摩訶止觀 觀病患境

The Mohe Zhiguan (Great Calming-and-Contemplation) does not romanticize illness as a gift. Illness can destroy moral discipline, like puncturing the flotation bladder used to cross the sea. It can damage concentration, like dismantling a bridge over a river. It can make one care only for this foul body of pus and blood and lose correct mindfulness. Illness can obstruct the path, and obstruct it deeply.

Zhizhe therefore does not begin with elegant transcendence. He asks one to discern the illness, find its cause, select a treatment, and observe harm and benefit. What comes from cold, heat, or food cannot be treated as dysregulation in seated meditation. Even the same method, applied excessively, can turn treatment into illness. Beyond faith, application, diligence, and constancy, one must recognize illness, act skillfully, persist, retain and discard, care and protect, and recognize obstruction. Practice is not an exercise in bravado. It resembles tuning a zither string: too loose or too tight, it produces no sound.

Yet healing illness is not the text's endpoint. Because of the same illness, some resent and slander, indulge desire, and move toward the three evils. Some produce shame and conscience and practice goodness. Some see the dangerous fragility of birth and death. Some begin from their own pain to find the pain of beings unbearable. Illness does not choose a direction for anyone. It only presses this one thought of mind to the place where one can no longer pretend not to see it.

The real turn is ceasing to seek a pure mind somewhere outside illness. This present thought of ill mind is neither real nor existent and is itself the Dharma realm. This does not deny pain; it ceases to nail “I” and “illness” into two solid entities. Only when the crazed and thirsty person stops chasing a mirage do body and mind settle. Only when mind stops racing after the six objects is there a place for correct wisdom of dependent origination to arise.

Illness then turns from private suffering into an entrance to compassion. When the child is ill, the parents become ill; when the child heals, the parents heal. A bodhisattva regulates one's own mind not to become cool and refreshed alone, but because the path of transformation cannot stop while beings remain ill. If one's own suffering only makes mind smaller, illness is still dragging one along. If it makes one genuinely see all who are ill, great compassion has begun to turn the object of illness.

Beryl can be clearly seen at the bottom of a deep pool, yet one cannot claim to hold it already. Even if illness diminishes and contemplative practice becomes luminous, one must not attach. Knowledge of stages prevents false claims; patient endurance prevents retreat; freedom from attachment prevents stopping at what has been attained. Then illness need not first vanish from one's life, yet it is no longer only a heavy burden blocking the road: the practitioner can swiftly enter the Dharma stream and obtain one great carriage.

The Third Object: Why Contemplate Illness?

Third is contemplating the object of illness. As long as one has this body, illness is already present. The four snakes differ in nature, and water and fire oppose one another. Owls share one roost; pythons and rats inhabit one hole. This body resembles a vessel filled with poison, a heavy burden, and a gathering place of many sufferings. It also resembles four neighboring states that invade and destroy one another. While their powers are equal, they remain temporarily at peace; when one takes advantage of another's weakness, it annexes it. From these similes one can understand whether earth, water, fire, and wind—the four elements—are harmonious or not. When buddhas greet one another, the customary question is “Little illness and little distress?” The Buddha accords with the world's custom. Since human beings have illness, expedient manifestation cannot be wholly without it; one can say only that illness and distress are slight.

Illness has two levels of meaning: first, illness genuinely undergone at the stage of cultivating causes; second, illness expediently manifested at the stage of realizing the result.

Vimalakīrti lay ill at Vaiśālī, using illness to raise the teaching. Through his own bodily illness, he instructed ordinary people, rebuked the Lesser Vehicle, admonished the Great Vehicle, and together with Mañjuśrī taught extensively about causal-stage illness and three kinds of discipline, as well as resultant-stage illness and four kinds of consolation. The Tathāgata likewise used entry into extinction to discuss permanence and manifested illness to teach great power. All these use expedient means to enter the Dharma gate of illness and guide everyone afflicted by illness and distress. Such expedient illness is not the illness contemplated in this object.

What is contemplated now is the body born through karmic retribution. The four elements act like four snakes and can obstruct and abolish cultivation of the noble path. If contemplated as they truly are, they can instead intensify one's application of mind. Those of highest wisdom and sharp faculties who have already understood patient endurance through the preceding object can penetrate the object of illness without laboriously hearing it repeated. It is now distinguished further for those who have not understood. This resembles felling a great tree that falls after ten thousand strokes of an axe, or carving a massive rock that is finally pierced after a hundred million blows. Therefore the explanation is repeated.

Prolonged illness and distant travel are great obstructions to meditative concentration. When the body becomes ill, one may lose previously cultivated meritorious karma and create immeasurable transgressions. Scripture says: “Destroying the flotation bladder, dismantling the bridge, and losing correct mindfulness.” Destroying moral discipline because of illness resembles destroying a flotation bladder. Damaging meditative concentration because of illness resembles dismantling a bridge. Producing inverted, wrong mind because of illness, cherishing this foul body of pus and blood, and instead damaging the pure Dharma-body is called “losing correct mindfulness.” For this reason, the object of illness should be contemplated.

Furthermore, some people ordinarily enjoy sound health but drift carelessly, linger, and grow indolent. When illness becomes acute, they instead apply mind more intensely and can accomplish many things. Beings differ in faculties and suitability, and some properly awaken within illness. This is taking the four siddhāntas as causes and conditions; therefore the object of illness must be taught.

Contemplation of illness has five sections: first, explaining characteristics of illness; second, explaining the causes and conditions through which illness arises; third, explaining methods of treatment; fourth, explaining harm and benefit; fifth, explaining how to cultivate calming-and-contemplation.

1. Characteristics of Illness

Those thoroughly versed in medicine can skillfully understand the four elements. The best physician listens to sound, the middling physician examines complexion, and the lesser physician takes the pulse. There is no need here to interpret medicine in detail; only its general outline need be known. The pulse concerns the whole medical art and cannot be explained fully here. Only the illness signs of the five viscera are briefly given: a pulse that is surging, large, and straight is a sign of liver illness; light and floating, a sign of heart illness; sharp and thrusting, a sign of lung illness; linked like a string of beads, a sign of kidney illness; heavy and slow, a sign of spleen illness. Fine distinctions are as taught by medical specialists.

If the body is painfully heavy, hardened and aching, withered and numb, weak and atrophied, or emaciated, these are signs of illness of the earth element. If the body is vacuous, swollen, and distended, these are signs of the water element. High heat throughout the body, aching joints, and breathing suddenly fatigued are signs of the fire element. A mind suspended and unsettled, dazed, distressed, and forgetful is a sign of the wind element.

Again, a face without luster and hands and feet without perspiration are signs of liver illness. A blue-gray complexion is a sign of heart illness. A dark, pear-colored complexion is a sign of lung illness. Lack of bodily strength is a sign of kidney illness. Skin rough like wheat bran is a sign of spleen illness.

If a white substance appears over the liver, causing painful eyes, red vessels spreading into white film; if the eyes are damaged, sores arise above or below them, tears flow on meeting wind and cold, or there is itching, stabbing pain, sunken eyes, and frequent anger in response to affairs, this is illness produced when the lungs harm the liver. It can be treated with he exhalation.

If there is faint heat in the heart, hands and feet cold in reverse, vexation and weakness in the chest, dry and cracked lips and mouth, or a mass beneath the navel; if hot food cannot be eaten, while cold food rushes upward against the chest; if there is dizziness, distress, sleepiness, forgetfulness, swelling of the heart, vertigo, slow speech, tightness in the back and shoulder blades, aching limbs, exhaustion of the heart and steaming heat in the body resembling malaria; or if masses or retained water form; if vision seems veiled by cloth so that only near objects are seen and distant ones are not, this is the kidneys harming the heart. It can be treated with chui and hu exhalations.

If the lungs are distended and full, the chest obstructed, both flanks painful, and both shoulder blades ache as though carrying a heavy load; if head and neck are tight, breathing is coarse and can only go out without coming in; if sores cover the body, the throat itches as though containing worms, yet one can neither swallow nor vomit, sores arise in the throat, and the jaws grow rigid; or if wind illness arises, pus and blood flow from the nose, sight grows dim, the bridge of the nose aches, flesh grows inside the nose so breath cannot pass and odors cannot be distinguished, this is illness caused by the heart harming the lungs. It can also arise when cold water and hot food meet and conflict. It can be treated with xu exhalation.

If the hundred vessels do not flow, every joint aches, the body swells, ears become deaf, nose blocked, waist painful, back rigid, and heart and abdomen distended; if qi surges upward and blocks the chest, the limbs are heavy, the face dark and thin, and the bladder region tight, painful, and distressed; if urination dribbles, the urinary passage is obstructed, and feet and knees become cold in reverse, this is the spleen harming the kidneys. In this class of illness, the illness-ghost described by the text resembles the Lord of the Stove, without head or face; when it arrives, it covers the person's body. It can be treated with 𡁱 exhalation.

If wind-itching arises on body and face, the skin becomes rough and scaly, and the whole body itches and feels oppressed, this is the liver harming the spleen. Its appearance is muffled and indistinct, sometimes like a child beating the wood of a stable, sometimes like a whirlwind circling in a mass. It can be treated with 𡀗 exhalation.

Again, constant dullness and sinking mean that the liver lacks the hun soul. Constantly forgetting what came before and after means that the heart lacks spirit. Frequent fear and madness mean that the lungs lack the po soul. Frequent grief or laughter means that the kidneys lack will. Frequent confusion and circling mean that the spleen lacks intention. Frequent despondency and unhappiness mean that the yin lacks essence. These are called “illness characteristics of the six spirits.”

