Shat Kriya Kala (Six Stages Of Disease Formation)

Abstract

The concept of kriya kala has been widely described in two separate entities as ritu kriya kala (seasonal) and vyadhi kriya kala (disease). Under ritu kriya kala normal physiological variations of dosha in each season has been discussed and accordingly certain measures are described in ritucharya to overcome the adverse effects. Vyadhi kriya kala described by Sushruta gives an idea about the consecutive stages of the disease and accordingly preventive measures were described to overcome complications. If accumulated dosha has been eliminated it won't manifest successive stages of kriya kala. If not eliminated, it passes to the next stage. As the disease advances to later stages it becomes stronger and stronger for management. So today we will read about shat kriya kala in brief in this article.

Introduction

It is the process of understanding the pathogenesis of disease in consecutive stages. Mainly six stages were described for the successive manifestation of the disease that is:

1. Accumulation:- Sanchaya
2. Aggravation:- Prakopa
3. Dissemination:- Prasara
4. Relocation:- Sthana samsraya
5. Manifestation:- Vyaktavastha
6. Disruption:- Bhedavastha

Sanchaya (Accumulation)

संहतिरूपा वृद्धिश्चय:।

Reference - (S.Su 21/18)

According to the above shloka:- Gradual accumulation of dosha in respective seats. It is the first stage of kriya kala. Accumulated dosha manifests certain symptoms are as follows:-

Vata Sanchaya Lakshana

• Stiffness and fullness in abdomen

Pitta Sanchaya Lakshana

• Yellowishness of body parts
• Mild increase in body temperature

Kapha Sanchaya Lakshana

• Heaviness in whole body
• Lassitude

Person develops aversion towards the causative factors which are responsible for accumulation of dosha.

Prakopa (Aggravation)

विलयन रूपा वृद्धि: प्रकोप:।

Reference - (S.Su 21/18)

According to the above shloka:- Accumulated dosha moving to other sites other than its main site. It is the second stage of kriya kala and also the second stage for preventive measures.

Difference Between The Prakopa & Prasara

After heating thick ghee (solid) it melts, it is the Prakopa stage. On further heating of melted ghee produces frothing and reaches the top of the heating utensil or comes out of the utensil is called prasara stage.

The following symptomatology manifest in Prakopa stage as per the involvement of dosha are as follows:-

Vata Prakopa Lakshana

Pain and movement of vata in maha srotas (large channels)

Pitta Prakopa Lakshana

• Sour eructations
• Burning sensation all over the body
• Excessive thirst

Kapha Prakopa Lakshana

• A version of food
• Excessive salivation in mouth

Prasara (Dissemination)

Overflow of dosha from their respective seats to other places takes place like fermented materials come out after keeping a mixture of yeast, water and flour in a vessel overnight. Main factor for movement is vayu (air) because of being mobile even though capricious. It is predominant in rajas which is the initiator of all happenings. As a large accumulation of water in excess breaks the barrier and mixes other pools of water and moves haphazardly in various directions. In the same way dosha also moves to different places with the help of vayu (air) either alone or in combinations are as follows and it is of 15 types.

1. Vata prasara
2. Pitta prasara
3. Kapha prasara
4. Rakta prasara
5. Vata pitta prasara
6. Vata kapha prasara
7. Pitta kapha prasara
8. Vata rakta prasara
9. Pitta rakta prasara
10. Kapha rakta prasara
11. Vata pitta rakta prasara
12. Vata kapha rakta prasara
13. Pitta kapha rakta prasara
14. Vata pitta kapha prasara
15. Vata pitta kapha rakta prasara

Aggravated dosha moves all over the body and manifests diseases whatever they strike. that is the whole body, half portion of the body, part of the body like clouds raining in the sky. If the aggravation of dosha is mild it may not produce diseases because it stays in hidden channels and produces diseases if preventive measures are not undertaken and after consuming causative factors in excess. Aggravated dosha spreads to different places and produces following symptomatology are as follows:-

Vata Prasara Lakshana

• Vata moves to different places other than its own seats
• Painful sensation in maha srotas (large channels)

Pitta Prasara Lakshana

• Localized burning sensation
• Sucking type of pain
• Burning sensation all over the body
• Emitting smoke from mouth

Kapha Prasara Lakshana

• Anorexia
• Indigestion
• Lassitude
• Vomiting

Sthana Samsraya (Relocation)

Agitated dosha spreads to different places and gets stuck somewhere because of obstruction in srotas due to abnormality in srotas is called sthana samsaraya. Agitated and disturbed dosha moves all over the body and produces diseases when a favorable environment was developed for dosha-dushya sammurchana due to unhealthiness of srotas in a particular site resulting in manifestation of diseases.

Udara

Dosha-dushya sammurchana in udara manifests following diseases:-

• Gulma (Tumor)
• Vidradhi (Abscess)
• Udara roga (Abdominal diseases)
• Agni vikara (Digestive fire related disorder)
• Vibandha (Constipation)
• Anaha (Flatulence)
• Visuchika (Cholera)
• Atisara (Diarrhea)
• Pravahika (Dysentery)
• Vilambika (Indigestion) etc.

