Attending the Sick
This gate opens not with a rule but with a story: an idle, unpopular monk falls ill and lies neglected until the Buddha himself comes, asks why he suffers alone, and answers by washing away his own disciple's filth with his own hands — the single act from which every later rule about attending the sick descends. From that founding scene the compendium moves outward: who exactly is obligated to look after the sick, the "Impermanence Hall" built to receive the dying before an image of Amitābha, and finally the discipline of speaking the Dharma to someone whose life is actually ending — with a mind gathered and undistracted, never scattered by trivial talk.
1. Milestone: The Buddha's Own Precedent — Founding This Practice by His Own Hand
This first chapter, "Establishing the Intent," explains why the Vinaya bothers to legislate something as ordinary as nursing the sick at all: because ordinary human affection, left to itself, reliably fails exactly the people who need it most. Dao Xuan states the problem in a single unsparing line — people draw close to the healthy and abandon the sick — and then Yuan Zhao's commentary supplies the scene that answers it: the Buddha, in his own lifetime, personally washing an unpopular, neglected monk with his own hands, and only then legislating that this must never happen again.
第四門
瞻視病人
瞻視病人中分為四章┬一制意
├二簡人
├三安置處所
└四說法斂念
第一章
制意
▲事鈔云『制意者。夫有待之形、多諸嬰累。四大互反、六府成病。
若不假相提接、薄命則無所託。然則世情流變、始終難一。健則親昵、病弱則捐捨。鄙俗恆情、未能忘此。故如來深鑒人物、知善來未崇、惡必相遵、故親看病。』
Gate Four
Attending the Sick
Attending the Sick divides into four chapters: first, Establishing the Intent; second, Selecting the Person; third, Placement; and fourth, Expounding the Dharma with Gathered Mindfulness.
Chapter One
Establishing the Intent
[Fresh citation] The Procedural Commentary says: "As for establishing the intent: a body burdened with dependent existence is heir to many entanglements. When the four great elements turn against one another, the six internal organs fall into sickness. Unless one relies on being supported and sustained by another, a person of scant fortune will have nowhere to turn. Yet worldly sentiment shifts and changes, never able to hold to one course from beginning to end: while healthy, people draw close to one another; once fallen ill and weak, they are cast aside. This is the common failing of vulgar sentiment, one that ordinary people have never been able to set aside. The Tathāgata, therefore, looking deeply into human character, knew that good conduct had not yet been exalted among them and that evil habit would surely be the one followed — and so he himself, in person, cared for the sick."
資持釋云『初敘意中、初敘病患。多嬰累者通目眾苦也。四大等者別示病惱也。若下次明瞻視。然下三示凡情。故下彰聖引導。按西域記、祇桓東北有塔、即如來洗病比丘處。如來在日、有病比丘含苦獨處。佛間、汝何所苦、汝何獨居。答曰、我性疏懶不耐看病、故今嬰疾無人瞻視。佛愍而告曰、善男子、我今看汝。』
The Zichi Commentary explains: "In this opening statement of intent, the first part sets forth the sickness itself. 'Many entanglements' points broadly to every kind of suffering; 'the four great elements' and so forth specifically indicates the affliction of illness. The passage beginning 'unless' next clarifies the need for attending upon the sick. The passage beginning 'yet' shows, in the third place, ordinary sentiment. The passage beginning 'the Tathāgata, therefore' then brings out the sage's own guidance. According to the Records of the Western Regions, northeast of Jetavana there stands a stupa — it marks the very spot where the Tathāgata himself washed a sick monk. In the Buddha's own lifetime, there was a monk who fell ill and, bearing his suffering alone, kept to himself. The Buddha asked him: 'What ails you? Why do you dwell alone?' He answered: 'By nature I am idle and careless, and could never bear to look after others when they were sick — so now that sickness has fallen on me, no one attends me.' The Buddha, moved with pity, said to him: 'Good man, I myself will care for you now.'"
