purgation. They fail to consider that normally, defecation does not happen automatically through the anus; it requires physical effort to push the stool down. After developing hemiplegia, one lacks the strength to move the limbs and lacks the strength to speak; how could there be sufficient strength to push stool down from below? Therefore, this is not wind-fire, but rather a lack of strength to propel the stool. Since the stool remains in the large intestine for a long time without being expelled, it naturally becomes dry.