2. Six Causes and Conditions through Which Illness Arises

Illness arises through six causes and conditions: first, illness caused by lack of harmony among the four elements; second, illness caused by immoderate food and drink; third, illness caused by unregulated seated meditation; fourth, ghosts and spirits gaining an opening; fifth, what Māra creates; sixth, illness arising through the force of karma.

Disharmony among the Four Elements

Disharmony among the four elements means performing labor or walking at inappropriate times, relying on strength to carry heavy loads, and what the original text calls 棠觸寒熱, that is, exposure to cold and heat. External heat increases the body's fire; when fire grows strong it damages water, producing illness from an increase of the fire element. External cold increases water; when water increases it harms fire, producing water illness. External wind increases qi; qi stirs fire, and fire in turn stirs water, producing wind illness. Or the three elements other than earth increase and harm earth, which is called “illness of the equal division.” Or what the original calls the 身分 increases and harms the other three elements; this too is illness of the equal division and belongs to earth illness. Once the four elements are disturbed, many sufferings compete to arise.

Immoderate Food and Drink

Immoderate food and drink can also cause illness. Pungent substances such as ginger and cinnamon increase fire; sweet and cooling substances such as sugarcane and honey increase water; pears increase wind; oils, fats, and rich foods increase earth; cucumbers can become causes and conditions for heat illness. These are foods that do not settle the body. Those who eat must distinguish the qualities of food.

After food enters the abdomen, it undergoes what the original calls “locking transformation.” Its coarse and heavy part becomes feces and urine; its refined part “melts and is locked,” flowing from three openings at the waist into the four limbs. The clear part becomes blood and moistens the whole body, like dust receiving water. If blood within the body is insufficient, the body withers and wastes away. The turbid part becomes fat, so former faculties, after declining, become waste while newly formed faculties congeal into flesh.

Again, the body's fire lies below and can “digest what enters the living store,” causing food and drink to “transform and flow,” change, and penetrate the whole body. A common saying states: “If you wish to age and live long, keep the feet warm and the head uncovered.” If bodily fire is above and one also eats food that does not settle the body, illness and distress arise.

Next, the five flavors each benefit and harm the five viscera. Sourness increases the liver and harms the spleen. Bitterness increases the heart and harms the lungs. Pungency increases the lungs and harms the liver. Saltiness increases the kidneys and harms the heart. Sweetness increases the spleen and harms the kidneys. If one knows which viscus has been harmed, one should abstain from the flavor that harms it, eat the flavor that benefits it, and weigh matters attentively oneself.

Unregulated Seated Meditation

Lack of regulation in seated meditation means sometimes leaning against a wall, pillar, or clothing, or lying down before the assembly has left the hall, with mind contemptuous and indolent. Māra thereby gains an opening and makes the spine emaciated and the joints painful. This is called “infusion illness” and is exceedingly difficult to treat.

Next, unregulated breath-counting often produces chronic ailments and contracts the sinews and vessels. If the eight contacts arise but one breathes in a way that conflicts with the contact, illness also occurs. The eight contacts mean that when mind joins the four elements there are four primary contacts and four dependent contacts, making eight: heavy, as if the body sinks downward; light, as if the body rises; cold, as if inside an icy chamber; hot, as if inside a house of fire; rough, as if being pulled backward; smooth, as if polished with oil; soft, as if boneless; coarse, as if the skin has become a husk. Among the eight contacts, four move upward and four downward. Inhalation follows earth and is therefore heavy; exhalation follows wind and is light. Inhalation also follows water and is cold; exhalation follows fire and is hot. Inhalation again follows earth and is rough; exhalation follows wind and is smooth. Inhalation again follows water and is soft; exhalation follows fire and is coarse. If the heavy contact arises but one repeatedly counts exhalations, breath conflicts with the contact that has arisen and illness occurs at once. The remaining contacts are known by analogy.

Again, using only calming without preparatory means can produce illness. Constantly stopping mind in the lower body often stirs earth illness. Constantly stopping mind in the upper body often stirs wind illness. Constantly gathering mind too urgently often stirs fire illness. Constantly loosening mind too broadly often stirs water illness.

Next, unregulated and one-sided use of contemplation can also produce illness. At initial entry into the womb, conceptual mind arises and summons the mother, who then thinks of the five objects—form, sound, odor, taste, and touch. The slightest movement of qi becomes water; water becomes blood; blood becomes flesh; flesh forms the five faculties and five viscera. If seated meditators now think and contemplate excessively, they damage the five viscera and produce illness: excessive conditioning of form stirs the liver; sound stirs the kidneys; odor stirs the lungs; taste stirs the heart; touch stirs the spleen.

Again, the eye excessively conditioning blue stirs the liver; red, the heart; white, the lungs; black, the kidneys; yellow, the spleen. The ear excessively conditioning calls stirs the liver; speech, the heart; crying, the lungs; chanting, the kidneys; singing, the spleen. The nose excessively conditioning rank odor stirs the liver; scorched odor, the heart; raw odor, the lungs; foul odor, the kidneys; fragrant odor, the spleen. The tongue excessively conditioning sour or vinegary taste stirs the liver; bitter taste, the heart; pungent taste, the lungs; salty taste, the kidneys; sweet taste, the spleen. The body excessively conditioning hard touch stirs the liver; warm touch, the heart; light touch, the lungs; cold touch, the kidneys; heavy touch, the spleen. These belong to mutual production among the five viscera; excessive conditioning produces illness.

In terms of mutual overcoming, excessively conditioning white overcomes the liver; black overcomes the heart; red overcomes the lungs; yellow overcomes the kidneys; blue overcomes the spleen. Sounds and the remaining objects are known according to the same rule.

If illnesses of the five viscera are hidden and difficult to know, they can be examined through what appears in seated meditation and dreams. If one often sees blue in meditation or dreams—blue people or beasts, lions, tigers, and wolves—and fear arises from this, it is liver illness. If one often sees red in meditation or dreams—fire arising, red people or beasts, red blades and staffs, young red men and women approaching, embracing, or holding one, or parents, siblings, and others—and joy or fear arises from this, it is heart illness. The remaining viscera are examined by analogy according to the colors seen.

Again, one-sided contemplation disturbs the four elements. If the contemplated object is not stable and one conditions this at one moment and that at another, contention arises within mind. From contention comes chaotic wind, forming wind illness. It resembles walking while leading an infant: one need only follow the child and proceed slowly; if one pulls urgently, hoping for quick arrival, disaster results instead.

If one single-mindedly guards one object while also producing a mind that expects a response, the force of wind and heat cannot be completely removed and heat illness forms. If a contemplated object arises within mind but one instead thinks it has ceased, or it ceases but one instead thinks it is arising, mind and object conflict and produce itching and pain, forming earth illness. If one cannot understand the contemplated object but forces contemplation, the water element increases and water illness forms.

Ghost Illness

The four elements and five viscera are not ghosts, and ghosts are not the four elements and five viscera. When a ghost enters the four elements and five viscera, this is called “ghost illness.” If one says there is no ghost illness at all, deviant shamans who treat every illness as ghost illness can sometimes still effect a cure. If one says there is no illness of the four elements at all, medical formulas that treat every illness with decoctions can sometimes still effect a cure.

There was once a king whose ghost illness originally occupied an empty place and was repeatedly injured by needles. The ghost king came in person and dwelt upon the king's heart; the person holding the needle could only fold his hands and could not insert it. This shows, according to the text, that ghost illness also exists. A ghost does not make someone ill without any cause. In fact, the person produces various wrong thoughts, such as wanting to know good and bad fortune in advance. The Duhuiluo ghost then creates transformations; blue, yellow, and other colors enter through the five faculties, causing wrong understanding to arise in the mental field, and one thereby knows good and bad fortune concerning a person, household, village, or state. This is not the wisdom of a noble one. If untreated, the text says, it will eventually kill the person.

Māra Illness

Māra illness and ghost illness are not wholly different. A ghost merely makes the body ill and kills the body. Māra, however, damages the contemplating mind and the wisdom-life of the Dharma-body, makes wrong thoughts and delusive conceptions arise, and seizes a person's merit; in this it differs from a ghost. This too occurs because a practitioner in seated meditation wrongly thinks of gain and support. Māra then manifests various clothes, food and drink, seven treasures, and miscellaneous objects. After the practitioner receives them and mind rejoices, these objects enter mind and become illness. Such illness is difficult to treat and will be discussed again among the treatments below.

Karmic Illness

Some karmic illness is created exclusively by the force of past-life karma; some occurs when breaking precepts in the present life stirs past karma. Illness formed through karmic force can still be correlated with the offense through the five faculties. The karma of killing becomes illness of liver and eye. The karma of drinking alcohol becomes illness of heart and mouth. The karma of sexual misconduct becomes illness of kidney and ear. The karma of false speech becomes illness of spleen and tongue. The karma of stealing becomes illness of lung and nose. Karma from violating the five precepts makes the five viscera and five faculties ill; only when karmic force is exhausted does the illness heal.

People who keep precepts in this life may also stir past karmic force by keeping them, thereby forming illness. Thus it is said: “If one has grave transgression, a headache can eliminate it; the recompense originally to be undergone heavily in hell is lightly undergone among humans instead.” Illness arises because karmic force is about to be exhausted. Karmic illnesses have many kinds, such as swelling and fullness, jaundice, and weakness. Whenever illness occurs, its source must be searched out and examined attentively before treatment is applied.

3. Distinguishing Treatments according to the Cause of Illness

Treatment should correspond to the different cause of illness. Illness arising from labor, walking, or food and drink must be cared for with formulas and medicine in order to heal. Illness arising from unregulated seated meditation must still be treated within seated meditation by skillfully regulating breath and contemplation; decoctions alone are not suitable. Ghost and Māra illness require profound strength of contemplative practice and great spirit-incantations in order to heal. Karmic illness uses contemplative strength inwardly and repentance outwardly in order to heal. Since treatments differ, their intent must be skillfully grasped; do not take hold of a blade only to cut oneself.