△事鈔續云『故律中。佛言、汝曹不相看視、誰當應為。乃至世尊為病人洗除大小便已、掃治臥處極令清淨、數衣臥之。
便立制云。自今已去、應看病比丘、應作瞻病人。若有欲供養我者、應供養病人。佛為極地之人、猶勵諸比丘、親自下接。況同法義重、如何相棄。』
[Continuation] The Procedural Commentary continues: "And so, in the Vinaya it is recorded: the Buddha said, 'If you yourselves will not look after one another, then who will?' — down to where the World-Honored One, for the sick monk's own sake, personally washed away his urine and feces, swept and cleaned his sleeping place until it was thoroughly spotless, and laid out bedding and settled him to rest. He then established this rule: 'From this day forward, there must be those who attend the sick — there must be caregivers appointed for the sick. If there is anyone who wishes to make offering to me, let him make offering to the sick.' The Buddha, being one who had reached the utmost ground, still exhorted the bhikṣus in this way, condescending to attend to the sick with his own hands — how much more, then, when the bond of the Dharma binds fellow practitioners together in such weighty kinship, could anyone cast another aside?"
資持釋云『二引證中、初引緣。便下立制。佛下結勸。』
The Zichi Commentary explains: "In this second passage, which cites proof: the first part cites the occasion. The passage beginning 'he then' establishes the rule. The passage beginning 'the Buddha' closes with an exhortation."
△事鈔續云『問、供養病者等佛何耶。
答。謂悲心看病、拔苦與樂、慈心行同佛故也。又論云、隨順我語、名供養佛。』
[Continuation] The Procedural Commentary continues: "Question: In what sense does making offering to the sick equal making offering to the Buddha? Answer: because caring for the sick out of a heart of compassion, pulling out suffering and bestowing joy, is a practice of loving-kindness identical in kind to the Buddha's own. And a treatise further says: to act in accordance with my words is itself called making offering to the Buddha."
資持釋云『三釋疑中、徵上律文、欲彰功行。答中、初約心行同佛。又下次約隨順法制。』已上皆見事鈔記卷四十
The Zichi Commentary explains: "In this third passage, resolving the doubt: it interrogates the Vinaya text cited above, wishing to bring out the merit of the practice. Within the answer, the first part addresses it in terms of the mind and conduct being identical to the Buddha's own; the passage beginning 'and further' next addresses it in terms of according with the established rule." [Zichi Commentary, fascicle 40]
上來瞻視病人中第一章制意竟
With this, the first chapter of Attending the Sick — Establishing the Intent — is concluded.
The companion study guide frames this whole chapter around one plain observation about ordinary people: we are drawn to whoever is thriving and we quietly step back from whoever is struggling, and almost no one manages to fully outgrow that habit on their own. The Buddha's response to that habit was not a lecture but a demonstration. The story behind it, preserved in the Records of the Western Regions and marked by an actual stupa at Jetavana, is worth sitting with in full: a monk too idle and self-absorbed to ever look after anyone else falls sick himself, and is left entirely alone as a result — exactly the outcome his own past neglect had earned him. The Buddha does not ask whether this monk deserves care before giving it. He asks only why he is suffering alone, and then, in person, cleans up his waste, remakes his bed, and settles him to rest.
The guide also draws out the practical force of what follows: the Buddha does not leave this as a single act of personal kindness but turns it immediately into a standing rule — every sick monk must have someone appointed to look after him — and then adds the line that gives the whole chapter its emotional charge: "if there is anyone who wishes to make offering to me, let him make offering to the sick." The concluding exchange makes explicit why that equivalence actually holds: caring for the sick out of a heart of compassion, pulling out suffering and giving joy, is simply the Buddha's own compassion practiced in miniature — which is also why an already-supreme teacher would still bother, in person, to do work that any attendant could have done for him.
2. Milestone: Selecting the Person
Having established that someone must always be assigned to the sick, the compendium's second chapter turns to a practical question: exactly who. Drawing on the Four-Part Vinaya, it lays out a clear order of responsibility, then extends the same duty to the community of women, with one boundary carefully preserved even in this context of care.
