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Concept of Shadkriyakala – Key to Early Diagnosis

Pathogenesis deals with the evolution of the disease. It deals with- various aetiological factors, How the aetiological factors bring about changes in the structural and functional units of the body i.e., VATA, PITTA, and KAPHA. How these molecular changes bring about structural rearrangements in various tissues and organs. How these structural changes rearrange the function of organs.How the disarranged function of one organ leads to the rearrangement of other organs i. E. Complications. Ayurveda describes in detail the six stages of evolution of diseases as Kriyakala which are stated as follows:

  1.  Chaya; accumulation of doshas because of the action of aetiological factors.
    2. Prakop; further increase in doshas.
    3. Prasar; dissemination of doshas which will respond to the stage of septicemia, viremia, or toxemia.
    4. Sthanasanshraya; localization of doshas in a particular tissue or organ
    5. Vyakta; manifestation of disease because of functional derangements.
    6. Bheda; further differentiation into a subtype of the disease.

Ayurveda emphasizes that the physician should not allow the disease to evolve further by recognizing the manifestation of disease at the earliest and guiding the patient appropriately.

It is surprising that even 5000 yrs before ayurvedic physicians could visualize the derangements at the molecular level as the root cause of the disease. Various signs and symptoms of the doshas vitiated according to their stage as mentioned below can be easily assessed by everyone on its own and can be consulted to the doctor.

  1. SANCHAYA Lakshana of doshas (stage of accumulation) Vata – stillness, and fullness of abdomen Pitta – yellowish discoloration, diminished body temp. Kapha-heaviness, lethargy
  2. PRAKOP (stage of aggravation) Vata – pricking pain due to gases in the abdomen Pitta – sour eructations, thirst burning sensation Kapha – anorexia, indigestion, malaise
  3. PRASAR(stage of Dissemination) Vata – the altered direction of doshas, distension of abdomen Pitta – increased level of burning, sensation with pain Kapha – anorexia, indigestion, malaise, vomiting
  4. STHANASAMSRAYA  –   (Stage of localization prodromal symptoms appear)
  5. VYAKTAVASTHA   (Stage of manifestation) In this stage, a disease with full signs and symptoms appear
  6. BHEDAVASTHA   is the chronic stage (Stage of complication)

So, there are six stages of disease manifestation according to Ayurveda. Clinical features start to appear only from the 4thstage. But a person can detect the signs of doshas imbalance himself in the first 3 stages and contact to the consultant, Thereby correcting it at a very early stage so as to check the disease progression.

Dr. Sangeeta Gupta
Professor
Department of Rognidan
FIMS, SGT University

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