Shatkriya kala refers to the six stages of disease progression and appropriate times for treatment according to Ayurveda. The six stages are: sanchaya (accumulation), prakopa (aggravation), prasara (spreading), sthansanshraya (localization), vyaktavastha (manifestation), and bhedavastha (complications). Understanding these stages helps determine prevention, prognosis, and appropriate curative or palliative treatment depending on the stage of disease. Treatment aims to remove doshas from their sites in early stages and treat the disease itself in later stages to prevent complications. Shatkriya kala correlates with concepts like nidana, samp
Shatkriya Kaala
• Itrefers to the recognition of the stages of a disease’s progress
and the appropriate time of treatment.
Shat - Six
Kriya - Treatment
Kala - Time or Stages
• Acharya Sushrut has described Shatkriya kala in vranaprashniya
adhyaya.
•It is very essential for early diagnosis ,prognosis and for adopting
timely preventive and curative measures.
•There are two types of kriya kala- vyadhi and ritu kriya kala.
SANCHAYA
(Stage of Accumulation)
•Accumulationof doshas in their own natural
sites.
•Doshas increase quantitatively but their quality
remains normal.
•Vague and ill defined symptoms characterized
by aversion of similar and attraction towards
opposite quality aahars and vihars.
PRAKOPA
(Stage of Aggravation)
Accumulated doshas get qualitatively vitiated and are ready
to move from their natural sites by appropriate aetiological
factors.
Vata aggravating vihara –excessive exercise, being awake at
night ,load carrying
Aharas-intake of bitter ,dry, cold, astringent foods
Pitta aggravating vihara-anxiety,fear,stress,anger
Aharas –sour, salty food, curd, mustard
Kapha aggravating vihara-day sleep, lack of exercise, etc
Aharas –maash (black gram), sesamum ,milk, aquatic meat, etc
10.
• स शीताभ्रप्रवातेषुघमाणिे च ञ्चवशेषतः |
प्रत्यूषस्यपराह्णे तु जीणेऽन्ने च प्रक
ु प्यञ्चत||२०||
• तदुष्णैरुष्णकाले च घनािे च ञ्चवशेषतः |
मध्याह्ने चार्णरात्रे च जीयणत्यन्ने च क
ु प्यञ्चत ||
• स शीतैः शीतकाले च वसिे च ञ्चवशेषतः |
पूवाणह्णे च प्रदोषे च भुक्तमात्रे प्रक
ु प्यञ्चत ||
• यस्माद्रक्तां ञ्चवना दोषैनण कदाञ्चचत् प्रक
ु प्यञ्चत |
तस्मात्तस्य यथादोषां कालां ञ्चवद्यत् प्रकोपणे ||
11.
Doshas Clinical featuresin
Prakopa avastha
Vata Koshtha toda
Vata Sancharana
Pitta Amla udgar
Pipasa
Paridaha
Kapha Anna dvesha
Hridaya utkleda
•तेषाां प्रकोपात् कोष्ठतोदसिरणाम्लीकाञ्चपपासापररदाहान्नद्वेषहृदयोत्क्लेदाश्च जायिे||
२७
• Types of Dosha Prakopa –
•Achaya Prakopa/ Pathyaja Prakopa • When Dosha jump directly to
Prakopa stage without passing through Chayaavastha
• does not require Samshodhana Chikitsa
• Sanchaya Prakopa /Apathyaja Prakopa
•Gradual increase of Doshas
• Requires Shodhana
12.
PRASARA
(Stage of Spread)
Inthis stage, doshas aggravated by above factors
start overflowing from their respective seats to
other sites like the overflowing of a mixture of
yeast, water and flour.
Vata being the causative agent, spreads other
doshas like a large accumulation of water, breaks
the barrier and flowing of water takes place in all
the directions.
This spread occurs in 15 types.
STHANSANSHRAYA
(Stage of localisation)
Doshaswhich are aggravated and spread,now get localised to
the sites where there is presence of ‘Kha vaigunya’
At this site, when the dosha dushya sammurchana takes place,
diseases occur accordingly.