Only six treatments within seated meditation are now explained briefly: first, calming; second, qi; third, breath; fourth, provisional visualization; fifth, contemplation of mind; sixth, techniques.

First Treatment: Calming

Master Wen says: “Fasten mind within an area the size of one bean at the navel. First loosen your clothing, look closely, and acquire the image. Then close the eyes, bring lips and teeth together, raise the tongue toward the upper palate, and make breath harmonious and compliant. If mind races outward, gather it back. If the acquired image cannot be recalled, loosen the clothing and look again, becoming thoroughly familiar with its appearance, then practice as before.” This can treat various illnesses and also produce many meditative concentrations.

While making this contemplation, immeasurable kinds of contact can also occur: sometimes pain like a needle prick, sometimes tightness like a rope pulling, sometimes itching like an insect bite, sometimes cold like water being poured, sometimes heat like fire burning. When these contacts arise, one should be single-minded and diligent without falling back. If one can pass beyond them, various meditative concentrations can arise. If spirit and thought are quiescent and unmoving, this is the characteristic of lightning samādhi. If this can even enable attainment of dhyāna, how could it fail to heal illness?

Mind is fastened at the navel because breath emerges from the navel and returns to enter there, its coming and going both bounded by the navel; from this, impermanence is readily awakened to. Furthermore, when a person enters the womb, consciousness-spirit first joins with blood, and the umbilical cord is attached at the navel. The navel connects and sustains life and is also the source of intestines and stomach. Tracing this source reveals the body's impurity and calms greed and desire. Contemplating the navel through the four establishments of mindfulness can become an entrance to the establishment of mindfulness of body. When cultivating the six wondrous gates, the navel is also the gate of calming and can concurrently become an entrance to the path. This method is therefore often used.

When calming is formally used to treat illness, this passage calls the cinnabar field the sea of qi and says that it can “lock away and swallow myriad illnesses.” If mind is stopped at the cinnabar field, breath becomes harmonious; this is the meaning in which it can cause illness to heal.

Another teacher says: “For upward qi with a full chest, painful flanks, a tight back, pain at the shoulder well, heat and distress in the heart, vexation and inability to eat, swelling of the heart, cold below the navel, heat above and cold below, disharmony of yin and yang, and qi-cough—these twelve illnesses—all stop mind at the cinnabar field.” The cinnabar field lies two and a half inches below the navel. If pain is urgent, move mind to the point Three Miles. If the pain still does not cease, move it above the transverse line of the nails of the two big toes until healing occurs.

Headache, red and painful eyes, heat in lips and mouth, swellings beside the nose, sudden abdominal pain, deafness in both ears, and rigidity of the neck—these six illnesses require placing a contemplated object between the feet and fixing mind upon it. If the abdomen soon becomes swollen, full, tight, and painful with water, remain single-mindedly focused on that object. If mind becomes vexed, rest briefly; when one can bear it again, resume cultivation, relying heavily on the preceding method. If some relief is felt, treatment must continue. If this produces tightness and pain in waist and feet, imagine a pit one fathom deep beneath the feet, move the former object to the bottom of the pit, and guard it with mind; the illness will naturally heal. Practice should occur in a quiet room.

Again, constantly stopping mind at the feet can treat every illness. Why? The five consciousnesses are all in the head, and mind constantly conditions upward. Mind drives wind, wind stirs fire, fire melts water, and water moistens the whole body. The upper body is therefore regulated while the lower becomes disordered, producing many illnesses and sometimes causing the feet to contract or become lame. The five viscera also resemble lotuses, gently facing downward. Conscious mind mostly conditions upward, so qi forcefully strikes the organs, overturning and damaging them and producing illness. If mind conditions downward, it causes fire to flow downward, allowing food and drink to undergo “locking transformation” and the five viscera to become regulated. Stopping mind at the feet is therefore described as an excellent treatment. The text says it was repeatedly used with profound benefit and was often effective when used to treat others; Jiang, Wu, Mao, and others are cited as examples.

Again, one can follow each site of illness in the body and stop mind there exclusively and attentively. If no other object is conditioned for three days, the text says, all will heal. Why? Open a door and wind enters; close the shutters and wind becomes still. Mind conditioning external objects resembles opening a door; stopping mind at the painful site resembles closing it. According to its principle and enumeration, it should be so. Mind also resembles a king and illness a thief. When mind abides here, the thief scatters and is defeated.

Yet mind need not always be stopped only at the site of illness. The Secret Method of the August Emperor says: “The two qi of heaven and earth join, each possessing the five phases metal, wood, water, fire, and earth, cycling like a ring. Thus metal transforms and produces water; water flows and wood flourishes; wood moves and fire shines; fire blazes and earth becomes firm—this is mutual production. Fire meets water and loses its light; water meets earth and cannot flow; earth meets wood and forms swelling and sores; wood meets metal and is cut and injured—this is mutual overcoming.” For example, metal overcomes wood. When the lungs are strong and the liver weak, stop mind at the lungs and take up white qi; the text says the liver illness will heal. The other four viscera are understood by analogy.

Again, calming treats illnesses of the four elements as follows: urgent calming treats water illness; relaxed calming treats fire illness; stopping mind at the crown treats earth illness; stopping mind at the feet treats wind illness.

Second Treatment: Qi

Treating illness with qi means using the six qi 吹, 呼, 𡁱, 呵, 噓, and 𡀗. All six are exhaled and inhaled between the lips, accompanied by movements of teeth and tongue. Move mind slowly and carefully, performing the qi together with provisional visualization.

For bodily cold use 吹, as when blowing a fire. For bodily heat use 呼. For pain in the hundred joints use 𡁱, which also treats wind. For vexation, fullness, and qi surging upward use 呵. For phlegm use 噓. For labor and weariness use 𡀗.

To treat the five viscera with the six qi: 呵 treats the liver; 呼 and 吹 treat the heart; 噓 treats the lungs; 𡁱 treats the kidneys; 𡀗 treats the spleen. All six can also jointly treat one viscus. If that viscus is cold use 吹; if hot use 呼; if painful use 𡁱; if vexed and full use 呵; if there is phlegm use 噓; if fatigued and weary use 𡀗. The other four viscera are treated likewise.

Again, blow qi from the mouth to remove cold, then slowly draw warm qi through the nose, entering gently without collision. Do this seven times in one sitting, then settle mind. After settling mind briefly, treat again with qi; this is formal application of the treatment. If ordinarily only expelling foul qi, once or twice is sufficient. Exhale 呼 through the mouth to remove heat and inhale coolness through the nose. Make 𡁱 through the mouth to remove pain and wind and draw peaceful qi through the nose. When using 呵 through the mouth to remove vexation, lower qi, and disperse phlegm, imagine phlegm in the upper chest leaving through the mouth and phlegm in the lower part flowing down with breath, so nothing need be replenished through the nose. 噓 removes fullness and distension, with what the original calls “peaceful locking” inside the nose. 𡀗 removes fatigue; draw harmonious qi through the nose to replenish and nourish. Exhalation and inhalation must both be attentive and not excessive. If one weighs them skillfully so increase and decrease are appropriate, the text says one can treat not only oneself but also assist others.

Third Treatment: Breath

Form body and mind depend on each other and thereby have breathing, just as firewood and fire depend on each other and thereby have smoke. From smoke's clarity or turbidity one can know whether the wood is rank or damp. By observing whether breathing is forceful or gentle, one can test whether the body is healthy or ill. If bodily movement produces chaotic wind, causing pain and itching, how could there be leisure to apply mind? It must be treated quickly.

First know that breathing has four accompanying characteristics. With sound it is called wind; guard it and mind scatters. Congealed and obstructed, it is called qi; guard it and it becomes still more obstructed. Unable to enter and leave completely, it is called panting; guard it and one grows fatigued. Only when it is soundless and unobstructed, entering and leaving completely, is it called breath; guard it and concentration can be attained.

One should find a quiet place, sit in full lotus, make the body level and upright, relax it, extend the four limbs, and arrange all the bones and joints so they correspond without leaning or bending. Loosen the belt, turn left and right, and adjust into comfort. Place the left hand upon the right, allowing the two thumbs merely to touch slightly. Relax the cheeks, open the mouth a little, and exhale at length four or five times. Then gradually straighten the head and slowly close the eyes without pressing the lids tightly, keeping the gaze dimly and slightly open. Only then use the breath.

Breath treats illness produced when the eight contacts conflict. If the heavy contact produces earth illness, preferentially use exhalation. If the light contact produces wind illness, preferentially use inhalation. If the cold contact produces water illness, preferentially use exhalation. If the hot contact produces fire illness, preferentially use inhalation. The remaining contacts are handled likewise. Once they are harmonized and equal, breathing can be used as one wishes. What is used here is ordinary breath used in counting breaths, not another kind newly created.

Next, separately use twelve breaths: rising breath, descending breath, scorching breath, filling breath, increasing breath, dissolving breath, cooling breath, warming breath, thrusting breath, sustaining breath, harmonizing breath, and replenishing breath. All twelve accompany provisional visualization. Why? At the first thought of entering the womb, one already has breath obtained as retribution. The fetus gradually grows with the mother's breath. Once pathways of wind become open and smooth, the fetus's breathing no longer enters and leaves with the mother's. After birth, when each occupies a separate place, each possesses its own breath. This is called “retributive breath.” Dependent breath is breathing that arises dependent upon mind. When anger or thoughts of desire arise, for example, breath flourishes. This is called “dependent breath.” The preceding six qi add provisional visualization to retributive breath; the present twelve add provisional visualization to dependent breath and therefore differ from the preceding.

