AN 4.157 Rogasutta

Dveme, bhikkhave, rogā. Katame dve? Kāyiko ca rogo cetasiko ca rogo. Dissanti, bhikkhave, sattā kāyikena rogena ekampi vassaṁ ārogyaṁ paṭijānamānā, dvepi vassāni ārogyaṁ paṭijānamānā, tīṇipi vassāni ārogyaṁ paṭijānamānā, cattāripi vassāni ārogyaṁ paṭijānamānā, pañcapi vassāni ārogyaṁ paṭijānamānā, dasapi vassāni ārogyaṁ paṭijānamānā, vīsatipi vassāni ārogyaṁ paṭijānamānā, tiṁsampi vassāni ārogyaṁ paṭijānamānā, cattārīsampi vassāni ārogyaṁ paṭijānamānā, paññāsampi vassāni ārogyaṁ paṭijānamānā, vassasatampi, bhiyyopi ārogyaṁ paṭijānamānā. Te, bhikkhave, sattā sudullabhā lokasmiṁ ye cetasikena rogena muhuttampi ārogyaṁ paṭijānanti, aññatra khīṇāsavehi.

Bhikkhus, there are these two kinds of disease. What two? Bodily disease and mental disease. Beings can be found who can claim freedom from bodily disease for one year; for two years; for three years; for four years; for five years; for ten years; for twenty years; for thirty years; for forty years; for fifty years; for a hundred years, and even longer. But, bhikkhus, those beings are extremely difficult to find in the world who can claim freedom from mental disease even for a moment, except those whose āsavas have been exhausted.

Cattārome, bhikkhave, pabbajitassa rogā. Katame cattāro?

Bhikkhus, there are these four diseases of one who has gone forth. What four?

Idha, bhikkhave, bhikkhu mahiccho hoti vighātavā asantuṭṭho itarītaracīvarapiṇḍapātasenāsanagilānappaccayabhesajjaparikkhārena.

Here, bhikkhus, a bhikkhu has many wants, is troubled and dissatisfied with whatever robes, almsfood, lodging, and medicines and provisions for illness are available to him.

So mahiccho samāno vighātavā asantuṭṭho itarītaracīvarapiṇḍapātasenāsanagilānappaccayabhesajjaparikkhārena pāpikaṁ icchaṁ paṇidahati anavaññappaṭilābhāya lābhasakkārasilokappaṭilābhāya.

Being one of many wants, troubled and dissatisfied with whatever robes, almsfood, lodging, and medicines and provisions for illness are available, he gives rise to an unwholesome desire to obtain recognition, not to be looked down upon, and to obtain gain, honor and reputation.

So uṭṭhahati ghaṭati vāyamati anavaññappaṭilābhāya lābhasakkārasilokappaṭilābhāya.

He rouses himself, applies himself and makes an effort in order to obtain recognition and to obtain gain, honor and reputation.

So saṅkhāya kulāni upasaṅkamati, saṅkhāya nisīdati, saṅkhāya dhammaṁ bhāsati, saṅkhāya uccārapassāvaṁ sandhāreti.

He approaches families calculatingly; he sits down calculatingly; he speaks Dhamma calculatingly; and he even regulates and restrains his defecation and urination calculatingly.

Ime kho, bhikkhave, cattāro pabbajitassa rogā.

These, bhikkhus, are the four diseases of one who has gone forth.

Tasmātiha, bhikkhave, evaṁ sikkhitabbaṁ: ‘na mahicchā bhavissāma vighātavanto asantuṭṭhā itarītaracīvarapiṇḍapātasenāsanagilānappaccayabhesajjaparikkhārena, na pāpikaṁ icchaṁ paṇidahissāma anavaññappaṭilābhāya lābhasakkārasilokappaṭilābhāya, na uṭṭhahissāma na ghaṭessāma na vāyamissāma anavaññappaṭilābhāya lābhasakkārasilokappaṭilābhāya, khamā bhavissāma sītassa uṇhassa jighacchāya pipāsāya ḍaṁsamakasavātātapasarīsapasamphassānaṁ duruttānaṁ durāgatānaṁ vacanapathānaṁ, uppannānaṁ sārīrikānaṁ vedanānaṁ dukkhānaṁ tibbānaṁ kharānaṁ kaṭukānaṁ asātānaṁ amanāpānaṁ pāṇaharānaṁ adhivāsakajātikā bhavissāmā’ti. Evañhi vo, bhikkhave, sikkhitabban”ti.

Therefore, bhikkhus, you should train yourselves in this way: ‘We will not be people of many wants, troubled and dissatisfied with whatever robes, almsfood, lodging, and medicines and provisions for illness are available. We will not give rise to an unwholesome desire for recognition, or for gain, honor and reputation. We will not rouse ourselves, apply ourselves or make effort for the purpose of obtaining recognition, gain, honor and reputation. We will patiently endure cold and heat, hunger and thirst; contact with flies, mosquitoes, wind, sun and creeping creatures; badly spoken and offensive words. We will become capable of enduring bodily feelings that have arisen which are painful, severe, sharp, piercing, disagreeable, unpleasant and even life-threatening.’ Bhikkhus, this is how you should train.