第二章
簡人
△事鈔云『二簡人中。四分。若有病者、聽和尚乃至弟子、從親至疏。若都無者、眾僧應與瞻病人。若不肯者、應次第差。
若無比丘沙彌優婆塞者。比丘尼式叉摩那沙彌尼優婆夷隨所可作應作、不應觸比丘。』
Chapter Two
Selecting the Person
[Continuation] The Procedural Commentary continues: "Second, on selecting the person: according to the Four-Part Vinaya, if there is a sick person, it is permitted that the preceptor, and even down to his own disciples, attend him, proceeding from those closest in relation to those more distant. If there is no one at all among these, the assembly of monks should provide a caregiver for the sick. If no one is willing, one should be appointed in turn according to sequence. If there is no bhikṣu, śrāmaṇera, or upāsaka available, then bhikṣuṇīs, śikṣamāṇās, śrāmaṇerikās, and upāsikās should each do whatever is proper for them to do — but they must not touch the bhikṣu."
資持釋云『初制本眾有三、一親屬自看。二僧與。三僧差。準無比丘、應令沙彌淨人看。若無下次開女眾。』見事鈔記卷四十
The Zichi Commentary explains: "In the first part, establishing the rule for the original assembly, there are three cases: first, relatives looking after their own; second, the assembly providing a caregiver; third, the assembly appointing one by turn. By analogy, if there is no bhikṣu present, a śrāmaṇera or a lay attendant should be made to look after the sick. The passage beginning 'if there is no' next opens the way for the assembly of women." [Zichi Commentary, fascicle 40]
上來瞻視病人中第二章簡人竟
With this, the second chapter of Attending the Sick — Selecting the Person — is concluded.
The study guide reads this short chapter as a deliberately practical fallback ladder rather than a rigid hierarchy: care by one's own relatives first, if any are available and willing; failing that, the community as a whole steps in to provide someone; and failing even that, the community assigns someone by rotation, so that a sick person is never simply left with no one at all. Only when no monk, novice, or male lay follower is on hand does the rule extend the same duty to nuns, female novices, and laywomen.
What the guide highlights as most telling is the single qualification attached to that extension — women may do whatever needs doing, but must not touch the bhikṣu directly. Even inside a chapter devoted entirely to compassionate care, the Vinaya does not treat propriety and compassion as competing values to be traded off against each other; it simply insists that both be honored at once, finding a way to make sure the sick are never abandoned without also setting aside the ordinary boundaries between monastics of different genders.
3. Milestone: The Impermanence Hall and Faith in Amitābha
The compendium's third chapter turns from who cares for the sick to where the dying were actually placed: a dedicated hall at the edge of the monastery, facing the setting sun, holding a single image of Amitābha Buddha. Nearly everyone who entered it died there — which is precisely why it was named for impermanence, and precisely why everything inside it was arranged to keep a dying person's mind fixed on one single point rather than scattered across the fear of the moment.
第三章
安置處所
▲事鈔云『三安置處所。若依中國本傳云、祇桓西北角日光沒處為無常院、若有病者安置其中。堂號無常、來者極多、還反一二。即事而求、專心念法。
其堂中置一立像、金薄塗之。面向西方。其像右手舉、左手中繫一五綵幡、腳垂曳地。當安病者在像之後、左手執幡腳、作從佛往淨剎之意。瞻病者燒香散華、莊嚴病者。乃至若有屎尿吐唾、隨有除之、亦無有罪。傳云。原佛垂忍土、意在拔除煩惱、不唯糞除為惡。如諸天見人間臭穢、猶人之見屏廁、臭氣難言。尚不以為惡、恆來衛護。何況佛德而有愛憎、但有歸投者無不拔濟。乃至為病者隨機說法。命終恆在佛所、不得移之。』
Chapter Three
Placement
[Fresh citation] The Procedural Commentary says: "Third, on the placement of the sick: according to the account transmitted from the Middle Kingdom, the northwest corner of Jetavana, where the sunlight sets, was made into the Impermanence Hall; whenever there was a sick person, he was placed within it. The hall is named 'Impermanence' because, of the very many who enter it, only one or two ever return. One seeks, in the very midst of this circumstance, to fix the mind singly on the Dharma. Within the hall stood a single standing image, overlaid with gold leaf, facing west. The image's right hand was raised; from its left hand hung a five-colored streamer, its lower end trailing down to the ground. The sick person was placed behind the image, made to grasp the trailing end of the streamer in his own left hand, forming the thought of following the Buddha to the Pure Land. Those attending the sick burned incense and scattered flowers, adorning the sick person's surroundings. And should the sick person soil himself with urine, feces, vomit, or spittle, it was cleaned away at once, without this being counted any fault. The transmitted account says: the Buddha, in deigning to appear within this endurable world, did so with the intent of uprooting affliction — not merely to sweep away filth as though filth itself were the evil. Just as the gods, looking upon the stench of the human world, find it as unbearable as a person finds the stench of a latrine, and yet do not for that reason treat it as something evil, but continue coming, without fail, to guard and protect — how much more, then, should the Buddha's own virtue, which knows neither love nor aversion, fail anyone who turns to him for refuge? There is no one who takes refuge in him whom he does not draw out and save. And so, for the sick, he expounds the Dharma according to their capacity; and once life has ended, they remain forever in the Buddha's presence, never to be moved from it."