The preceding text says that conditioning the five colors produces illnesses of the five viscera. Such illness arises dependent upon the five viscera, so dependent breath is now used to treat it. Rising breath treats heavy earth illness. Descending breath treats suspended wind illness. Scorching breath treats distension and fullness. Filling breath treats withering and emaciation. Increasing breath can grow the four elements; non-Buddhists who ingest qi presumably ingest only this growing qi. Dissolving breath disperses phlegmatic films. Cooling breath treats heat. Warming breath treats cold. Thrusting breath treats abdominal masses, swellings, and toxins. Sustaining breath treats agitation and unrest. Replenishing breath nourishes deficiency and fatigue. Harmonizing breath integrates the four elements. When making each breath, one causes it to accomplish what mind imagines. One must know the illnesses in detail and use the corresponding breath without error.

Fourth Treatment: Provisional Visualization

The preceding treatments of qi and breath already include provisional visualization. Visualization alone is now used to treat illness. Examples are Master Bian's method of treating a goiter, the needle method for someone with an abdominal mass, the method of using “warm ghee” in the Āgamas to treat depletion, and the method of swallowing the snake〔and so forth〕.

Fifth Treatment: Contemplation of Mind

Contemplation of mind treats illness without provisional visualization or special breathing. It directly contemplates this one thought of mind. Sought inwardly or outwardly, mind cannot be obtained. Who, then, is pressed by illness, and who undergoes it?

Sixth Treatment: Techniques

Techniques seem distant when unknown and immediate once known. Examples include methods for treating the throat and teeth and pinching the big toe to treat the liver〔and so forth〕. Techniques are shallow and immediate and largely belong to what the original calls “displayed illusion.” Monastics do not need them and originally should not study them; if already learned, they should be quickly relinquished. Yet when cultivating the four kinds of samādhi, this fragile, foam-like body is uncertain in harm and benefit. Temporarily borrowing techniques to treat illness, settle the body, and preserve practice of the path should not be blamed. But using techniques to solicit reputation, pursue gain, and agitate worldly custom is Māra's illusion and fraud. Cast it off quickly! Cast it off quickly!

If thirty-six beasts disturb a person, the text directs reciting the incantation three times:

波提陀　毘耶多　那摩那　吉利波　阿違婆　推摩陀　難陀羅　憂陀摩　吉利摩　毘利吉　遮陀摩

When subtle mind is first attained, an external object may suddenly touch mind, startling and throwing it, so breath surges upward, the abdomen distends, the chest becomes oppressed, and the head aches and grows dull. The text explains this as the six spirits roaming throughout the body and losing their guarded places when startled and thrown; external harmful spirits enter the body and seize their dwellings, producing these symptoms. Its treatment is to close the mouth and contract the nose so qi cannot leave. Once qi fills the entire body, release it in a long exhalation; from head to foot, imagine the whole body expelling breath and draw it until completely exhausted. Do this three times and then recite the incantation:

支波晝　烏蘇波晝　浮流波晝　牽氣波晝

After reciting it three times, regulate breath and count from one through ten, directing exhalation and inhalation with the words 阿那波那，阿晝波晝. The text says the illness then heals.

The ancient painful treatment recorded here states that if one suffers red or white dysentery, is suddenly struck by a harmful influence, has a blue complexion, rolled-back eyes, blackened lips, and cannot recognize people, one forcefully pinches and presses the cinnabar field by hand and strikes the painful place on the body forty or fifty times with a staff. The original then asks its own intent and says that no illness is not made by mind. When sorrow and anxious thought are present in mind, harmful qi gains an opening. Pain presses the mind so it has no leisure for wayward delusive thought; harmful qi then departs and the illness disappears.

4. Harm and Benefit

Both harm and benefit have gradual and sudden forms. Overusing breath so that the five viscera suddenly overturn is sudden harm. Even if they do not suddenly overturn at first, the condition can gradually intensify until they finally overturn; this too is harm progressing from gradual to sudden. Some who cultivate skillfully suddenly obtain immediate benefit; this is sudden benefit. Others temporarily remain at a stalemate with illness and heal only gradually afterward. It resembles taking a decoction and gaining benefit step by step over months and years. Inner treatments are the same. Sharp mind with light illness, sharp mind with grave illness, dull mind with light illness, and dull mind with grave illness produce the differences of gradual benefit, sudden benefit, gradual harm, and sudden harm.

Worldly medicines consume both wealth and labor. Their flavors are bitter and astringent, difficult to swallow, and accompanied by many prohibitions. People who cherish life and care for the body still calculate whether to take them, in what the original calls 死計將餌. These inner treatments cost not a coin, take not half a day of labor, bring no anxiety over bitterness in the mouth, and permit food and drink as one wishes, yet people uniformly refuse to practice them. Ordinary people cannot distinguish treasure; few can harmonize with a song in a high mode. I grieve deeply over this.

If ten principles are complete, the text says, good results will necessarily occur. The ten are: first, faith; second, application; third, diligence; fourth, constancy; fifth, distinguishing illness; sixth, preparatory means; seventh, duration; eighth, knowing what to retain and discard; ninth, knowing how to care and protect; tenth, recognizing coverings and obstructions.

Faith is the source of the path and the first gate of entry into the Buddha-Dharma. It resembles the person treating leprosy who believed blood to be milk, or someone revering camel bone as a true śarīra. One must now firmly believe that this method can treat this illness without doubt. Yet faith without application still brings no benefit, like holding a sharp sword without using it against raiders and instead being harmed by them. Failure to apply a treatment is the same.

Why is diligence necessary? During the first, middle, and last watches and morning and evening, one must be single-minded and diligent until perspiration appears. Stop halfway while drilling wood for fire and fire is difficult to obtain. Lack of diligence is the same.

What is constancy? Continuously apply the treatment, with every thought abiding on the object without disturbance. What is distinguishing illness? Discern the cause from which illness arose, as explained above. If illness is not recognized and a treatment is applied recklessly, treatment and illness do not correspond and no actual benefit occurs.

What are preparatory means? Skillfully apply the treatment so exhalation and inhalation each find their place and visualization can be accomplished without losing what is suitable. It resembles zither strings that can be loose or tight. Pegs and bridges must be adjusted repeatedly, and the fingers press and pluck with varying force, before sound and rhythm become harmonious.

What is duration? If applying a treatment has not yet brought benefit, continue practicing without interruption, regardless of days or months. What is knowing what to retain and discard? If something benefits, apply it diligently; if it harms, change the treatment. What is knowing how to care and protect? Know the various prohibitions well and do not violate them in walking, standing, going and coming, or food and drink. What is recognizing coverings and obstructions? If treatment brings benefit, do not speak noisily about it. If it has not yet brought benefit, do not doubt or slander it. The text says that if one tells others, an illness not yet healed will fail to heal; even if already healed, it will recur. After recurrence, further treatment again will not heal it; even if it does, twice the effort is required.

If the ten principles are complete and the preceding treatments applied, the text says benefit is certain beyond doubt. The treatise concludes with “guaranteeing and undertaking,” saying that this ultimately will not be false.

Mohe Zhiguan, Fascicle Eight [Upper].

Mohe Zhiguan, Fascicle Eight [Lower].

Taught by Great Master Zhizhe of Tiantai in the Sui.

Recorded by his disciple Guanding.

If one skillfully cultivates the four kinds of samādhi with fitting regulation, the treatise says that by power of the path one will necessarily be free of the various illnesses. Even if there is slight conflict, an “unseen blade” will support one and illness naturally dissolve and heal. Suppose many obstructions arise together like mountain peaks: the text establishes the extreme vow of “casting oneself toward death and sacrificing life.” Even if only the faint breath of a remnant life remains, one vows to complete practice in the place of awakening. Once the mind of relinquishment is determined, what transgression cannot be extinguished and what karma cannot be changed? The examples of Chen's needles and Kaishan〔and so forth〕 follow. It then asks in return: could there still be four elements or five viscera that cannot be harmonized and healed?

It resembles Śakra's palace, which minor ghosts reverently avoid. The place of awakening has great spiritual power and does not permit delusive and deviant influences to intrude. It also resembles a strong governor whose city guards are strong; when the governor is timid, the guards panic. Mind is the body's master, and gods of the same name, gods born together, and other spirits can protect people. When mind is firm, guardian spirits are strong. If bodily spirits are already so, how much more the spirits of the place of awakening? It is also like the story told when the Great Treatise explains diligence, in which a ghost sticks to five parts of the body〔and so forth〕. One need only single-mindedly cultivate samādhi, and the text says the various illnesses will be removed.

5. Cultivating Calming-and-Contemplation through the Ten Dharmas

Cultivation of calming-and-contemplation is likewise divided into ten dharmas according to the preceding pattern〔and so forth〕. First, set aside the conceivable object. Illness as a cause and condition can produce mental practices of the ten Dharma realms.

Some people regress from their original mind because of illness, abandon meditative concentration, and slander the Three Treasures. They do not consider the illness a calamity evoked by previous evil karma but instead say cultivating goodness brings no blessed recompense, producing a great wrong view. Others cherish body and preserve life by eating fish, meat, pungent foods, and drinking alcohol without restraint, and by eating at improper times. After illness heals and the body grows strong, they may indulge the five desires. Wholesome mind completely disappears, evil karma blazes, and they create transgressions of upper, middle, and lower grades. This is creating the three evil Dharma realms because of illness.

If someone reflects that the suffering of this illness was evoked entirely by former unwholesomeness, deep shame and conscience arise and one no longer dares to do evil. Even while sunk in grave illness and pain, wholesome mind does not change, and wholesome conduct of upper, middle, and lower grades arises. This is creating the three wholesome Dharma realms because of illness.