Ordinarily, when people say they are healthy, they mean the body. They may have no serious disease, their tests may be normal, or they may have gone for years without needing treatment. The Buddha accepts that ordinary meaning, but then introduces a second and far more demanding standard: health of mind.

A physically healthy person can become mentally disturbed within seconds. One sentence of criticism can produce anger and hours of replay. A photograph can produce envy. A compliment can produce conceit. A financial loss can produce fear. The body may remain medically healthy while the mind is being pushed and pulled by conditions.

The sutta therefore asks us to reconsider what we call normal. A mind repeatedly dominated by craving, aversion, comparison, fear, conceit or dissatisfaction may be socially ordinary, but it is not yet completely healthy in the Dhamma sense.

The expression cetasiko rogo must be understood carefully. The Buddha is not saying that virtually every person has a modern clinical psychiatric disorder. Depression, bipolar disorder, schizophrenia, dementia, trauma-related disorders and other medical conditions belong to different diagnostic frameworks and may require professional treatment.

The clue in this sutta is aññatra khīṇāsavehi — except those whose āsavas have been exhausted. The disease being diagnosed is the mind’s remaining vulnerability to greed, aversion, ignorance, craving, becoming, conceit, dissatisfaction and recognition-seeking.

A person can therefore be psychologically functional and still be disturbed by insult, intoxicated by praise, pulled by lust, threatened by status loss, or dissatisfied when comfort is reduced. That conditional vulnerability is the disease under examination here.

The Buddha does not say “except monks,” “except meditators,” “except scholars,” or even “except those with strong samādhi.” The exception is the khīṇāsava — the one in whom the āsavas have been exhausted. This sets complete mental health at the level of final liberation.

A practitioner may have long periods of calm, very little anger, strong samādhi and considerable insight. Yet if subtle craving, becoming, conceit or ignorance remains, conditions can still find something to grip. The disease-producing capacity has not yet been removed at the root.

This protects practice from confusing temporary quiet with final cure. A peaceful retreat or refined meditative state may be genuine progress, but the deeper question remains: has the underlying susceptibility ended, or has it simply not been activated recently?

The four diseases of the renunciant are best read as stages in one deterioration. First there are many wants and dissatisfaction. What is available no longer feels sufficient. Second, because satisfaction is not found in simplicity, the mind turns toward recognition, gain, honor and reputation. Third, energy is deliberately mobilized to obtain them. Fourth, behavior itself becomes calculated so that other people form the desired impression.

The progression is psychologically exact: “This is not enough for me” becomes “I should receive better treatment”; that becomes “people should recognize my importance”; then “I must do what is necessary to obtain that recognition”; finally even visiting, sitting and teaching can be arranged around image.

This explains why contentment is not a minor virtue. It is preventive medicine. If the first disease is seen early, the later stages need not develop.

The Buddha does not deny basic requirements. Food, clothing, shelter and medicine may all be necessary. The disease begins when the mind converts support into an expanding list of conditions that must be satisfied before it agrees to be content.

A simple meal may meet the body’s need, but the mind adds preferred taste, preparation, timing, entertainment and the feeling that one deserves something better. A safe room may be sufficient, but comparison introduces size, comfort, furniture and status. The physical requirement remains small while the psychological requirement grows.

For a lay practitioner the objects may be a phone, car, salary, house or holiday. Vipassanā sees the precise moment when use ends and identity begins.

The sutta links many wants and dissatisfaction with vighāta — frustration or distress. This exposes causality. We usually say, “I am upset because I did not get what I wanted.” Vipassanā asks whether the distress would exist in the same form without the wanting.

Ten people can receive the same simple meal and only one becomes angry. The meal cannot fully explain the anger. The difference lies in expectation: “This should be different,” “I deserve better,” “they should know how to treat me.” Now a neutral condition has become evidence about “me.”

When frustration appears, investigate the expectation before automatically changing the environment. What exactly was demanded? Who is the imagined person who should have received something different? What happens when the expectation is seen rather than obeyed?

The second disease is subtler because the desired object becomes social identity. The sutta points toward not being looked down upon and toward lābha, sakkāra and siloka — gain, honor and reputation.

A person can give up expensive possessions and still be deeply attached to respect. A renunciant may live simply but feel wounded when not greeted properly. A teacher may own little and still be preoccupied with audience size. A meditator may renounce entertainment yet want others to know about unusual experiences.

The practical test is simple: what happens when recognition is withheld? If the mind contracts, becomes angry, disappointed or driven to prove itself, the dependency has been exposed.

Digital technology can spread Dhamma widely, and the technology itself is not the disease. The diagnostic question is what happens in the mind around measurable recognition.

A discourse receives five hundred views; another receives fifty thousand. Subscriber numbers rise. Comments praise the speaker. Another teacher attracts a larger audience. Does the mind remain the same? Does disappointment arise when numbers fall? Does comparison appear? Is the next topic chosen because it is useful, or because it is likely to perform well?

