Day 67: Understanding Ādīnava Saññā through the Girimānanda Sutta (AN 10.60) – Study Notes from BMV Monday Sutta Study with Bhante Dr. G. Chandima

Why Ādīnava Saññā?

Through the concept of Ādīnava Saññā, the Buddha highlights 49 types of health issues, primarily physical ailments. These aren’t just random occurrences; they can arise from the natural process of aging, or from poor choices we make, such as unhealthy lifestyle habits, mental health issues, poor food choices, and lack of fitness. It’s important to understand that these issues often don’t arise due to bad karma, but simply because we carry a physical body. 

The body, made up of the five aggregates (form, feeling, perception, mental formations/karma, and consciousness), is inherently subject to decay, aging, and illness. The Buddha teaches us the reality of the body, not to foster negativity, but to help us gain a deeper understanding of its true nature and inevitable vulnerabilities. By recognizing this, we can approach life with greater wisdom and acceptance, free from resistance or fear, and, most importantly, take steps to avoid illness as much as possible.

Why 49 Health Problems?

1. Eye-disease (cakkhu rogo)
2. Inner Ear-disease (sota rogo)
3. Nose-disease (ghāna rogo)
4. Tongue-disease (jivhā rogo)
5. Body-disease (kāya rogo)
6. Head-disease (sīsa rogo)
7. Outer Ear-disease (kaṇṇa rogo)
8. Oral disease (mukha rogo)
9. Tooth disease (danta rogo)
10. Lip disease (oṭṭha rogo)
11. Cough (kāso)
12. Asthma (sāso)
13. Catarrh (pināso)
14. Heartburn (ḍāho)
15. Fever (jaro)
16. Stomachache (kucchi rogo)
17. Fainting (mucchā)
18. Dysentery (pakkhandikā)
19. Gastric Pain (sūlā)
20. Cholera (visūcikā)
21. Leprosy (kuṭṭhaṁ)
22. Boils (gaṇḍo)
23. Eczema (kilāso)
24. Tuberculosis (soso)
25. Epilepsy (apamāro)
26. Ringworm (daddu)
27. Itch (kaṇḍu)
28. Scab (kacchu)
29. Chickenpox (rakhasā)
30. Scabies (vitacchikā)
31. Hemorrhage (lohitaṁ pittaṁ)
32. Diabetes (madhumeho)
33. Hemorrhoids (aṁsā)
34. Cancer (piḷakā)
35. Fistula (bhagandalā)
36. Illnesses caused by imbalances in bile (pittasamuṭṭhānā ābādhā)
37. Illnesses caused by imbalances in phlegm (semhasamuṭṭhānā ābādhā)
38. Illnesses caused by imbalances in wind (vātasamuṭṭhānā ābādhā)
39. Illnesses caused by imbalances in bile, phlegm and wind (sannipātikā ābādhā)
40. Illnesses produced by change of climate (utupariṇāmajā ābādhā)
41. Illnesses caused by careless behaviour (visamaparihārajā ābādhā)
42. Illnesses caused by assault/over-use (opakkamikā ābādhā)
43. Illnesses produced as the result of kamma (kammavipākajā ābādhā)
44. Cold (sītaṁ)
45. Heat (uṇhaṁ)
46. Hunger (jighacchā)
47. Thirst (pipāsā)
48. Defecation (uccāro)
49. Urination (passāvo)

There are few important things to note about the above 49 sicknesses.

• Some interpretations expand the list to 50 by treating lohitaṁ and pittaṁ as separate conditions—lohitaṁ referring to blood loss and pittaṁ to issues related to the gallbladder. This distinction is more based on practical usage rather than textual authority.
• Some are rogā, and some are ābādā. Rogā refers to painful experiences, typically sicknesses, while ābādhā refers to disruptions in the body and mind, which may not always involve pain, though they can manifest as pain.

The key insight here is that by understanding the 49 types of health issues, we can become more attuned to the causes of both physical and mental illness/disruptions to the well-being. When we recognize the conditions that can lead to sickness or disruption in our body and mind, we can often avoid those situations or take proactive steps to protect our health before problems arise. This awareness allows us to make more informed choices about our well-being, similar to how modern health experts emphasize prevention through diet, exercise, and lifestyle choices.

In other words, by applying the wisdom gained through Ādīnava Saññā, we can cultivate a more conscious approach to health. The Buddha is teaching us to be mindful of our bodies, their limitations, and the conditions that make us susceptible to illness. By doing so, we can maintain a healthier body and mind, and approach sickness with greater understanding and less fear. It’s important to note that Buddhism does not present a quick fix or "painkiller" for health problems. Rather, it offers a concrete strategy for avoiding health issues and disruptions to the body and mind.

The Buddha’s teachings, as conveyed to Venerable Girimānanda, offer hope—not only in the potential for recovery but also in maintaining that hope throughout the process of healing. Understanding life in this way enables us to continue striving toward health, both physically and mentally.

Thus, the Buddha’s approach to health goes beyond merely acknowledging pain and disruptions to the body and mind; it is about cultivating the wisdom to prevent unnecessary suffering and living more consciously in terms of our well-being. This aligns closely with today’s emphasis on preventive health, where awareness and understanding are central to maintaining good health.