If illness causes fear of birth and death and one knows that this ill body is repaying past karmic force, one asks: if more karma of birth and death is created, where will future wandering end? Suffering and accumulation are dangerous and fragile, accompanying one from life to life and making one suffer without cease. One should therefore seek the quiescent and signless nirvāṇa. This is illness producing the śrāvaka Dharma realm.

Again, contemplate this illness. It is one's form body and mind that are ill, and because of this illness they will finally decline, age, and die. Death exists because of birth; birth because of past existence; existence arises from grasping, grasping from craving, craving from feeling, feeling from contact, contact from the six sense fields, and the six sense fields from name and form. Form means the four elements and five faculties; name means the four minds.

Then contemplate from what the five faculties and four elements arise. Blue arises from wood, yellow from earth, red from fire, white from wind, and black from water. Further contemplate wood arising from water, water from wind, wind from earth's yang qi, earth from fire, fire from wood, and wood returning again to arise from water. Pursued in this way, the cycle revolves without end and no dharma can arise from itself. As the external five phases are so, the colors of the internal five viscera are likewise: the liver arises from blue qi, the heart from red qi, the lungs from white qi, the kidneys from black qi, and the spleen from yellow qi.

Ask again: Does this liver arise from itself or from another thing? One then knows that the liver arises from the kidneys, kidneys from lungs, lungs from spleen, spleen from heart, and heart from liver. The liver cannot arise from itself and returns to arising from the kidneys. Seeking inwardly through the four elements and five viscera in this way, since all lack intrinsic substance, why does the body not disintegrate? Because four minds sustain it: consciousness-mind sustains earth, perception-mind sustains wind, feeling-mind sustains fire, and formations-mind sustains water. Therefore the body does not disintegrate.

Ask again: Do the four minds arise from themselves or not from themselves? One then knows that formations-mind arises from feeling-mind, feeling-mind from perception-mind, perception-mind from consciousness-mind, consciousness-mind from past formations, past formations from ignorance, ignorance from delusive conception, and delusive conception again from delusive conception.

A scripture says: “Delusive conception gives rise to delusive conception, revolving through the twelve links of dependent origination.” It resembles a mad and thirsty person who sees a shimmering mirage, takes it for water, and chases southward. Unable to find water, he shouts “Water!” and an echo answers from the sky. Thinking he has traveled far past the south and that water must lie northward, he turns and runs north. He chases in all four directions but finds nothing. In extreme distress, he supposes that the water has burrowed into the ground, claws the earth, and roars in search of it. Exhausted, he finally tumbles into darkness and still finds no water.

Running south represents the tongue faculty pursuing the object of taste. Running north represents the ear faculty pursuing sound. Running west represents the nose pursuing odor. Running east represents the eye pursuing form. Clawing the ground represents the body pursuing touch. Entering darkness represents mind pursuing ignorance. In this way the six faculties run everywhere after the six objects. Not one object can be obtained, nor is the true mark of the conjunction of causes and conditions attained; one only exhausts oneself and suffers.

After becoming aware, the person no longer runs. Because there is no running, body and mind settle. Once mind settles, understanding suddenly opens and correct wisdom concerning causes and conditions arises. One knows that form, mind, and other dharmas have been intrinsically quiescent from the beginning, neither arising nor ceasing. Only through inverted delusive conception are they said to arise and cease. If one no longer follows delusive conception, ignorance ceases, through to aging and death ceasing. Past karma is completed and new karma is no longer created, like ceasing to light a fire and therefore having no smoke. Since ignorance and aging and death are unobtainable, whom could illness make ill? This is contemplating illness and producing the pratyekabuddha Dharma realm.

Again, contemplate that this illness brings many sufferings because one cherishes body, life, and wealth. It also comes from incomplete moral discipline, producing frequent illness and short life; from weak and timid resolve, unable to endure patiently, so bodily spirits do not come to protect one; from weak diligence, with no wholesome dharma to assist in dispelling calamity; from lack of meditative concentration, so illness disturbs one; and from little wisdom, unable to penetrate impermanence, suffering, emptiness, and nonself, so the body is bound by this illness.

From one's own illness one now sympathizes with the illness of other beings, thereby producing loving-kindness and compassion and arousing vows and practice. Relinquish everything without stinginess, endure peacefully in accord with correct principle, apply mind correctly and diligently, and awaken to impermanence. This is illness producing the bodhisattva Dharma realm of the six perfections.

Again, contemplate this illness and know that it arises from inverted delusive conceptions and many afflictions in former lives. These delusive conceptions have no true intrinsic nature; both self and nirvāṇa are empty. This is illness producing the bodhisattva Dharma realm of the Shared Teaching.

Again, contemplate this illness as ultimately empty. Although empty with nothing undergone, one still undergoes the various feelings. Since Buddha-Dharma is not yet complete, feeling should not be extinguished in order to grasp realization. This is illness producing the bodhisattva Dharma realm of the Distinct Teaching.

The various dharmas above arise sequentially because of illness and are called the “conceivable object.” They are not the object directly contemplated now.

First Mode: Contemplating the Inconceivable Object of Illness

The inconceivable object means contemplating one thought of ill mind as neither real nor truly existent, but itself Dharma-nature and the Dharma realm. All dharmas converge upon this one dharma of illness, and no dharma surpasses it. There is only the whole Dharma realm, without distinctions among the remaining nine realms. It resembles a wish-fulfilling jewel, neither empty nonexistence nor real existence, with neither before nor after. Illness is likewise: beyond speech, apart from all characteristics, quiescent and pure, and therefore called “inconceivable.” After penetrating the real limit of illness, what is there to rejoice over and what to grieve? While making this contemplation, illness suddenly disappears and heals.

The Suvarṇaprabhāsa Sūtra says: “Simply hearing this statement, illness is removed and healed.” This is the meaning of the first contemplation. It also says: “Others with deep and grave illnesses difficult to cure came to the elder's dwelling; the elder compounded many medicines for them, and only then did their illnesses heal.” This is the meaning of the subsequent nine contemplations.

Second Mode: Genuinely Arousing the Mind of Loving-Kindness and Compassion

All beings possess this principle in full but cannot recognize it. They follow the current of delusions of views and thought and sink into the great sea of fragmentary birth and death. A bodhisattva feels profound compassion for them and wishes to give them the joy of the truths of path and cessation in which what is not existent is immediately empty. This is an ill bodhisattva regulating one's own mind through contemplation of emptiness. Once mind is regulated, real illness heals; because of loving-kindness and compassion, expediently manifested illness arises again. Born in the land of fragmentary birth and death, the bodhisattva sees people in fragmentary birth and death as an only child. When the child is ill, the parents become ill together and use their own bodily illness to console the child. When the child's illness heals, the parents' illness also heals. This is called “the ill bodhisattva who consoles beings through the two contemplations of embodying and analyzing dharmas.”

Again, contemplate this illness as itself empty and quiescent, yet know that beings are not all liberated through contemplation of emptiness alone. One should therefore recognize the many Dharma gates within emptiness and illness. Because śrāvakas and pratyekabuddhas do not know these gates, they follow the current of ignorance and lack of knowledge, sink into the great sea of transformational birth and death, and cannot distinguish the different categories of illness. Buddha-Dharma therefore cannot appear, nor can beings and pure lands be accomplished.

For this reason the bodhisattva arouses loving-kindness and compassion, removes the suffering of lack of knowledge, and gives the joy of wisdom of the varieties of the path, which skillfully distinguishes. This is an ill bodhisattva regulating one's own mind through contemplation of the provisional. Once mind is regulated, real illness heals; because of loving-kindness and compassion, expedient illness arises again. Born in the land of expedient means, the bodhisattva sees people in that land as an only child. When the child is ill, the parents become ill together and use their own bodily illness to console the child. When the child's lack of knowledge heals, the parents' illness also heals. This is called “the ill bodhisattva in the Distinct Teaching who consoles beings.”

Again, contemplate this illness as itself the Dharma realm, yet know that beings cannot immediately accord with the Middle Way. This principle has not yet become manifest, and beings follow the current of ignorance and sink into the great sea of transformational birth and death. Scripture says: “The three worthies and ten nobles abide in retribution.” These are causal and resultant illnesses in the land of true recompense. For this reason the bodhisattva arouses loving-kindness and compassion, removes the suffering of ignorance, and gives ultimate joy. This is an ill bodhisattva regulating one's own mind through contemplation of the Middle Way. Once mind is regulated, real illness heals; because of loving-kindness and compassion, expedient illness arises again. Born in the land of true recompense, the bodhisattva sees people in transformational birth and death as an only child. When the child is ill, the parents become ill together and use their own bodily illness to console the child. When the child's ignorance heals, the parents' illness also heals. This is called “the ill bodhisattva in the Perfect Teaching who consoles beings.”

These three illnesses arise in one mind; the three forms of regulation are regulated through one contemplation; the three forms of loving-kindness and compassion are perfectly universal loving-kindness and compassion; the three manifestations are the universal-gate manifestation; and the three consolations are teaching in one voice. They are distinguished as above for ease of understanding. In terms of reality, they are themselves inconceivable loving-kindness and compassion.

Only the layman Vimalakīrti fully possesses this Dharma: three real illnesses perfectly removed and three expedient illnesses universally manifested. Few could exchange questions and answers with this person of highest virtue. Kings and elders still possessed all their real illnesses and could not bear his charge. Practitioners of the two vehicles, though they had removed grasping at characteristics, declined to go. Bodhisattvas had only slightly removed adventitious afflictions and would often be subdued by him. Only Mañjuśrī's power of the path approached his, enabling him to strike the capacity and receive the intent, and therefore to go.

Mañjuśrī asks: “Householder, from what cause and condition does this illness arise? How long has it existed? How should it cease?” The householder replies: “My present illness arises from great compassion. Because beings are ill, I am ill; when beings' illness heals, my illness heals.”

