Concept of Shatkriyakala

Prof. Sangeeta Gehlot

& Dr. Sonam Agarwal
Department of Kriya Sharir, Faculty of Ayurveda, IMS, BHU
 Introduction
• It is the stages of progressive pathogenesis of a disease .
• It is the different opportunity for a physician to break the pathogenesis of a disease
i.e. early diagnosis and treatment as soon as possible.
• The term Kriyakala refers to the recognition of the stage of a disease progress,
which helps to determine appropriate measure to correct the imbalance in Doshas
(biological factors).
• It is a compound expression, comprised of Kriya and Kala, where Kriya means the
choice to treatment (medicine, food and daily-routine) used to improve the
disturbance in Doshas, and Kala refers to the stage of progress of a disease

Shat Kriya Kala

Prayatanaadi Karma
Six stages of pathogenesis of Cheshtamuchyate/ treatment Time
diseases procedures for Dhatusamyta
 सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम ्
व्यक्तं भेदं च यो वेत्ति दोषाणां स भवेद्भभषक् (Su.Su.21/36)

Sanchaya

Bheda Prakopa

Shatkriyakal
a

Vyakta Prasara

Sthana-
sanshraya
 SANCHAYA

चयो वद
ृ ्धिः स्वधाम्न्येव प्रदवेषो वद
ृ ्धहे तष
ु ु ववपरीतगण
ु ेच्छा च ( A.H.Su.12/ 22)

Accumulation of Dosha occurs at

their own places.

Accumulated Dosha resides at their own

sites instead of free circulating.

Subject has aversion against the etiology of Dosha Sanchaya

and strong desires towards anti causes of Sanchaya.
 Cause of Dosha Sanchaya

Improper Disturbed
Diet Lifestyle
Causes Of Dosha
Sanchaya
Trividha Hetu and Kala
Psychological
Factors

It may also include the genetic predisposing factors , for example in case of Diabetes mellitus and
hypertension.

Thus the disturbance in homeostasis can be overcome through appropriate diet and life style modification
• Accumulation of Dosha also occurs in accordance to timing of meal, age, day- night and
season.
Features manifested during Sanchayavstha

तत्र सकञ्चतानां खलु दोषाणां स्तब्धपूणक

ण ोष्ठता पीतावभासता मन्दोष्मता चाङ्गानां
गौरवमालस्यं चयकारणत्तवद्वेषश्चेतत भलङ्गातन भवकन्त | तत्र प्रथमः क्रियाकालः
(Su.Su.21/18)
Vata Dosha Pitta Dosha Kapha Dosha

Anganamgauravam
Stabdhapoorna Peetavabhasata
(heaviness of the body
Koshthata (stiffness (yellowish discoloration)
parts)
and fullness in Mandoshmata (low body
Aalasya (lassitude)
abdomen) temperature)
 PRAKOPA
(The stage of vitiation)
कोपस्तन्ू मागणगाभमता|
भलङ्गानां दर्णनं स्वेषामस्वास््यं रोगसम्भवः (A.H.Su.12/23)

•Doshas which were previously accumulated and stagnated in their own sites tend
to circulate to other sites.
•The appearance of symptoms indicate the disturbance in homeostasis i.e. health.
•According to Dalhana, Prakopavastha is extended state of Chayavastha in which
Doshas are in liquid or gaseous forms and tend to leave their sites.
•It results due to indulgence in Dosha Prakopaka Aahara (food)-Vihara (regimen).
 Causes of Vata Prakopa

Diet Lifestyle Diurnal and seasonal

Food article of : • Suppression of • Cold season ,

• Katu, Tikta , natural urges. Rainy season
Kashaya Rasa • Night • At the starting of
• Ruksha , Laghu awakening day and night
and Sheeta Dravya
• Adhyashana ,
Vishamashana
• Examples : Pulses
 Causes of Pitta Prakopa
Diet Life Style Psychological Diurnal and
seasonal

Food articles of : Over exertion Anger, Grief , • At the mid of the

• Katu, Amla and Anxiety day and night
Lavana Rasa • During the
• Teekshna , Ushna, digestion of meal
Laghu and Vidahi • Hot season and
substances autumn
• Taking food in
small quantity
• Example : Tila
taila, Pinyaka
 Causes of Kapha Prakopa

