止觀輔行傳弘決 8.20

8.20

次正釋中，文自為五。初病相中，先略明辯脈所以中云「診」者，候脈也。云「今不須精判」等者，不須如向上中下醫委論脈法。今略明之。脈者血氣所行道也。夫脈法者本在醫道，非可具知，今須略知五藏之相而用治法。四時脈相者，春絃、夏洪、秋浮、冬沈、土王四季，用對五行五藏相生相剋以辯脈相。略明候法者，從魚至貫名為尺澤，即大拇指後、大橫文前名之為魚，大橫文後名之為貫。貫後三寸名為寸口，尺後寸前名為關陽。肝心出左，脾肺出右。左腎為命門，右腎為命根。肺脈來時如順榆葉曰平，如風吹毛曰病，如連珠者曰死。心脈來時如管曰平，如連珠曰病，前曲後直如帶鉤曰死。肝脈來時薄弱曰平，如張弓弦曰病，如雞蹈地曰死。脾脈來時阿阿如綖曰平，如雞舉足曰病，如鳥啄水漏曰死。腎脈來時微細而長曰平，如彈石曰病，如解索曰死。諸脈暫大復小為陰，暫小復大曰陽。然諸候體文中易了，而指下難明。今且略知，未煩委悉。今文明五藏相者，非是相生亦非相剋，但當藏太增而成於病。如木性多直，今太洪直。次大性升，今多輕浮。金性堅利，今太尖銳。水性流注，今則滴瀝。土性堅澁，今太沈重。或性過分致病，或衰弱故而致患也。若相剋者，準五行可知。從「面無光澤」下，五藏體減故致成病。木主肝，若枝葉枯燥是木之病，故無光澤等如木無潤。火主心也，火若失色不赤是火之病，故面青皅而成病也。金主肺，肺色白而今色黑，是肺病也。水主腎，流處壅滯令體無力，故腎病也。土主脾，如堆阜不平，即脾病也。從「肝上有白物」去，五行相剋，故五藏病生，故用六氣治於五藏。治法應在下治法中，今文對此略明為便，故預列之，後文治中不復更出。然此六氣但取呼吸帶聲出氣為治，亦不全用字體為義。如「吹」者，亦云冷氣。次「噓氣」者，云出氣。「呼」者，煖氣也。「𡁱呵𡀗」此三，全無此之字體，但有「譆」字，即痛聲也，但須呼吸。聲似五音，即屬五藏，還治五藏。用者應於牙齒唇舌調停出聲，使不失五音。呵屬商，吹呼屬羽，噓屬徵，𡁱屬宮，𡀗屬角，五行對之以屬五藏。今並用本藏上氣以治本藏，所以用本藏者，既剋他藏令他藏病，故用本氣牽歸本藏，不令害他。如肺害肝是金剋木，還用肺氣收取金行，餘之四藏準此可知。「淋」字亦應作痲。「其病鬼如竈君」者，秖是黑色耳。腎被脾害即成腎病，病鬼還隨本藏之色，故如竈君。第一本中具約五色明五藏鬼，今文但略於腎藏明之。準文次第，應在病因緣中，即鬼病也，文隨便故寄此中列。次釋脾云「其色籠桶」者，應云黃籠桶也。從「有多惛惛」去，是六神病相。此準俗說，故一神各守一藏，王於六根。陰是身之根本，通於五藏五根。如《經律異相》中云「昔有國王令人覓師子𮙬，如其不得當斷汝命。懼王命故處處求覓，得師子𮙬送來上王。中道睡臥，六根六神各諍其功。目神言：『由我視故，知師子𮙬處。』耳神言：『由我聽故，知師子𮙬處。』足神言：『由我至故，能取是𮙬。』手神言：『由我捉持，得師子𮙬。』鼻神言：『由我嗅故，得師子𮙬。』諸神皆言舌最無功，舌神不伏倍索其功。有一羅漢因行遇見是人神諍，恐王錯殺，即隨𮙬者以至王所。𮙬者前至，王問𮙬者：『為是師子𮙬不耶？』答云：『不真。』王令殺之。羅漢具為大王說之，其人免死。」彼文本喻處眾之人各伐其功，則無德之人最為尤害。此喻雖似各有根神，非他有情。

Next, in the correct explanation, the text is divided into five parts. First, in [the section on] the characteristics of disease, as for what is stated in the brief explanation of the rationale for diagnosing the pulse, 'diagnosis' (zhen) means examining the pulse. As for what is said about 'now there is no need to discriminate with precision' and so forth, there is no need to exhaustively discuss the pulse methods of superior, middling, and inferior physicians as mentioned above. Now it is explained in brief. The pulse is the pathway traversed by blood and qi. The pulse method originally belongs to the medical arts and cannot be fully known [here]; now it is only necessary to briefly know the characteristics of the five viscera in order to apply therapeutic methods. Regarding the characteristics of the pulse in the four seasons: in spring it is wiry, in summer flooding, in autumn floating, in winter sunken, and earth dominates the four seasonal intervals; these are correlated with the mutual generation and mutual overcoming of the five elements and five viscera to discern the characteristics of the pulse. To briefly explain the method of examination: from the 'fish' (yu) to the 'crossbar' (guan) is called the chize; that is, behind the thumb and before the large transverse crease is called the 'fish', and behind the large transverse crease is called the 'crossbar'. Three inches behind the crossbar is called the cunkou, and behind the chi and before the cun is called the guanyang. The liver and heart appear on the left; the spleen and lungs appear on the right. The left kidney is the gate of life (mingmen), and the right kidney is the root of life (minggen). When the lung pulse arrives, if it is smooth like elm leaves, it is called normal; if like wind blowing on hair, it is called diseased; if like a string of beads, it is called death. When the heart pulse arrives, if it is like a pipe, it is called normal; if like a string of beads, it is called diseased; if curved in front and straight behind like a belt hook, it is called death. When the liver pulse arrives, if faint and weak, it is called normal; if like a drawn bowstring, it is called diseased; if like a chicken treading