Beings' real illness arises from delusion and craving. As soon as delusion and craving arise, great compassion arises with them; as soon as delusion and craving cease, great compassion also ceases. Some beings have healed and some have not. Bodhisattvas likewise sometimes manifest illness and sometimes do not. When a bodhisattva no longer has illness, one knows the child's illness has healed. If illness remains, the work of transformation has not stopped. The inquiry after illness in the square chamber and back pain at Maocheng have this meaning.

Since the bodhisattva's vow equals empty space, the illness manifested also fills the Dharma realm. This is called “inconceivable loving-kindness and compassion.” Its power is so vast that as soon as the bodhisattva arouses this mind, illness heals without waiting to cultivate the subsequent dharmas. The examples of Faxi and Tiantai follow〔and so forth〕. If arousal of mind is insincere, deceiving beings and seeking gain through the Three Treasures, illness will not heal. Genuine honesty has great power.

Third Mode: Skillfully Settling the Mind

When practitioners become ill in the place of awakening, they embody and understand the object of illness and arouse the great mind as above. Then they straighten the body, abide in correct mindfulness, cultivate only calming and only contemplation, and skillfully regulate through the four siddhāntas so that everything is appropriate. In a single sitting they feel cool and refreshed. Illness decreases either suddenly or gradually. This is called “great medicine,” and one no longer chaotically changes to other treatments.

Fourth Mode: Pervasively Breaking through Dharmas

When practitioners are ill, they contemplate whether the form body is ill or mind is ill. If form itself were illness, external forms such as mountains and forests should all be ill and corpses should undergo illness. Yet corpses and forests never experience illness and distress, so form should be known not to be illness. It is only through thought within mind that one reckons this illness truly exists.

Now contemplate ill mind. It arises neither from itself, another, both self and other, nor without cause; none of the four alternatives can be obtained. It is neither within nor without and is ultimately pure. Mind is like empty space: who is ill? The Vimalakīrti Sūtra says: “It is not the earth element and does not depart from the earth element. It does not combine with the body because the body's characteristics are unobtainable; nor does it combine with mind because mind is like an illusion.” The arising of ill mind cannot be obtained, and its non-arising likewise cannot be obtained. Both arising and non-arising and neither arising nor non-arising likewise cannot be obtained. Single, repeated, and complete propositions are as explained above when breaking the object of the aggregates and sense fields.

Fifth Mode: Discerning Passage and Obstruction

When contemplating the dharma of illness, discern the four truths, twelve links of dependent origination, and six perfections within every proposition. Whether contemplating illness or wisdom, discern the four truths, twelve links, and six perfections within every proposition, distinctly and without doubt. Understand “letter” and “non-letter,” know what is attainment and what loss, all as explained above.

Sixth Mode: Regulating the Factors of the Path

If one contemplates illness as precisely the four elements, illness is impure. If illness departs from the four elements, it is pure. If illness is neither the four elements nor apart from them, it is neither pure nor impure. Existence and the true, nonexistence and the non-true, emptiness and provisionality, neither emptiness nor provisionality, withering and flourishing, neither withering nor flourishing—all these meanings do not differ from the establishment of mindfulness of body.

Contemplated in this way, feelings in illness are neither suffering nor pleasure; perceptions and formations in illness are neither self nor nonself; ill mind is neither permanent nor impermanent, all known by analogy with the preceding meanings. The thirty-seven factors of the path can all be accomplished while lying ill upon bed and pillow. Knowing suffering while there is no suffering, one enters the cooling pool.

Seventh Mode: Counteraction and Aids to the Path

If illness has still not healed while cultivating correct contemplation, borrow the six treatments explained above: calming, qi, breath, provisional visualization, contemplation of mind, and techniques. Primary and auxiliary practices cultivated together can even enable entry into the path; how could they fail to remove bodily illness?

Eighth Mode: Knowing the Stages

While making this contemplation, although still confined to bed and pillow, know one's present stage deeply. The principle I contemplate with regard to illness is distinctly present, like beryl sunk at the bottom of a deep pool. But my present contemplative wisdom is only at the stage of name. Causal illness has not yet been removed; “resultant illness belongs to its division” refers separately to the stage to which resultant illness belongs.

At the stage of semblance-understanding, causal illness becomes slightly lighter and the mind of the path more mature; resultant illness remains heavy, and various calamities still cannot be avoided. If one realizes patience with non-arising, causal illness is exhausted, yet resultant illness can remain. One should not become arrogant before reaching a corresponding stage and claim one's ill conduct equals that of persons of highest virtue.

Ninth Mode: Patient Endurance

Diligently cultivate primary and auxiliary practice without being obstructed and stopped by inner or outer conditions. The original reads 答正助稽留，疾成道廢; the graph 答 is retained according to the base text, and punctuation remains undecided. It is not corrected to 若 in the vernacular layer. If mind can abide in illness without moving or retreating, what must be done can be accomplished.

Tenth Mode: Freedom from Attachment to Dharmas

Even if illness has diminished and contemplative practice become clear, do not thereby produce greedy attachment or defiled love. When all ten dharmas are accomplished, one swiftly enters the Dharma stream. This is called cultivating Great Vehicle contemplation within the object of illness, attaining patience with non-arising and obtaining one great carriage. The rest can be known by analogy with the preceding〔and so forth〕.

If Having a Body Is Already Illness, How Can Illness Become a Separate Object?

Question: The treatise opens by saying, “Having a body is itself illness.” If a body is already inseparable from illness, is illness not simply part of the aggregates, sense fields, and elements? Why establish it as a separate object?

Answer: Four snakes sharing one place do not become one snake; water and fire dwelling together still oppose one another. Owls sharing a roost and pythons and rats inhabiting one hole describe sharing a place while differing in nature. Four neighboring states describe temporary peace while powers are equal and annexation when one exploits a weakness. The body may ordinarily appear stable, but the four elements have not thereby ceased to conflict; their powers merely hold one another temporarily. The object of illness appears in the interval between this “temporary harmony” and “exploiting a weakness.”

The treatise therefore does not first promise a body that will never decay and then treat illness as an accidental event. It sees burden in the body's very constitution. A poisonous vessel holds poison; a heavy load continually presses the shoulders; a thicket of suffering is where many sufferings gather. Before illness arises, the four elements hold one another; when illness arises, their incompatibility becomes manifest. Practice need not wait until the body recovers to some ideal state, because the body one is waiting for has always stood between rest and unrest, increase and decrease.

Yet illness further divides into real and expedient. Vimalakīrti relied on illness to raise the teaching, and the Tathāgata entrusted himself to extinction to discuss permanence: they guided beings by manifesting illness. The illness contemplated in this object is the illness genuinely undergone by a body born through karmic retribution. Distinguishing expedient and real first prevents a noble one's manifestation from being taken as an ordinary person's already-realized object, and prevents ordinary suffering from being beautified as accomplished transformation of others. The place where practice can begin now lies only in this ill body that one is undergoing, that is abolishing cultivation, and that is also pressing one to apply mind.

Since Illness Obstructs the Path, How Can It Instead Intensify One's Application of Mind?

Question: Illness can damage cultivation. Why does the treatise also say that if it can be contemplated, it instead increasingly benefits application of mind? Are these two statements not opposed?

Answer: Illness can indeed become a great obstruction. It can make one destroy precepts like puncturing the flotation bladder that crosses the sea, lose concentration like dismantling a bridge over a river, and cherish a foul body of pus and blood, producing wrong inversions and forgetting the pure Dharma-body. Illness is not naturally a spiritual friend. If it merely carries one away, one may destroy moral discipline, damage concentration, produce wrong inversion, and ruin the pure Dharma-body.

Yet relaxed indolence during health often postpones the great matter of birth and death. Acute illness instead places impermanence directly before one. Some people therefore apply mind more intensely and accomplish what they ordinarily could not. Illness becomes an object not because pain itself possesses merit but because the practitioner turns to contemplate. The same illness can make someone regress or awaken, cherish only body and life or see their impermanence.

A great tree needing ten thousand axe-blows to fall and a massive rock needing a hundred million strikes to be pierced illustrate repeated explanation for those who have not yet penetrated. If patient endurance has already been penetrated through the preceding object, illness can be illuminated as soon as it comes, without renewed discussion. If it has not, another axe-blow and another strike are required. Repetition does not change to a different path; it enables the same calming-and-contemplation to pass through this hard layer of illness.

Why Do the Five Sections First Discern Illness and Only Then Cultivate Calming-and-Contemplation?

Question: Since calming-and-contemplation is the purport, why not directly contemplate mind? Why first discuss characteristics and causes of illness, treatments, and harm and benefit?

Answer: The treatise first establishes five sections: characteristics of illness, causes of illness, methods of treatment, harm and benefit, and calming-and-contemplation. This order prevents “contemplation” from becoming a slogan that flattens differences. Pulses differ as surging and straight, light and floating, sharply thrusting, linked like beads, or heavy and slow. Bodies differ as painfully heavy and hardened, vacuous and swollen, blazing hot and aching, or suspended, dazed, and distressed. Mutual harm among the five viscera further unfolds different signs in eyes, mouth, chest and flanks, waist and knees, skin, and elsewhere. Although the medical art is not exhausted here, characteristics of illness must still be known briefly; treatment cannot be applied at will before any distinction is made.

The six causes of illness press the differences another step deeper. Disharmony of the four elements, immoderate food and drink, unregulated seated meditation, ghosts and spirits gaining an opening, what Māra creates, and what karmic force produces cannot be mixed into one cause. Treatments for labor, walking, and food do not substitute for those for dysregulation in seated meditation. Ghost, Māra, and karmic illnesses likewise each have the counteractions established by the treatise. “First know the source, then apply treatment” is the joint hinge preserved by the first four sections.

