Aṅguttara Nikāya · Discourse 10.108

Doctors

Tikicchakasutta — Samaṇasaññāvagga — the eleventh chapter of the Tens, opening the Third Fifty

Setting
None stated in the source
Speakers
The Buddha alone, addressing the mendicants
Form
An ordinary medical practice acknowledged and limited, then the same ten-factor teaching reframed as an infallible purgative
Length
~2 minutes to read
Difficulty
★☆☆☆☆ — the fifth of this chapter's reframed repetitions

Why this discourse

Turning from ritual to medicine, this discourse contrasts the acknowledged unreliability of ordinary doctors' purgatives with a “noble purgative” that, unlike any physical remedy, is guaranteed to work every time it is applied.

Reading guide

The teaching in one sentence

Ordinary doctors prescribe purgatives for bodily disorders of bile, phlegm, and wind, and such purgatives genuinely exist but sometimes fail; the noble purgative — the ten right factors, each purging its wrong counterpart and the bad qualities it produces — works without fail every time.

Medicine, acknowledged and bounded

As with AN 10.107's bone-washing ceremony, this discourse begins by granting the reality and even usefulness of an ordinary practice — medical purgatives genuinely treat bodily disorders — before drawing a sharp line at its limitation: it “sometimes works and sometimes fails,” unlike the teaching that follows.

Guaranteed success as the key difference

The entire force of this discourse's contrast rests on one word: works without fail. Physical medicine is real but probabilistic; the noble purgative, applied to the ten right factors, is presented as categorically certain — not merely more effective than ordinary medicine, but effective in a fundamentally different, unconditional way.

Purging as a bodily register, still applied to the mind

By choosing a medical purgative rather than a general cleaning image, this discourse locates the ten right factors' effect specifically in the register of illness and cure: wrong view and its consequences are treated not merely as dirt to be removed but as a genuine disorder, with the ten right factors functioning as its guaranteed remedy.

Key terms

tikicchaka — “doctor” — this discourse's own title, naming the ordinary medical practitioners whose purgatives are contrasted with the noble one.
pittasamuṭṭhānānaṁ ābādhānaṁ semhasamuṭṭhānānaṁ ābādhānaṁ vātasamuṭṭhānānaṁ ābādhānaṁ — “illnesses stemming from disorders of bile, phlegm, and wind” — the traditional threefold classification of bodily ailment ordinary purgatives treat.
kadāci sujjhati kadāci na sujjhati — “sometimes works and sometimes fails” — the Buddha's own assessment of ordinary medical purgatives' limitation.
ariyaṁ virecanaṁ ekantasujjhanaṁ — “a noble purgative that works without fail” — the discourse's own name for the ten right factors, the categorical alternative to fallible medicine.
sammādiṭṭhissa micchādiṭṭhi virecitā hoti — “for one of right view, wrong view is purged” — the recurring formula's opening clause under this discourse's medical framing.

The text

The discourse in full: ordinary medical purgatives acknowledged and limited, then the noble purgative that works without fail. Translation: Bhikkhu Sujato (CC0, SuttaCentral).

Ordinary purgatives, and their limitation

§1“Mendicants, doctors prescribe a purgative for eliminating illnesses stemming from disorders of bile, phlegm, and wind. There is such a purgative, I don’t deny it. But this kind of purgative sometimes works and sometimes fails. I will teach a noble purgative that works without fail. Relying on that purgative, sentient beings who are liable to rebirth, old age, and death, to sorrow, lamentation, pain, sadness, and distress are freed from all these things. Listen and apply your mind well, I will speak.” “Yes, sir,” they replied. The Buddha said this:

The noble purgative that works without fail

§2“And what is the noble purgative that works without fail? For one of right view, wrong view is purged. And the many bad, unskillful qualities produced by wrong view are purged. And because of right view, many skillful qualities are fully developed. For one of right purpose, wrong purpose is purged. … For one of right speech, wrong speech is purged. … For one of right action, wrong action is purged. … For one of right livelihood, wrong livelihood is purged. … For one of right effort, wrong effort is purged. For one of right mindfulness, wrong mindfulness is purged. … For one of right immersion, wrong immersion is purged. … For one of right knowledge, wrong knowledge is purged. … For one of right freedom, wrong freedom is purged. And the many bad, unskillful qualities produced by wrong freedom are purged. And because of right freedom, many skillful qualities are fully developed. This is the noble purgative that works without fail. Relying on this purgative, sentient beings who are liable to rebirth, old age, and death, to sorrow, lamentation, pain, sadness, and distress are freed from all these things.”

· · ·

Self-check quiz

5 questions. Click an answer to see immediate feedback. No score is recorded — this is for your own checking.

Question 1 of 5
What limitation does the Buddha name for ordinary medical purgatives?
Correct: B. A real, useful, but probabilistic remedy, acknowledged rather than dismissed.
Question 2 of 5
What single word does the guide identify as the key difference the discourse draws?
Correct: B. A difference in kind, not merely degree.
Question 3 of 5
What is the "noble purgative" in this discourse?
Correct: B. Familiar content from earlier in this chapter, reframed under a medical image.
Question 4 of 5
According to the guide, what does choosing a medical purgative image (rather than a general cleaning image) accomplish?
Correct: B. A deliberate shift in register from ritual cleanliness to medical disorder.
Question 5 of 5
Where is this discourse set?
Correct: D. No location is given for this discourse.
Answered 0 of 5 · Correct 0