While bodily health may last for years or even decades, it is very rare to find beings who can enjoy freedom from mental illness even for a moment. The Buddha goes on to describe four illnesses that afflict one gone forth.

AN 4.157  Roga sutta - Illness

“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 |illness::disease, sickness [roga]|. What two? Bodily illness and mental illness. Beings are found who can claim to enjoy bodily health for one, two, three, four, and five years; for ten, twenty, thirty, forty, and fifty years; and even for a hundred years and more. But it is very rare to find beings in the world who can claim to enjoy mental health even for a moment, apart from those |whose mental defilements have ended::who is awakened through the complete exhaustion of the mental effluents, taints [khīṇāsava]|.

Cattārome, bhikkhave, pabbajitassa rogā. Katame cattāro?

There are, bhikkhus, these four illnesses incurred by |one gone forth::renunciant, ordained [pabbajita]|. What four?

Idha, bhikkhave, bhikkhu mahiccho hoti vighātavā asantuṭṭho itarītaracīvarapiṇḍapātasenāsanagilānappaccayabhesajjaparikkhārena.

1.) Here, bhikkhus, a bhikkhu is |full of desires::with longing and yearning for many things, greediness [mahiccha]|, |distressed::afflicted or frustrated with [vighātavant]|, and |discontent::displeased, unhappy [asantuṭṭha]| with any kind of robe, alms food, lodging, support for the sick, and medicinal requisites he obtains.

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

2.) Being full of desires, distressed, and discontent with whatever robe, alms food, lodging, support for the sick, and medicinal requisites he obtains, he sets his mind on a |harmful::injurious, destructive, bad, or evil [pāpaka]| wish — |gaining recognition::winning respect, getting a reputation [anavaññappaṭilābha]| and obtaining |acquisitions, respect, and popularity::gains or possessions, honor or reverence, and fame or praise [lābhasakkārasiloka]|.

So uṭṭhahati ghaṭati vāyamati anavaññappaṭilābhāya lābhasakkārasilokappaṭilābhāya.

3.) He arouses himself, strives, and makes an effort for the purpose of gaining recognition and obtaining acquisitions, respect, and popularity.

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

4.) He approaches families |with an ulterior motive::calculating [saṅkhāya]|, sits down with an ulterior motive, speaks the |Dhamma::teachings of the Buddha that point to the nature of reality, the ultimate truth [dhamma]| with an ulterior motive, and even restrains the urge to relieve himself with an ulterior motive.

Ime kho, bhikkhave, cattāro pabbajitassa rogā.

These, bhikkhus, are the four illnesses incurred by one 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 thus: ‘We will not be full of desires, distressed, and discontent with whatever robes, alms food, lodging, support for the sick, and medicinal requisites we obtain. We will not set our mind on a harmful wish for gaining recognition and obtaining acquisitions, respect, and popularity. We will not arouse ourselves, strive, or make an effort for gaining recognition and obtaining acquisitions, respect, and popularity. We will be patient with cold and heat, with hunger and thirst, with the contact of flies, mosquitoes, wind, sun, and creeping creatures; with ill-spoken and unwelcome words; and when painful bodily feelings arise — intense, harsh, sharp, disagreeable, unpleasant, and even life-threatening — we will endure them.’ Thus, bhikkhus, you should train yourselves.”

Last updated on October 9, 2025

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