This also shows that the final section does not escape the preceding four. If one does not know what method is being used, why it is used, or whether it brings harm or benefit, so-called application of mind readily becomes another form of dysregulation. When calming-and-contemplation enters the object of illness, it does not cancel discerning illness; it gives discerning illness, applying treatment, and contemplating mind each its place.

Why Are the Causes of Illness Traced All the Way to the Mind's Object?

Question: Among the six causes, the range is already broad, from cold, heat, and food to ghosts, Māra, and karma. Why does unregulated seated meditation further divide into the eight contacts, stopping mind above or below, five colors and five sounds, and even what is seen in meditation and dreams?

Answer: Because seated meditation is not merely “sitting.” Leaning against a wall or pillar and lying down before the proper time concern bodily deportment and contemptuous indolence. Breath-counting conflicting with the eight contacts is a mismatch between breathing and tactile feeling. Stopping mind too low, too high, too urgently, or too loosely is bias in calming. Shifting the contemplated object from one thing to another, exclusively guarding one thing, mistaking arising for ceasing, or forcing an uncorresponding contemplation is bias in contemplation. Body, breath, calming, and contemplation can each become dysregulated layer by layer.

The treatise matches each of the objects form, sound, odor, taste, and touch to the five viscera, then lists blue, red, white, black, and yellow; calling, speech, crying, chanting, and song; rank, scorched, raw, foul, and fragrant odor; sour, bitter, pungent, salty, and sweet taste; hard, warm, light, cold, and heavy touch. It reveals that where mind goes and how excessively it goes are not wholly unrelated to the body. Excessive conditioning can produce one-sided movement.

The simile of walking with an infant reveals this most clearly. One need only follow the child's steps. Pull urgently in hopes of arriving early, and harm instead results. An unstable contemplated object naturally produces contention and chaos, but single-mindedly guarding an object while expecting a response can likewise trap wind and heat within it. Deviations in practice do not occur only during indulgence; they can also occur through excessive effort and an urgent demand for results.

Why Is No One of the Six Treatments Supreme?

Question: The treatments are calming, qi, breath, provisional visualization, contemplation of mind, and techniques. Since contemplation of mind can seek inwardly and outwardly and see mind as unobtainable, why retain all the preceding treatments?

Answer: Different causes of illness require different applications. Care with formulas and medicines cannot replace regulation of breath and contemplation within seated meditation, and regulation within seated meditation cannot replace every formula or medicine. The same holds within the six treatments. Calming has different objects, including the navel, cinnabar field, soles, and site of illness. Qi has the six forms 吹, 呼, 𡁱, 呵, 噓, and 𡀗. Breath first distinguishes wind, qi, panting, and breath; then it discusses inhalation and exhalation in relation to the eight contacts and separately twelve breaths accompanied by visualization. Provisional visualization, contemplation of mind, and techniques each have their own uses.

The similes of door and wind, king and thief state the principle of stopping mind directly. When a door opens, wind arrives; when it closes, wind is still. When the king is settled, the thief disperses. Yet the treatise immediately adds that mind need not be stopped only at the site of illness. This turn prevents the simile from being grasped as a fixed Dharma. Urgent calming, relaxed calming, stopping at the crown, and stopping at the feet face different conditions. The six qi likewise require increase and decrease to be weighed among cold, heat, pain, vexation, phlegm, and weariness. The crucial matter is not an impressive name for a treatment but whether it directly corresponds to the illness.

The section on techniques makes selection still clearer. To protect the four samādhis, temporarily settle a fragile, foam-like body, and preserve practice of the path, a technique may be borrowed. If it is used to solicit reputation and gain or startle worldly society, it should be abandoned immediately. The same technique, according to the mind that uses it and the end toward which it is directed, may become a preparatory means protecting the path or descend into Māra's illusion. The six treatments are not six abilities for display but six classes of method that must be situated according to illness, time, harm, and benefit.

What Do the Ten Principles of Harm and Benefit Regulate?

Question: If the treatments have already been listed, why separately explain harm and benefit and further add ten principles such as faith, application, diligence, and constancy?

Answer: Because the same treatment, applied to different people, different degrees of illness, and in different ways, can produce gradual or sudden results, harm or benefit. Sharp mind with light illness, sharp mind with grave illness, dull mind with light illness, and dull mind with grave illness cannot all be summarized by saying merely “it was used.” Excessive use of breath can suddenly overturn the five viscera; before sudden overturning, it can also gradually intensify. Through skillful cultivation, some people suddenly benefit, while others recover step by step like taking medicine over years.

The ten principles place treatment back within long-term practice. Faith without application resembles holding a sharp sword but not using it against thieves. Diligence without constancy resembles stopping midway while drilling wood for fire. Applying treatment recklessly without recognizing illness cannot correspond directly to it. Without preparatory means, one resembles a zither string still too loose or tight to produce harmonious sound. Without knowing what to retain and discard, one keeps what harms and stops what benefits. Without knowing how to care and protect, one's movements and food violate the prohibitions anew. Faith, application, diligence, constancy, distinguishing illness, preparatory means, duration, retaining and discarding, care and protection, and recognition of coverings and obstructions together regulate both the method and the person using it.

The two images of zither strings and drilling for fire concern measure and continuity respectively. Continuity without measure may overapply a treatment; measure without continuity cannot penetrate chronic illness. The ten principles therefore do not add ten more treatments outside the six. They enable the six to be applied correctly and continuously, with harm and benefit understood.

How Do the Four Samādhis Return the Ill Body to the Place of Awakening?

Question: After the fascicle title reappears, the treatise again speaks of the four kinds of samādhi, support by the “unseen blade,” and not sparing body or life. How does this relate to the preceding treatments of illness?

Answer: The preceding discussion does not establish “absence of illness” as the highest result of practice. If the four samādhis are cultivated skillfully and fittingly regulated, power of the path and support by the “unseen blade” can lessen the obstruction of illness. Even if obstructions rise like peaks, practitioners still vow to complete the place of awakening. The body should be cared for, but does not become a reason to retreat from vows. Body and life may be protected, but are not worth exchanging for the work of the path.

When the governor is strong, the defenders are strong; when the governor is timid, they panic. Mind is the body's master, so the treatise finally returns protection to one mind. Śakra's palace makes lesser ghosts respectfully withdraw; a ghost sticking to five places still cannot make a diligent person stop the mind. Both images place the emphasis on non-retreat. The purpose of treating illness is not to make one revolve around illness forever but to settle the body and preserve the path. If illness remains, one still does not abandon the place of awakening.

How Can the Same Illness Produce the Ten Dharma Realms?

Question: Upon reaching cultivation of calming-and-contemplation, why does the treatise first explain the ten Dharma realms produced because of illness, yet then say these are not the object of correct contemplation?

Answer: Because illness itself does not decide a person's direction. Some people lose their original mind because of illness, slander the Three Treasures, indulge food and the five desires to sustain life, and create the three evils from illness. Others recollect that illness was evoked by former unwholesomeness, produce profound shame and conscience, and preserve wholesome mind even in extremity, creating the three kinds of goodness from illness. Some fear birth and death because of illness and seek quiescent nirvāṇa. Others contemplate backward from aging and death through birth, existence, grasping, craving, feeling, contact, six sense fields, and name and form, then from the four elements and five viscera to the four minds, past formations, ignorance, and delusive conception, producing correct wisdom of dependent origination.

The crazed and thirsty person pursuing a mirage is the longest simile in this passage. Mistaking shimmering heat for water, he chases south without finding it, hears an echo and runs north, pursues all four directions, then claws the ground and enters darkness, only exhausting himself. Tongue pursues taste, ear sound, nose odor, eye form, body touch, and mind ignorance. The six faculties run after the six objects like the madman chasing water, with nowhere truly able to yield what is sought. Only when running stops do body and mind settle; only when they settle does correct wisdom of dependent origination arise.

Others feel compassion for other people's illness because of their own and arouse the vows and practices of the six perfections. Some contemplate illness and delusive conception as both empty. Some know ultimate emptiness yet do not rush to extinguish feeling and grasp realization. These realm-minds arising sequentially from illness all have cause and result that can be explained and sequences that can be discerned; they are therefore called the conceivable object. They are distinguished first in order to see clearly how illness can draw mind in ten directions. Correct contemplation cannot stop in any one direction.

What, Ultimately, Does the Inconceivable Object of Illness See?

Question: If the three evil, three wholesome, two-vehicle, and three bodhisattva realms are all not correct contemplation, must correct contemplation seek a pure mind elsewhere, apart from illness?

Answer: It seeks nothing else. This one thought of ill mind is neither real nor existent and is itself Dharma-nature and the Dharma realm. All dharmas converge on the object of illness, and not one leaves the Dharma realm. This does not expand illness into the one real existence. The substance, before and after, and fixed characteristics of illness are all unobtainable. A wish-fulfilling jewel falls into neither emptiness nor existence and is neither before nor after. Ill mind likewise cuts off speech, leaves characteristics, and is quiescent and pure.

“Having penetrated the real limit of illness, what is there to rejoice or grieve over?” does not mean bodily feeling henceforth lacks suffering and pleasure. It means what is contemplated is no longer locked within the two extremes of joy and grief. Illness removed merely by hearing one sentence is the simile of the first contemplation. Grave illness healed only by compounding many medicines is the simile of the continuous accomplishment of the remaining contemplations. The first contemplation does not cancel the subsequent nine dharmas, nor do the subsequent nine seek another object apart from the first.

The inconceivable therefore does not make illness mysterious. It refuses to fix ill mind as form, as mind, or as arising from self, other, both, or no cause. Mountains, forests, and corpses do not undergo illness and distress, so form itself is not illness. Seek ill mind inwardly and outwardly, and none of the four alternatives can be obtained. Illness is still being undergone, but a fixed intrinsic nature of the one who undergoes and of ill mind cannot be obtained. Correct contemplation unfolds at this point of neither escape nor fixation.