『中國本傳戒壇圖經所謂別傳是也。日光沒處者壇經云、西方為無常之院、由終歿於天傾之位也。今寺亦有、但方隅不定、不知法故。其堂中下次明設像。立彌陀者歸心有處也。然十方淨土而偏指西方者、繫心一境、想念易成故。西方諸佛而獨歸彌陀者、誓願弘深、結緣成熟故。是以古今儒釋、靡不留心。況濁世凡愚、煩惱垢重、心猿未鎖、馬難調、捨此他求、終無出路。請尋大小彌陀經十六觀經往生論十疑論等諸文、詳究聖言、必生深信矣。像面向西病者在後謂將終之時已前、常須瞻像、令其繫心。忍土者梵語娑婆、此云堪忍、大悲經云此界眾生忍受三毒及諸煩惱故。人間臭穢者感通傳、天人云。人中臭氣、上熏於空四十萬里、諸天清淨無不厭之。但以受佛付囑、令護於法。佛尚與人同止、諸天不敢不來。恆在佛所者恐心無繫、念世事故。』見事鈔記卷四十
"'The account transmitted from the Middle Kingdom' refers to what the Diagrammatic Scripture of the Ordination Platform calls the 'Separately Transmitted Account.' As for 'where the sunlight sets': the Platform Scripture says the west is made the hall of impermanence because it is there that one's life comes to its end, in the position where the heavens themselves tilt downward. Such halls exist in monasteries today as well, but their orientation is no longer fixed, because the underlying rule has been forgotten. The passage beginning 'within the hall' next clarifies the setting up of the image. That the image erected is Amitābha shows that the mind that takes refuge has somewhere definite to go. Now, although there are Pure Lands in every one of the ten directions, the west alone is singled out because binding the mind to a single object makes contemplation easier to accomplish; and although there are Buddhas throughout the west, Amitābha alone is the object of refuge because his vows are vast and profound, and his karmic bond with beings here has fully ripened. This is why, from ancient times to the present, neither Confucian scholar nor Buddhist practitioner has failed to give this his attention — how much more, then, should the ordinary and the foolish of this turbid age, whose afflictions lie thick as filth, whose monkey-mind remains unchained and whose horse of desire is hard to tame, find that, apart from this refuge, there is in the end no way out at all. I ask the reader to search out the greater and lesser Amitābha Sūtras, the Sūtra of Sixteen Contemplations, the Treatise on Rebirth, the Treatise on Ten Doubts, and other such texts, and to examine the sages' own words in full detail — one will surely give rise to deep faith. 'The image faces west, and the sick person is placed behind it': this means that, in the time before life's end actually arrives, one must constantly gaze upon the image, so as to bind the mind to it. 'This endurable world' translates the Sanskrit sahā, meaning 'able to endure'; the Great Compassion Sūtra says that the beings of this world-realm endure the three poisons and all other afflictions. 'The stench of the human world' is described in the Record of Miraculous Response, where a heavenly being says: the foul odor of humankind rises up into the sky for four hundred thousand li, and the gods, being pure, all find it repugnant without exception; yet, having received the Buddha's own charge to guard the Dharma, and since the Buddha himself dwells among human beings, the gods dare not fail to come as well. 'They remain forever in the Buddha's presence': this is out of fear that, were the mind left unbound, it would turn back to thinking of worldly affairs." [Zichi Commentary, fascicle 40]
上來瞻視病人中第三章安置處所竟
With this, the third chapter of Attending the Sick — Placement — is concluded.
