藥師經疏 1.101

1.101

經。或有眾生至是為初橫　三辨文分為二。一徵。二結。就初文中文分為九。一醫治失御。二柱被王刑。三放逸亡魂。四火來焚燒。五津流所溺。六逢獸亡生。七飢餒受終八起屍相損。九山崖墜落。此則初也。得病非重等者。以無資緣故而便致死。或後醫人療治失所者。依金光明經第七卷說。流水問父。云何當知四大諸根衰損代謝而得諸病。時父持水而答其子。三月是夏。三月是秋。三月是冬。三月是春。是十二月三月而說。從如是數一歲四時。若二二說足滿六時三三本攝二二現時隨是時節消息飲食是能益身。醫方所說隨是歲中諸根四大代謝增損令身得病。有善醫師隨順四時。三月將養調和六大隨病飲食及以湯藥。問如是諸病何時當發。答多風病者憂則發動。其熱病者秋則發動。等分病者冬則發動。其肺病者春則增劇。問。諸病若增云何對治。答。有風病者。憂則應服肥膩醎酢及以熱食。有熱病者。秋服冷甜。等分分服甜酢肥膩。肺病春服肥膩辛熱。問。諸病源由因何而起。答。飽食然後則發肺病。於食消時則發熱病。食消已後則發風病。如是四大隨三時發。問。諸病相多食復當云何。答。風病羸損補以蘇膩。熱病下藥服呵梨勒。等分應服三種妙藥。所謂甜辛及以蘇膩。肺病應服隨能吐藥。問。若風熱病肺病等分違時而發當何療治。答。應當任師籌量隨病飲食湯藥。由師失疫不順醫方遇違緣故非時而死。故宋本云。有病不治。又不修福湯藥不順針灸失疫不值良醫為病所困於是滅亡。又法華經第二卷說。若修醫道順方治病。更增他疾。或復致死。若自有病無人救療。設服良藥而復增劇。所患雖輕實不應死而便橫死。是為初橫。

Sūtra: "There may be sentient beings... this is called the first untimely death."
Three: the detailed exposition has two parts: first, the examination; second, the conclusion. In the first part, the text is divided into nine:
1. Medical treatment mishandled;
2. Injustice of royal execution;
3. Heedlessness and loss of soul;
4. Fire burning;
5. Drowning in waters;
6. Meeting wild beasts and losing life;
7. Starvation leading to death;
8. Harm by vetālas;
9. Falling from cliffs.
This is the first. Regarding "contracting an illness that is not severe," etc.: because of the lack of supportive conditions, death results. Regarding "or afterwards a physician mishandles the treatment": according to the seventh fascicle of the Suvarṇaprabhāsa Sūtra, Jalavāhana asked his father: "How is one to know the decline, wear, and transition of the four great elements and sense organs, whereby illnesses are contracted?" At that time the father, holding water, answered his son: "Three months are summer; three months are autumn; three months are winter; three months are spring. These are spoken of as twelve months in groups of three months. Counted in this way, one year has four seasons. If spoken of in pairs, they make a full six seasons. The groups of three originally subsume them, while the pairs are the manifest seasons. Adapting drinks and food according to these seasons benefits the body. What the medical treatises speak of is that in accordance with the transition, increase, and decrease of the sense organs and the four great elements throughout the year, the body is afflicted with illness. A good physician follows the four seasons: over three months, he nurtures and harmonizes the six elements, adapting drinks, food, and medicinal decoctions to the illness."
Question: "When do these various illnesses break out?"
Answer: "Those with predominant wind illnesses have them break out when grieving. Those with heat illnesses have them break out in autumn. Those with balanced [humour] illnesses have them break out in winter. Those with lung illnesses have them grow severe in spring."
Question: "If the various illnesses increase, how should they be remedied?"
Answer: "Those with wind illnesses, when grieving, should take rich, salty, sour, and hot food. Those with heat illnesses, in autumn, take cold and sweet food. For balanced [humours], take sweet, sour, and rich food. For lung illnesses, in spring, take rich, pungent, and hot food."
Question: "From what origins and causes do the various illnesses arise?"
Answer: "After eating to fullness, lung illness breaks out. When the food is being digested, heat illness breaks out. After the food is digested, wind illness breaks out. In this way, the four great elements break out according to the three periods."
Question: "When the symptoms of illness are numerous, what should the diet be?"
Answer: "For wind illness and emaciation, tonify with ghee and rich foods. For heat illness, use purgative medicine and take harītakī. For balanced [humours], one should take three kinds of wondrous medicine, namely sweet, pungent, and ghee. For lung illness, one should take medicine that induces vomiting as appropriate."
Question: "If wind, heat, lung illness, and balanced humours break out out of season, how should they be treated?"
Answer: "One should let the physician deliberate and adapt food, drink, and medicinal decoctions to the illness."
Due to the physician's failure to check the disease and not following medical rules, encountering contrary conditions, one dies untimely. Therefore the Song version says: "Having an illness and not treating it, nor cultivating merit; medicinal decoctions not conforming [to the illness], acupuncture and moxibustion failing to check the disease, not meeting a good physician; overwhelmed by illness, one thereby dies." Furthermore, the second fascicle of the Saddharmapuṇḍarīka Sūtra says: "If one practices the medical way and treats illness according to the prescriptions, it only increases other sicknesses, or even brings about death. Or if having an illness oneself, with no one to rescue and treat it, even if taking good medicine, it increases in severity." Although what one suffers from is light, one really should not die, yet one meets an untimely death. This is the first untimely death.