Diet Life style Diurnal and

seasonal

Food substances of • Day time sleeping • At the starting of

• Madhura, Amla and • Lack of exercise day and night
Lavana Rasa • Spring season
• Sheeta, Guru and
Snigdha Substances
• Example : Food items
made up of Pishta ,
milk, sugarcane
• Adhyashana
 Types of Dosha Prakopa

• When Dosha jump directly to Prakopa stage without

Achaya Prakopa/ passing through Chayaavastha
Pathyaja Prakopa • It does not require any Samshodhana Chikitsa like
Vamana, Virechana

Sanchaya Prakopa • Gradual increase of Doshas

/Apathyaja • Requires Shodhana Chikitsa
Prakopa/Kathinyabala • Doshas are in liquefied state or gaseous
(solidified increase) state
 Symptoms of Dosha Prakopa
तेषां प्रकोपात ् कोष्ठतोदसञ्चरणाम्लीकात्तपपासापररदाहान्नद्वेषृददयो््लेदाश्च
जायन्ते
तत्र द्त्तवतीयः क्रियाकालः ( Su.Su.21/27)
Vata Prakopa-
• Koshthatoda Sancharan (pricking pain and movement of Vata in
abdominal region)
Pitta Prakopa-
•Amlika(sour eructation)
•Paridaha(burning sensation all over the body)
•Pipasa (excessive thirst)
Kapha Prakopa
• Annadwesha (aversion to food)
• Hridyotkleda (excessive salivation in mouth)
 Prasara (The stage of dissemination)
• This stage marks with the dissemination of vitiated Dosha to different parts
of the body.
• The aggravated Dosha leave their original path and spread to the other parts
of the body through different channels.
• If appropriate management is taken, the pathogenesis stops here but if not
it progresses to further stages .
• This spread of Dosha is of fifteen types.
• Can be understand from the similes of
प्रकुत्तपतानां क्रकण्वोदकत्तपष्टसमवाय
महानुदकसञ्चयोऽततवद्
ृ धः सेतुमवदायाणपरे णोदकेन ( Su.Su.21/36)
एवं प्रकुत्तपतानां प्रसरतां वायोत्तवणमागणगमनाटोपौ, ओषचोषपररदाहधम
ू ायनातन त्तपिस्य,
अरोचकात्तवपाकाङ्गसादाश्छर्दण श्चेतत श्लेष्मणो भलङ्गातन भवकन्त; तत्र तत
ृ ीयः
क्रियाकालः (Su.Su.21/36)
Features of Vata Prasara :
• Vimarga gamana(regurgitation)
• Aatopa (flatulence and gurgling)

Features of Pitta Prasara :

•Osha (burning sensation accompanied with sweating and restlessness)

•Chosha (painful sucking sensation)

• Paridaha (burning sensation around the part involved)
• Dhumayana ( feeling of movement of hot fumes inside head, neck ,
throat and palate)

Features of Kapha Prasara-

• Arochaka (anorexia)
• Avipaka( indigestion)
• Angasada (inertness in limb)
• Chardi (vomiting)
Sthansamshraya (The stage of localization)

कुत्तपतानां र्ह दोषाणां र्रीरे पररधावताम ्

यत्र सङ्गः खवैगण्ु याद्व्याधधस्तत्रोपजायते ( Su.Su.24/10)

•The aggravated Doshas which were previously localized, starts circulating to whole
body and resides in the Srotas where there is any kind of Khavaigunya i.e.
anatomical or physiological abnormality. it marks the beginning of specific diseases
• In this state, Dosha Dushya Sammurchana i.e. involvement between Dosha and
Dushya takes place at the site of Srotovaigunya.