The study guide is careful to explain why this arrangement is not simply pious decoration. The hall sat at the point in the monastery grounds where the sun visibly sets, and its name was chosen deliberately — of those carried in, almost no one walked back out. Rather than hide that fact, the design leans directly into it: a gold image of Amitābha, facing west, one hand trailing a long streamer down to where the dying person lay just behind the statue, left hand closed around its end. The physical gesture and the mental one are the same act — to hold the streamer is to hold, quite literally, onto the thought of following the Buddha toward the Pure Land, at the exact moment when everything else about a person's situation, their body included, is falling away.
The guide also draws out why Amitābha specifically, among all the Buddhas of all the Pure Lands, was chosen as the object of this final devotion: not because other Buddhas or other Pure Lands are somehow lesser, but because a mind at the point of death benefits enormously from having exactly one thing to hold onto rather than many, and because Amitābha's own vows are described as unusually vast and his karmic bond with beings of this world as unusually ripe. It closes with the passage about the gods and the smell of the human realm, which the guide reads as the chapter's real point in disguise: the gods find human beings genuinely repugnant, and stay anyway, out of loyalty to the Buddha's own charge to protect the Dharma. If beings that pure will not abandon this world's dying for its literal stench, the passage is saying, then the Buddha's own compassion — which plays no favorites at all — abandons no one who turns toward him, however unclean or however far gone the body has become.
4. Milestone: Speaking to the Dying — Reciting a Lifetime of Good
The compendium's fourth and final chapter, "Expounding the Dharma with Gathered Mindfulness," opens with its first of two sections: what anyone present — not only the designated caregiver — can do for a dying person. The core instruction is simple and strikingly close to what hospice workers today call a life review: while the dying person can still hear and understand, recount for them, aloud, the good they actually did across their life.
第四章
說法斂念
說法斂念中分為二節┬一餘人勸導
└二瞻病勸導
第一節
餘人勸導
▲事鈔云『四說法勸善者。十誦。應隨時到病者所。為說深法、是道非道、發其智慧。先所習學、或阿練若、誦經、持律、法師、阿毗曇、佐助眾事。隨其解行而讚歎之。』
Chapter Four
Expounding the Dharma with Gathered Mindfulness
Expounding the Dharma with Gathered Mindfulness divides into two sections: first, Exhortation by Others Present; and second, Exhortation by the One Attending the Sick.
Section One
Exhortation by Others Present
[Fresh citation] The Procedural Commentary says: "Fourth, on expounding the Dharma to encourage what is wholesome: the Ten Recitations Vinaya says one should go, according to the occasion, to where the sick person is, and expound the profound Dharma for him — what is the path and what is not the path — so as to give rise to his wisdom. As for whatever he had previously studied and practiced — whether forest dwelling, sutra recitation, upholding the Vinaya, expounding the Dharma, the Abhidharma, or assisting with the assembly's various affairs — one should praise him according to his own understanding and conduct."
資持釋云『深法但是佛教、通得云深。是道謂出世法、非道即世間法。』
The Zichi Commentary explains: "'The profound Dharma' means simply the Buddha's own teaching in general — any of it may be called 'profound.' 'What is the path' refers to the dharmas that transcend the world; 'what is not the path' refers to the dharmas of the mundane world."
△事鈔又云『傳云。中國臨終者。不問道俗親緣、在邊看守。及其根識未壞、便為唱讀一生已來所修善行。意令病者內心歡喜、不憂前途。便得正念不亂、故生好處。』
[Continuation] The Procedural Commentary further says: "A transmitted account states: in the Middle Kingdom, when someone approaches the moment of death, whether monastic or lay, whether kin or not, those present keep watch at his side. While his faculties and consciousness are not yet impaired, they recite aloud, for his sake, the good conduct he has cultivated over the course of his entire life. The intent is to make the sick person's own heart rejoice within, so that he has no cause to be anxious about what lies ahead; in this way he attains right mindfulness, undistracted, and so is born in a good place."