the ground, it is called death. When the spleen pulse arrives, if soft and gentle like thread, it is called normal; if like a chicken lifting its foot, it is called diseased; if like a bird pecking or water leaking, it is called death. When the kidney pulse arrives, if subtle, fine, and long, it is called normal; if like a snapping stone, it is called diseased; if like an unravelling rope, it is called death. If any pulse is temporarily large and then small, it is yin; if temporarily small and then large, it is called yang. However, these examination entities are easy to understand in the text, but difficult to discern under the fingers. Now they are known merely in brief, without needing to be troublesome in detail. Now, when the text explains the characteristics of the five viscera, it is neither mutual generation nor mutual overcoming; it is merely that a given viscus excessively increases and thereby develops into a disease. For instance, the nature of wood is mostly straight; now it is excessively surging and straight. Next, the nature of fire is to ascend; now it is mostly light and floating. The nature of metal is hard and sharp; now it is excessively pointed and sharp. The nature of water is to flow and pour; now it trickles drop by drop. The nature of earth is hard and astringent; now it is excessively heavy and sinking. Either an excess in its nature causes disease, or because of its debility it brings about illness. If it is mutual overcoming, it can be understood in accordance with the five elements. From 'the face lacking luster' downward, it is because the substance of the five viscera is depleted that disease is caused. Wood governs the liver; if the branches and leaves are withered and dry, it is a disease of wood; therefore, lacking luster and so forth is like wood lacking moisture. Fire governs the heart; if fire loses its colour and is not red, it is a disease of fire; therefore, the face turning blue-black develops into disease. Metal governs the lungs; the colour of the lungs is white, but now its colour is black, which is a disease of the lungs. Water governs the kidneys; when its flowing passages are obstructed and congested, causing the body to lack strength, it is a disease of the kidneys. Earth governs the spleen; if it is uneven like mounds and hillocks, it is a disease of the spleen. From 'there being white matter upon the liver' onward, the five elements mutually overcome one another, and thus diseases of the five viscera arise; therefore, the six qi are used to treat the five viscera. The therapeutic methods should belong to the section on therapeutic methods below; now, for convenience, the text explains them briefly in correspondence to this, and so they are listed in advance and will not be brought up again in the later treatment section. However, these six qi merely utilize breathing accompanied by vocalized exhalation for healing; they do not entirely rely on the written characters for their meaning. For instance, 'chui' is also called cold breath. Next, 'xu-qi' is called exhaled breath. 'Hu' is warm breath. As for these three—'xi', 'he', and 'si'—there are no such character forms at all, but there is only the character 'xi' (譆), which is a sound of pain; one merely needs to breathe. When the sound resembles the five musical notes, it corresponds to the five viscera, and in turn treats the five viscera. The practitioner should modulate and emit the sound between the teeth, lips, and tongue so as not to lose the five notes. 