Eg – Localisation in udara- visuchika,atisara
Localisation in Basti- ashmari, mutraghata
Localisation in Guda- arsha,bhagandara
When established in this way, there is appearance of
premonitory symptoms of the diseases.
VYAKTAVASTHA
(Stage of Manifestation)
Inthis stage, well manifested symptoms of the
disease appear.
It is also known as Vyadhidarshana avastha.
Santapa lakshan – Jwar
Atidrava sarana – Atisara
शोफार्ुणदग्रन्तिञ्चवद्रञ्चर्ञ्चवसपणप्रभृतीना प्रव्यक्तलषणतणता ज्वरातीसारप्र
भृतीनाां च |
तत्र पिमः ञ्चियाकालः ||
18.
BHEDAVASTHA
(Stage of Complications)
Inthis stage,the disease attains chronicity
(deerghakalanubandha) and also specific signs and
symptoms of the dosha dominant in the disease
manifest.
If not treated properly, they become incurable.
Eg- vranas burst and become ulcers and
fever, diarrhea attain chronicity
•ज्वराञ्चतसारप्रभृतीनाां च दीघणकालानुर्न्धः |
तत्राप्रञ्चतञ्चियमाणेऽसाध्यतामुपयान्ति ||
19.
Importance of Shatkriyakala
Nidana parivarjana-
Avoidance of the causative factors can prevent the occurrence of the
disease.
Helps in arresting pathogenesis in early stage.
It gives an idea of the prognosis of disease, prophylactic treatment and
curative treatment.
तत्र वायोः ञ्चपत्तस्थानगतस्य ञ्चपत्तवत् प्रतीकारः, ञ्चपत्तस्य च कफस्थानगतस्य कफव
त्, कफस्य च वातस्थानगतस्य वातवत् ; एष ञ्चियाञ्चवभागः ||
सियेऽपहृता दोषा लभिे नोत्तरा गतीः |
ते तूत्तरासु गञ्चतषु भवन्ति र्लवत्तराः ||
तेषामपहरणं च बहुदोषे शोधनं, मध्यदोषे लङ्घनपाचनम्, अल्पदोषे संशमनमममत||
Measures for maintenanceof homeostasis at
different stages
• First three stages of Kriyakala - life style and dietary
modification. •
• At Prasaraavastha treatment according to Sthanika
Dosha
• If the Vata encroaches Pitta Sthana, Pitta should be
managed. If the Pitta encroaches Kapha Sthana, Kapha
should be managed. If the Kapha encroaches Vata
Sthana, Vata should be managed •
• At last three stages : Treatment according to disease,
Rasayana , Shodhana, Shaman , Shastrachikitsa ,
palliative measures or incurable depending upon the
advancement of disease
22.
Correlation between NidanaPanchak and Shatkriya kala
Sanchaya
Prakopa
Nidana
Prasara
Sthansanshraya Purvarupa
Vyaktavastha Roopa
Bhedavastha Upshaya and Anupshaya
Samprapti
23.
Kriyakala in viewof contemporary science
• Diabetes mellitus
1. Sanchaya - Predisposing factors like genetic /presence of diseases
like obesity, PCOD/ life style
2. Prakopa - Augmented hepatic glucose production, Decreased
insulin-mediated glucose transport primarily in muscle and
adipose tissues, Impaired beta-cell function
3. Prasara - Hyperlipidemia, Hypercholestremia, Impaired renal
functions, increased various cytokines like leptin
4. Sthanasanshrya - Impaired insulin-mediated glucose transport in
(primarily) muscle and adipose tissues due to altered gene
expression and insulin resistance •Impaired blood glucose level
5. Vyakta - Polyuria, Polydipsia, Polyphagia
6. Bheda - Diabetic retinopathy and nephropathy, Diabetic
ketoacidosis,Heart stroke, Multiple organ failure