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Artist's commentary
東方同音異義語~LUNATIC JAPANESE HOMONYMS
When Kanji was adopted from Chinese, the tonal aspect was dropped in Japanese, leading to a vast number of homonyms. Thus, in conversations, we rely heavily on context to discern the intended meaning.
Source: https://www.reddit.com/r/touhou/comments/140hhfs/comment/jmvljkt/