資持釋云『令唱讀者準此、生前所修一切功德並須記錄。凡為看病、常在左右、策其心行、恆令念善。以捨報趣生、唯在臨終心念善惡。』已上皆見事鈔記卷四十
The Zichi Commentary explains: "As for having it recited aloud: on this basis, every meritorious deed cultivated during the person's lifetime must actually be recorded. Whoever attends the sick should remain constantly at their side, spurring on their mind and conduct, causing them always to be mindful of the good. For it is precisely at the moment the body is relinquished and a new life is taken up that everything turns on whatever good or evil the dying mind holds at that very last moment." [Zichi Commentary, fascicle 40]
The study guide points out how strikingly modern this instruction sounds even though it predates any contemporary hospice movement by well over a thousand years: gather at the dying person's side while they can still hear and understand, and recount, out loud, the good they actually did across their life. It reads this less as sentimental comfort and more as a precise technical intervention, aimed directly at the doctrine explained right alongside it — that what determines where a being is reborn is not the whole balance sheet of a lifetime, but specifically whatever state of mind, wholesome or unwholesome, happens to be present in the very last moment before death.
Because that last moment carries this much weight, the guide notes, the instruction to record a person's good deeds is not incidental — it means keeping some actual account, over the course of a life, of what someone has done well, precisely so that it can be handed back to them when they need it most: at the point where anxiety about what comes next is most capable of crowding out a settled, peaceful mind.
5. Milestone: The Caregiver's Own Exhortation — Gathered Mindfulness at the End
The chapter's second section narrows from "whoever happens to be present" to the caregiver's own responsibility, and it is here that "gathered mindfulness" earns its place in the chapter's title: a caregiver reading the dying person's own strength, sharpness of mind, and personal inclination, and then speaking — with a mind kept deliberately collected rather than scattered — whatever will actually reach that particular person in the time remaining.
第二節
瞻病勸導
▲事鈔云『其瞻病者、隨其前人病有強弱、心有利鈍、業有粗細、情有去取、當依志願隨後述之。
或緣西方無量壽佛。或兜率彌勒佛。或靈鷲釋迦本師。或身本無人、妄自立我。或外相似有、實自空無、如至燄處則無水相。或為說唯識無境、唯情妄見。
各隨機辯而誘導之。』
Section Two
Exhortation by the One Attending the Sick
[Fresh citation] The Procedural Commentary says: "As for the one attending the sick: according to whether the person before him is ill severely or mildly, whether his mind is sharp or dull, whether his karma is coarse or fine, and whether his own inclination favors one thing over another, one should proceed in accordance with his aspiration, as follows. One may direct him to Amitāyus Buddha in the west, or to Maitreya Buddha in Tuṣita, or to Śākyamuni, our original teacher, on Vulture Peak. One may explain that the body originally has no self within it, and that a self is falsely posited upon it. One may explain that outward appearances only seem to exist, while in truth they are themselves empty — like arriving at a mirage, where, on reaching it, there proves to be no water there at all. Or one may expound that in Consciousness-Only there is no external object, and that all such things are merely deluded perceptions arising from sentiment. In every case, one should adapt to the person's own capacity and skillfully guide him accordingly."
