“All conditioned formations are suffering” — when one sees this with wisdom, one becomes disenchanted with suffering. This is the path of purification.

Sabbe saṅkhārā dukkhāti — all conditioned formations are suffering: the second mark of existence. Dukkha not as “pain” but as inherent dissatisfaction, fragility, incapacity to provide permanent satisfaction.

The statement is radical: not “some” formations but “all”. Not “sometimes” but intrinsically. Dissatisfaction is not accidental but constitutive of the conditioned.

The same structure as verse 277 repeats exactly with the substitution of anicca for dukkha. The path of purification can begin through any of the three doors — impermanence, suffering, or non-self.

Seeing universal dukkha is not pessimism but the precise medical diagnosis that permits treatment. The physician who says “you have a disease” is not pessimistic — they are accurate. And accurate diagnosis permits cure.