The same applies to websites, retreat attendance, donations and public invitations. A sharp test is: if public recognition disappeared tomorrow, would the work continue with the same care and intention? The answer reveals whether service is primary or whether lābha-sakkāra-siloka has quietly entered the motivation.

The third disease is subtle because the person becomes energetic: he gets up, applies himself and makes effort. Outwardly this can look admirable. The Buddha therefore shows that effort is not automatically wholesome merely because it is intense.

Two people can perform the same work. Both may teach, travel, organize and publish. One acts from compassion and responsibility. The other is driven by recognition and status. The visible behavior can be almost identical while the mental direction is different.

Before acting, ask: why am I doing this? During the action: what response am I hoping people will give me? Afterward: what happens if nobody notices or someone else receives the credit? These questions expose what is actually fueling the effort.

The fourth disease is the culmination. The repeated saṅkhāya shows calculated conduct: approaching families calculatingly, sitting calculatingly, speaking Dhamma calculatingly, even regulating ordinary bodily behavior calculatingly. Planning itself is not the problem; image-management for gain, honor and reputation is.

A person can learn the appearance of spirituality: slow walking, gentle speech, composed sitting, humble language and visible restraint. These may all be genuine. The inward test is whether the same simplicity remains when nobody is watching, whether behavior changes in front of influential people, and whether wealthy supporters are treated differently from unknown visitors.

When image becomes more important than purification, spiritual life itself has become part of the disease.

The same mechanism can enter meditation. A refined experience arises — deep samādhi, unusual calm, insight or a major shift. Then another movement begins: “I have reached something others have not.” From there can come the wish to be known, respected or treated differently.

An experience that could support dispassion is then converted into bhava — becoming. A new identity is manufactured: advanced meditator, jhāna practitioner, person who understands what others do not.

The key question is not merely whether a label is technically correct. What happens to the mind around the label? Does it reduce comparison and conceit, or create a subtler version of “I am”?

The closing training may seem to change subject, but the connection is direct. At the root of dissatisfaction is the demand that experience conform to preference: it should be cooler, I should not be hungry, people should speak respectfully, my body should not hurt, I should receive better conditions.

Endurance weakens this dependency. Heat can be present without hatred of heat. Hunger can be present without panic. Harsh speech can be heard without constructing a wounded identity for days. Pain can be experienced without immediately adding the demand that reality must be different before the mind can be at peace.

This does not mean refusing sensible protection, food or medical care. It means not making comfort and approval prerequisites for inner stability.

The discourse explicitly acknowledges severe, sharp, unpleasant and even life-threatening bodily feelings. Liberation therefore does not make the body invulnerable. The body can age, become ill, experience injury and die.

The important distinction is between physical pain and the mind’s appropriation of pain. The body may register burning, throbbing or weakness. The mind then adds fear, resentment, self-pity and “Why is this happening to me?” The second layer is not identical with the first.

Vipassanā separates these layers. Sensation is known as sensation. Unpleasant feeling is known. Aversion and fear are known if they arise. The construction of “my suffering” is known as construction. The purpose is not to deny pain but to stop automatically turning bodily disease into a second disease of mind.

Someone may speak harshly for five seconds. The sound ends, but the mind can continue the event for five days by replaying the sentence, imagining replies, telling others, remembering older grievances and preparing future arguments.

The original contact was brief. Mental proliferation recreates it repeatedly. Hearing occurs, unpleasant feeling appears, and then the mind constructs: “He does not respect me,” “I should have said this,” “next time I will show him.”

Endurance does not mean approving abuse or refusing appropriate boundaries. It means not allowing another person’s five seconds of speech to become one’s own five days of internally manufactured suffering.

Anyone who teaches, leads a center or receives public respect can use this sutta as a regular diagnostic. If attendance falls, does disappointment arise? If another teacher becomes popular, does comparison arise? If donations fall, does anxiety appear? If someone disagrees publicly, does defensiveness arise? Are prominent supporters treated differently from people who cannot contribute?

These questions are not accusations. They are instruments of Vipassanā. The point is to see the disease while it is still a movement of mind, before it determines conduct.

A disease honestly recognized can be treated. A disease renamed as virtue becomes much harder to abandon.

The greatest practical value of AN 4.157 is early diagnosis. It is easier to catch “this meal is not good enough” than to discover years later that an identity has been organized around status. It is easier to notice discomfort when someone else receives praise than to recognize a mature pattern of rivalry.

When dissatisfaction appears, know it. When comparison appears, know it. When the desire to be acknowledged arises, know it. When the impulse comes to tell others about an accomplishment mainly so that they will think differently of you, know it. When behavior changes because an influential person is present, know that change.

The task is not self-condemnation. It is knowing and seeing. What condition produced this movement? What feeling is present? What does the mind expect to gain? What identity is being protected? What happens when the urge is not followed? This is how the discourse becomes a living Vipassanā manual.