資持釋云『初明說法中二、前明量機。病強弱者觀其健困也。心利鈍者智明昧也。業粗細者粗如營福、細如禪講等。情取捨者所樂異也、如下西方兜北等是。此四觀察、義無不盡。隨宜方便、臨事自裁。
或下次明說法三、初令緣佛。或教稱名、或令觀相、或歎功德令生欣樂。或身下次示心觀。即性空相空唯識三觀。至燄處者喻相空也。謂如渴鹿逐於陽燄、遙見似不、至彼元無。
各下後示隨緣。不必如上故。』
The Zichi Commentary explains: "In this passage, which first sets forth the expounding of the Dharma, there are two parts. The first sets forth gauging the person's capacity. 'Ill severely or mildly' means observing whether he is robust or failing. 'Mind sharp or dull' means whether his wisdom is clear or clouded. 'Karma coarse or fine' means coarse as in managing worldly merit-making, fine as in meditation and the study of doctrine. 'Inclination favoring one thing over another' means that what different people find agreeable differs, as with the west, Tuṣita, and the north mentioned below. These four points of observation leave nothing out in principle; one should adapt as is fitting, exercising one's own judgment as the occasion demands. The passage beginning 'one may' next sets forth, in three parts, the actual expounding of the Dharma. The first causes the person to fix his mind upon a Buddha — whether by teaching him to recite the name, or having him visualize the Buddha's marks, or praising the Buddha's virtues so as to give rise to joyful aspiration. The passage beginning 'one may explain that the body' next shows contemplation of the mind — namely the three contemplations of the emptiness of nature, the emptiness of characteristics, and Consciousness-Only. 'Arriving at a mirage' is offered as a metaphor for the emptiness of characteristics: it is like a thirsty deer chasing after a shimmering mirage — seen from a distance it seems to be water, but on arriving there, there was never any water there at all. The passage beginning 'in every case' shows, last, adapting to conditions as they arise — one need not, that is, hold rigidly to the methods given above."
△事鈔又云『應以經卷手執示其名號。又將佛像對眼觀矚、恆與善語、勿傳事。
華嚴偈云。又放光明名見佛、彼光覺悟命終者、念佛三昧必見佛、命終之後生佛前。見彼命終勸念佛、又示尊像令瞻敬、又復勸令歸依佛、因是得成明淨光。』
[Continuation] The Procedural Commentary further says: "One should place a sutra scroll in the sick person's hand and show him the Buddha's name upon it. One should also hold a Buddha image before his eyes for him to gaze upon and attend to, constantly offering him wholesome words, and must not pass on worldly affairs. A verse from the Avataṃsaka Sūtra says: 'Again there is a radiance called Seeing the Buddha; that light awakens those at the moment of death; through the samādhi of buddha-recollection, they are certain to see the Buddha, and after life ends, they are born before the Buddha. Seeing that his life is ending, one urges him to recollect the Buddha, and further shows him the honored image so that he may gaze upon it with reverence, and further exhorts him to take refuge in the Buddha — by this cause he comes to attain a bright and pure radiance.'"
資持釋云『二示經像中、初示經像。次引華嚴為證。』已上皆見事鈔記卷四十
The Zichi Commentary explains: "In this second passage, on showing the sutra and the image: the first part shows the sutra and the image themselves; what follows cites the Avataṃsaka Sūtra as proof." [Zichi Commentary, fascicle 40]
上來瞻視病人中第四章說法斂念竟
With this, the fourth chapter of Attending the Sick — Expounding the Dharma with Gathered Mindfulness — is concluded.
上來別行篇中第四站瞻視病人竟
With this, Gate Four of the Part on Special Practices — Attending the Sick — is concluded.
The study guide reads the four-fold assessment opening this section — strength of illness, sharpness of mind, coarseness of karma, personal inclination — as a deliberate refusal to hand caregivers a single script. What actually reaches a given dying person differs enormously from one person to the next, so the caregiver is instructed to observe first and speak second, choosing between directing the person's attention toward a Buddha — Amitābha, Maitreya, or Śākyamuni, depending on where that person's own devotion already leans — or, for someone with a more contemplative bent, guiding them through one of three ways of seeing through fixed appearances, illustrated with the memorable image of a thirsty deer chasing a mirage that turns out, on arrival, to have never held any water at all.
It is this section's title that gives the whole chapter its name, and the guide is careful to explain why "gathered mindfulness" — 斂念, literally a gathering-in or collecting of the mind, as opposed to letting it scatter — belongs specifically here rather than being a generic virtue. The concrete instructions bear this out directly: place the sutra in the dying person's own hand, hold an image where their eyes actually rest, speak only wholesome words, and deliberately withhold ordinary news and worldly chatter — not out of secrecy, but because a mind approaching death is unusually fragile and easily pulled off whatever single point it has managed to settle on. The verse from the Avataṃsaka Sūtra that closes the whole gate makes the stakes explicit: it is precisely this undistracted recollection of the Buddha, sustained through to the very last moment, that the tradition holds capable of carrying someone, at the instant life ends, directly into the Buddha's presence.