Why Do All Three Contemplations Occur between Parents and an Ill Child?

Question: Emptiness, provisionality, and the Middle are contemplations of dharmas. Why does the treatise repeatedly say in every contemplation that when the child is ill, the parents are ill too?

Answer: Because regulating one's own mind is not the end of correct contemplation. All beings possess this principle yet cannot recognize it, and a bodhisattva therefore produces compassion. To regulate mind through contemplation of emptiness is to see beings following the stream of views and thought into the sea of fragmentary birth and death and wish to give the joy of the path and cessation of emptiness. To regulate through contemplation of the provisional is to see practitioners of the two vehicles unable to distinguish the various Dharma gates and wish to remove the suffering of lack of knowledge and give the joy of wisdom of the varieties of the path. To regulate through contemplation of the Middle is to see beings unable immediately to enter the Middle Way and wish to remove the suffering of ignorance and give ultimate joy.

Within each contemplation, real illness is removed because mind is regulated, while expedient illness arises because of loving-kindness and compassion. The parents do not become ill through ignorance of illness, nor can they merely stand on the shore and watch. When the child is ill, the parents enter the child's condition with a body sharing the illness. When the child's illness heals, the parents' illness heals. Here illness changes from private suffering into shared responsibility, and contemplation from self-regulation into consolation of beings.

The three illnesses arise in one mind; the three forms of regulation are regulated through one contemplation; the three forms of loving-kindness and compassion are perfectly universal; the three manifestations are the universal-gate manifestation; the three consolations are teaching in one voice. They were divided into three for ease of understanding. What they actually indicate is inconceivable loving-kindness and compassion. The exchange between Mañjuśrī and Vimalakīrti states this completely: illness arises from great compassion; because beings are ill, the bodhisattva is ill; when beings heal, the bodhisattva heals. While beings' delusion and craving remain unexhausted, the path of transformation does not rest. As vows equal empty space, manifested illness fills the Dharma realm.

How Are All Ten Modes Practiced upon the Sickbed?

Question: When bodily strength declines in illness, how do the ten modes of contemplation avoid becoming only a sequence on paper?

Answer: After arousing mind, first settle mind skillfully. Straighten the body, establish correct mindfulness, cultivate only calming and only contemplation, and regulate appropriately. In one sitting one feels cool and refreshed; whether illness decreases suddenly or gradually, one is no longer drawn away by disorder. Next, investigate and break the dharma of illness. If form itself were illness, forests and corpses should also undergo illness. If illness is only reckoned by mind, contemplate the four alternatives of ill mind as unobtainable and inner and outer as empty. It is not the earth element and does not depart from the earth element; it combines neither with body nor mind.

Then discern the four truths, dependent origination, and six perfections within every proposition and know passage and obstruction, attainment and loss. Regulate the factors of the path through purity, impurity, and double negation so that all thirty-seven can be accomplished upon bed and pillow. If correct contemplation does not remove illness, borrow the preceding six treatments as auxiliary practice. Primary and auxiliary are practiced together, without mistaking auxiliary for correct contemplation or refusing auxiliary because of correct contemplation.

Beryl at the bottom of a deep pool is the image for knowing stages. Principle can be distinctly seen without one's hand already having reached it. Contemplative wisdom at the stage of name cannot be passed off as semblance-understanding, much less as patience with non-arising. The gradual lightening of causal illness does not mean resultant illness has appeared. Resultant illness can still occur after entry into non-arising, but this does not mean an ordinary person's real illness is already a noble one's manifestation. Because beryl is visible, one does not belittle oneself. Because the deep pool still intervenes, one does not become proud.

Finally come patient endurance and freedom from attachment. Inner and outer obstructing conditions cannot make primary and auxiliary practice stop. The diminishing of illness and clarification of contemplation cannot make one cling to what has been attained. If one remains unmoving and non-retreating amid illness, the task is accomplished. If attachment does not arise when contemplation becomes clear, the ten dharmas are genuinely complete. The opening had a poisonous vessel, heavy burden, and thicket of suffering; the conclusion obtains one great carriage. This does not decorate the ill body as treasure. It means illness no longer merely drags one toward regression and the practitioner can instead swiftly enter the Great Vehicle Dharma stream.

Through the Eye of the Fuxing

The first crucial distinction Zhanran makes line by line is to bring the distinction between expedient and real illness into the object of correct contemplation. Vimalakīrti and the Tathāgata's manifested illnesses are expedient; what is actually contemplated here is real illness produced by increase and decrease among an ordinary person's four elements. He further matches the opening four snakes, owls, pythons, and rats one by one to the four elements and gathers poisonous vessel, heavy burden, and thicket of suffering under suffering of the aggregates. These line-by-line correspondences illuminate the flow of the text without replacing the original forms of the treatise's similes.

Regarding why the teaching is repeated, Zhanran judges the great tree and ten thousand axes, massive rock and hundred million strikes as “because dull faculties and grave illness require repeated discernment of contemplative practice”〔T1912 0397c15〕. He further gathers destruction of moral discipline, damage to concentration, and production of wrong inversion under the three trainings, expressly recording, “moral discipline and concentration are as in the text; from ‘producing wrong inversion’ onward is loss of wisdom”〔T1912 0397c23〕. These are judgments of the Zhiguan Fuxing Chuanhong Jue and are not inserted retrospectively as the treatise's direct speech.

Within the sequence of five sections, Zhanran especially preserves “briefly know the characteristics of illness in order to recognize illness and apply treatment.” Pulse signs of the five viscera indicate only that one viscus is too strong or too weak and are not identical with the later mutual overcoming among the five viscera. Characteristics of illness among the six spirits are expressly judged to rely on secular accounts and are not elevated to scriptural proof. Lack of regulation in seated meditation unfolds through bodily deportment, the eight contacts conflicting with breath, excessive use of calming, and one-sided contemplation. Ghost and Māra both gain openings through wrong thought, yet injure body and life versus the contemplating mind. These divisions prevent the six causes from being kneaded into one.

Among the six treatments, Zhanran distinguishes the six voiced qi from retributive and dependent breath, situates the twelve breaths as arising dependent upon mind and accompanied by visualization, and supplements from an older recension the events of treating a goiter, the golden needle, warm ghee, and swallowing a snake. The two phonetic passages are judged only to be incantations, whose function is explained through the counteractive siddhānta; no Sanskrit is invented from their sounds. Only at the mode of aids to the path are the earlier calming, qi, breath, provisional visualization, contemplation of mind, and techniques regathered as auxiliary practice when correct contemplation has not removed obstruction. The six treatments can assist the correct but do not replace correct contemplation.

For harm and benefit, Zhanran gathers the body into four propositions: sharp mind and light illness is sudden benefit; sharp mind and grave illness gradual benefit; dull mind and light illness gradual harm; dull mind and grave illness sudden harm. He further divides the lower-fascicle passage on the four samādhis into the four intentions of power of the path, unseen aid, methods of treatment, and not sparing body or life. One group distinguishes results from applying treatments, the other protection at the place of awakening, preventing “illness healed” and “path accomplished” from being confused as one measure.

At the head of the ten modes, Zhanran distinguishes the two events in the Suvarṇaprabhāsa Sūtra: illness removed merely by hearing reveals the first contemplation, while many medicines treating grave illness reveal the subsequent nine modes beginning with arousal of mind. Each of the three contemplations of consolation contains four levels—self-regulation, compassionate manifestation of birth, receiving benefit within manifested birth, and conclusion establishing the contemplation's name—and finally remains gathered in one mind. He explains the great medicine for settling mind as “only quiescence and only illumination, seeking nothing else,” and points out that treatment through the ultimate meaning simultaneously carries unconditioned loving-kindness and compassion. Quiescence and illumination do not separate; regulating mind and feeling compassion for beings do not separate.

Within the sequence of consolation through three contemplations, Zhanran distinguishes three real illnesses as views and thought, lack of knowledge, and ignorance, and situates the places where expedient illness appears within the three lands of fragmentary birth and death, expedient means, and true recompense. After distinguishing them, he still gathers them through the three contemplations in one mind and loving-kindness and compassion in one mind. Parents falling ill with their child therefore do not establish another cause of illness. They mean that a bodhisattva manifests shared activity according to the level of beings' delusion. He also reads Mañjuśrī's inquiry after illness as directly striking this capacity: great compassion arises along with delusion and craving, and the path of transformation does not rest while beings remain unhealed. Manifested illness in the square chamber and back pain at Maocheng are thereby both included within the textual current of great compassion responding through illness.

Regarding arousal of mind amid illness, Zhanran does not call every forceful endurance a genuine great mind. If one deceives beings and seeks something by exploiting the Three Treasures, one remains in falsehood. Only the power of sincere arousal of mind can remove illness without awaiting subsequent dharmas. This distinction connects to settling mind below: first inconceivable loving-kindness and compassion determine its direction; then quiescence and illumination regulate mind, without seeking reputation or results as a substitute for arousal of mind.

Thereafter, pervasively breaking through dharmas traces illness as reckoned by mind and investigates its causal accomplishment and continuity. The factors of the path unfold in sequence according to the inversions broken, the truth-object conditioned, the wisdom that contemplates, and what the Dharma gate represents. Knowledge of stages distinguishes beginning and end through the six identities: the presence or absence of bodily illness cannot alone determine realization, and distinctly seeing principle at the stage of name cannot be promoted into a claim of realization. Although patient endurance and freedom from attachment receive no long commentary, they must still be established in the original sequence of the ten modes. The great carriage at the end marks the complete accomplishment of all ten dharmas, not certification based on reduction of illness alone.