Bastigata

When there is a dosha-dushya sammurchana in basti region produces following diseases:-

• Prameha (Diabetes)
• Ashmari (Renal stone)
• Mutraghata (Retention of urine)
• Mutra dosha (Urine related diseases) etc.

Medhragata

Dosha-dushya sammurchana in medhra pradesa manifests following diseases:-

• Niruddha Prakasa (Phimosis)
• Upadamsa (Sexually transmitted diseases)

Gudagata

Dosha-dushya sammurchana in guda region manifests following diseases:-

• Bhagandara (Fistula-in-ano)
• Arsa (Haemorrhoids)

Vrsanagata

Vriddhi manifests

Urdhvajatrugata

Manifest urdhvajatru gata vikara

Tvak, Mamsa And Sonitagata

त्वक शब्देनात्र रसो विवक्षित:। (Dalhana)

According to the above sholaka:- Rasa is considered in place of tvak (skin) because any changes happening in rasa are expressed in skin. Diseases are:- Ksudraroga (minor diseases), Kustha (skin diseases), Visarpa (Herpes zoster) etc.

Medagata:- Disease are:- Granthi (Cyst), Apachi (Glandular swelling), Arbuda (Tumor), Galaganda (Goiter), Alaji (Eye disorder) etc.

Asthigata:- Diseases are:- Asthi vidradi (overgrowth of bones and extra teeth)

Padagata:- Disease are:- Shlipada (Elephantiasis), Vatasonita (Gout), Vatakantaka (Plantar fasciitis) etc.

Sarvangagata:- Diseases are:- Jvara (Fever), Vatavyadhi (vata related disorders), Prameha (Diabetes), Pandu roga (Anemia), Sosha (Tissue depletion) etc.

In this particular stage of kriya kala premonitory signs and symptoms of the diseases are seen. It is the fourth stage of kriya kala and treatment must be employed to correct dosha, dushya or both.

Vyaktavastha (Manifestation)

व्यधि: प्रव्यक्तं रूपं व्यक्ति:।

Reference - (S.Su 21/34)

According to the above shloka:- Appearance of clear cut symptoms of the disease.

Cardinal signs and symptoms of the diseases are expressed in this stage. For example:-

• Increased temperature is observed in jvara (fever)
• Excessive passing of watery stools is seen in atisara (diarrhea)
• Abnormal enlargement of abdomen is observed in udara roga (abdominal diseases)

Bhedavastha (Disruption)

In case of varnas (wound/ulcer) they burst and become ulcers. Certain diseases attain chronicity like jirna jvara (chronic fever), pravrddha amavata (rheumatoid arthritis) etc. In this stage specific signs and symptoms of the diseases manifests like vataja jvara lakshana, pittaja jvara lakshana etc. and also it refers to chronicity of the diseases. This particular stage of manifestation is very difficult to cure and if not treated at the earliest disease may become incurable.

Ritu Kriya Kala

Seasonal variation of dosha occurs in respective seasons like accumulation of dosha, agitation of dosha and alleviation of dosha takes place in subsequent ritus (seasons).

Chaya (Accumulation Of Doshas)

Increase of dosha in its own place and manifest dislike for things which are responsible for accumulation and like the opposite qualities of substances.

Kopa (Agitation Of Dosha)

Spreading of dosha to different places manifests symptoms of aggravated dosha like vata prakopa lakshana, pitta prakopa lakshana and kapha prakopa lakshana. Patients may feel ill health and disease may manifest if not managed properly with preventive measures. In this particular stage initially dosha variation symptoms arise, if not taken care at this stage it manifests premonitory signs and symptoms of the disease or even attain chronicity.

Prasama Or Sama (Alleviation Of Dosha)

स्वस्थानस्तस्य समता विकारासम्भव: शम:।

Reference - (A.Hr.Su 12/23)

Dosha attains normalcy in their respective seats and disease will not manifest.

Chaya, prakopa and prashama of vata dosha occurs in three seasons commencing with grisma (summer):-

• Chaya - grisma (summer)
• Prakopa - varsa (rainy)
• Prasama - sarad (autumn)

In case of pitta it commences with varsa (rainy):-

• Chaya - varsa (rainy)
• Prakopa - sarad (autumn)
• Prasama - hemant (pre winter)

For kapha it starts with sisira (winter):-

• Chaya - sisira (winter)
• Prakopa - vasant (spring)
• Prasama - grisma (summer)

Vata increases during grisma (summer) ritu due to usage of things possessing qualities such as laghu (light), ruksa (dry) etc. in the bodies of persons possessing such qualities but it does not undergo prakopa due to the presence of heat in abundance. Pitta undergo chaya in varsa (rainy) ritu due to production of amla vipaka (sour metabolic property) of water and foods but do not undergo prakopa due to coldness. Kapha dosha accumulates in excess in sisira (winter) ritu due to the consumption of foods and drinks which are snigdha (oily) and sita (cold) in nature and body of person of similar nature and it does not become prakopa due to solidification.

Conclusion

In this article we read about the six stages of disease formation that tells about the consecutive stages of disease and preventive measures for other complications. Early detection of disease helps to manage the disease successfully without much discomfort in planning the treatment. Chaya, prakopa, and prasama are the normal physiological effects on the dosha due to seasons, foods, nature etc. and there may not be chaya, prakopa and prasama may not occur in respective seasons. In case of any query kindly visit