'He' belongs to shang; 'chui' and 'hu' belong to yu; 'xu' belongs to zhi; 'xi' belongs to gong; 'si' belongs to jue; the five elements correspond to them so as to correlate with the five viscera. Now, the ascending qi of the original viscus is utilized throughout to treat the original viscus. The reason for using the original viscus is that since it overcame another viscus and caused that other viscus to become diseased, the original qi is used to draw it back to its original viscus and not let it harm the other. For example, when the lungs harm the liver, this is metal overcoming wood; the lung-qi is used in turn to gather back the element of metal. The remaining four viscera may be understood by analogy with this. The character 'lin' (淋) should also be written as 'ma' (痲). 'Its disease-ghost is like the Kitchen God' means merely that it is black in color. When the kidneys are harmed by the spleen, it develops into kidney disease; the disease-ghost corresponds to the color of the original viscus, and is therefore like the Kitchen God. The first version [of the text] comprehensively explains the ghosts of the five viscera according to the five colors; the present text merely explains it briefly regarding the kidney viscus. According to the order of the text, it should be in [the section on] the causes and conditions of disease, namely ghost-induced diseases; because it is convenient for the text, it is lodged and listed here. Next, explaining the spleen, it says 'its color is indistinct' (longtong), which should be 'indistinctly yellow'. From 'there being much confusion and stupor' onward, these are the characteristics of disease of the six spirits. This follows worldly accounts, whereby one spirit each guards one viscus and rules over the six sense-faculties. The aggregates are the foundation of the body and pervade the five viscera and five sense-faculties. As it says in the Jinglü yixiang: 'Formerly, there was a king who commanded a man to search for a lion's tail-tuft, saying: "If you do not obtain it, I shall take your life." Fearing the king's command, he sought everywhere, obtained the lion's tail-tuft, and was bringing it to present to the king. Resting and asleep halfway along the road, the six sense-faculties and six spirits each disputed their merits. The eye spirit said: "Because I looked, I knew the place of the lion's tail-tuft." The ear spirit said: "Because I listened, I knew the place of the lion's tail-tuft." The foot spirit said: "Because I arrived, I was able to take this tail-tuft." The hand spirit said: "Because I seized and held it, we obtained the lion's tail-tuft." The nose spirit said: "Because I smelled, we obtained the lion's tail-tuft." The various spirits all said that the tongue had the least merit, but the tongue spirit refused to submit and demanded double the merit. There was an arhat who, while traveling, happened to see this person's spirits disputing; fearing the king would execute him mistakenly, he followed the tail-tuft bearer to the king's place. When the tail-tuft bearer stepped forward, the king asked the tail-tuft bearer: "Is this a lion's tail-tuft or not?" [The tongue spirit] answered, "It is not genuine." The king ordered him killed. The arhat explained the matter fully to the great king, and the man escaped death.' That original text was an analogy for people dwelling in a community who each boast of their own merit, in which case a person without virtue is the most harmful. Although this analogy appears as if each faculty has its own spirit, they are not separate sentient beings.