Hunger is the highest illness. Conditioned things are the highest suffering.
Having known this as it is, Nirvana is the highest happiness.

jighacchā paramā     rogā   saṅkhārā  paramā  dukhā
|                   |             |            |              |           |
N.f.         Adj.m.     N.m.     N.m.      Adj.m.    N.m.
Nom.Pl.  Nom.Pl. Nom.Pl. Nom.Pl.  Nom.Pl. Nom.Pl.
|                   |_______|             |             |_______|
|______________|                    |___________|

List of Abbreviations

etaṃ     ñatvā   yathā+bhūtaṃ nibbānaṃ paramaṃ sukhaṃ
|                |          |           |             |             |             |
Pron.n. V.ger. Rel.Adv. Adv.       N.n.      Adj.n.      N.n.
Acc.Sg.     |          |______|        Nom.Sg. Nom.Sg. Nom.Sg.
|                |_________|                   |            |________|
|_____________|                             |__________|
          |_____________________________|

jighacchā: jighacchā-, N.f.: appetite, hunger. Nom.Pl. = jighacchā.

paramā: parama-, Adj.: most, highest, absolute. Nom.Pl.m. = paramā.

rogā: roga-, N.m.: disease, illness. Nom.Pl. = rogā.

saṅkhārā: saṅkhāra-, N.m.: conditioned thing, world of phenomena. The meaning of this word is very wide, here we will use "conditioned thing". It comprises all of the world around us, including ourselves. Nom.Pl. = saṅkhārā.

paramā: parama-, Adj.: see above. Nom.Pl.m. = paramā.

dukhā: dukha-, Adj.: unpleasant, painful, difficult. Spelled dukha- here instead of the more usual (and proper) dukkha-. As an N.m.: suffering. Nom.Pl. = dukhā.

List of Abbreviations

etaṃ: etad-, Pron.: this. Acc.Sg.n. = etaṃ.

ñatvā, V.ger.: having known. It is a ger. of the verb ñā- (to know).

yathābhūtaṃ, Adv.: as it is, according to reality. It is a compound of:
    yathā, Rel.Adv.: as, just like.
    bhūta-, Adj.: being, having become. It is a p.p. of the verb bhū- (to be).
Acc.Sg. = yathābhūtaṃ, here used as an Adv.

nibbānaṃ: nibbāna-, N.n.: Nirvana, the goal of Buddhism. Nom.Sg. = nibbānaṃ.

paramaṃ: parama-, Adj.: most, highest, absolute. Nom.Sg.n. = paramaṃ.

sukhaṃ: sukha-, N.n.: happiness. Nom.Sg. = sukhaṃ.

List of Abbreviations

    This verse consists of three syntactically independent sentences. They are:
    1) jighacchā paramā rogā (hunger is the highest illness). The subject is the noun jighacchā (hungers, nominative plural). The verb is omitted, implying the verb "to be". The object is the noun rogā (illnesses, nominative plural) with its attribute, the adjective paramā (highest, nominative plural).
    2) saṅkhārā paramā dukhā (conditioned things are the highest suffering). The subject is the noun saṅkhārā (conditioned things, nominative plural). The verb is omitted, implying the verb "to be". The object is the noun dukhā (sufferings, nominative plural) with its attribute, the adjective paramā (highest, nominative plural).
    3) etaṃ ñatvā yathābhūtaṃ nibbānaṃ paramaṃ sukhaṃ (having known this as it is, Nirvana is the highest happiness). This can be further analyzed into two sentences:
    a) etaṃ ñatvā yathābhūtaṃ (having known this as it is). The subject is omitted. The verb is ñatvā (having known, gerund). It has an attribute, the adverb yathābhūtaṃ (as it is, according to reality). The object is the pronoun etaṃ (this, accusative singular).
    b) nibbānaṃ paramaṃ sukhaṃ (Nirvana is the highest happiness). The subject is the noun nibbānaṃ (Nirvana, nominative singular). The verb is omitted, implying the verb "to be". The object is the noun sukhaṃ (happiness, nominative singular) with its attribute, the adjective paramaṃ (highest, nominative singular).

    Once the Buddha came to the village of Ālavi. On that day, one poor man had lost his ox and he spent the whole morning looking for it everywhere.
    The villagers offered almsfood to the Buddha and monks. After the meal, everybody got ready to listen to the Dharma, but the Buddha waited for the poor man, because he knew the man was very close to attaining the first stage of Awakenment.
    When the man found his ox, he came back to the village. He was very tired and hungry. So the Buddha directed the villagers to let him eat first and only then he expounded the Dharma. At the end of the discourse, the poor man attained the first stage of Awakenment.
    Later the monks asked the Buddha why he waited for the man before he delivered the discourse. The Buddha told them that the man was very hungry and very tired and if he had not eaten, he might not be able to comprehend the Dharma fully and reach the first stage of Awakenment.

Sentence pronunciation

Word pronunciation:

jighacchā
paramā
rogā
saṅkhārā
dukhā
etaṃ
ñatvā
yathābhūtaṃ
yathā
bhūtaṃ
nibbānaṃ
paramaṃ
sukhaṃ