क्षिप्यमाणः खवैगुण्याद्रसः सज्जतत यत्र सः

करोतत त्तवकृततं तत्र खे वषणभमव तोयदः ( Ch.Chi.15/37)
In this stage, all the prodromal symptoms of diseases appear. So
this stage is also called the Poorvarupa of diseases
स्थानसंश्रतयणः िुद्धा भात्तवव्याधधप्रबोधकम ्
दोषाः कुवणकन्त यकललङ्गं पव
ू रू
ण पं तदच्
ु यते’
(Chakrapani
on Su.Su.21/37)
The sign and symptoms produced in this stage are on the
basis of sites where Dosha Dushya Samurchhana occurs.
Symptoms manifested during
Prasaravstha
एवं प्रकुत्तपतातांस्ताञ ् र्रीरप्रदे र्ानागम्य तांस्तान ् व्याधीन ् जनयकन्त |
ते यदोदरसकन्नवेर्ं कुवणकन्त तदा गल ु म
त्तवद्रध्युदराकननसङ्गानाहत्तवसधू चकाततसारप्रभत ृ ीञ्जनयकन्त; बकस्तगताः
प्रमेहाश्मरीमत्रू ाघातमत्र ू दोषप्रभत ृ ीन ्; मेढ्रगता तनरुद्धप्रकर्ोपदं र्र्क ू दोषप्रभत ृ ीन ्; गद
ु गता
भगन्दरार्णःप्रभत ृ ीन ्; वष ृ णगता वद् ृ धीः; ऊध्वणजत्रग ु तास्तध्ू वणजान ्; ्वङ्मंसर्ोणणतस्थाः
िुद्ररोगान ् कुष्ठातन त्तवसपाांश्च; मेदोगता ग्रन््यपच्यबद ुण गलगण्डालजीप्रभत ृ ीन ्; अकस्थगता
त्तवद्रध्यनुर्यीप्रभत ृ ीन ्; पादगताः श्लीपदवातर्ोणणतवातकण्टकप्रभत ृ ीन ्; सवाणङ्गगता
ज्वरसवाणङ्गरोगप्रभत ृ ीन ्; तेषामेवमभभसकन्नत्तवष्टानां पूवरू ण पप्रादभ
ु ाणवः तं प्रततरोगं वक्ष्यामः
|तत्र पव ू रू
ण पगतेषु चतथ ु ःण क्रियाकालः
(Su.Su.21/33)
S.N Organ Disease

1. Udara  Gulma (abdominal tumor)

 Vidradhi (internal abscess)
 Udara roga (diseases of liver, spleen and ascites)
 Anaha (constipation)
 Visuchika (acute gastroenteritis) and Atisara ( acute entero
colitis)

2. Vasti  Prameha (DM)

 Ashmari (renal calculus)
 Mutraghata (retention of urine)
 Mutrakriccha(difficult and painful micturition)
3. Medra  Upadansha (sores on the penis),
 Niruddhaprakarsha (Phimosis)
 Shukadosha
4. Guda  Bhagandara (fistula-in-ano) and Arsha (hemorrhoids)
5. Vrushana  Vriddhi (hydrocele, haematocele, orchitis)
6. Urdhwajatrugat  Diseases above the clavicle region
7. Twak, Mamsa and  Kshudraroga (minor maladies)
Shonitagata  Kustha( skin disorders)
 Visarpa (erysipelas)

8. Medagata  Granthi (lymphadenitis)

 Apachi, Arbuda ( tumor benign or malignant)
 Galaganda ( goiter)
 Alji ( a type of carbuncle)etc
9. Asthi  Vidradhi (osteomyelitis)
 Anushayi ( periostitis)
10. Pada  Shlipada (filariasis),
 Shonita-vata
 Vyakti (The stage of manifestation)

• अत ऊध्वां व्याधेदणर्न
ण ं वक्ष्यामः- र्ोफाबदुण ग्रकन्थत्तवद्रधधत्तवसपणप्रभत
ृ ीनां
प्रव्य्तलिणता ज्वरातीसारप्रभत ृ ीनां च | तत्र पञ्चमः क्रियाकालः
( Su.Su.21/34)
• Disease manifests their cardinal symptoms after interaction between
Dosha and Dushya. For e.g:-
• Increased body temperature is observed in Jwara
• Excessive watery stool in Atisara
• Abnormal enlargement of abdomen in Udara Roga
प्रव्य्तलिणता व्याधीनां व्यक्तरर्यथणः( Chakrapani on
Su.Su.21/33)
Bheda (The stage of complication)

अत ऊध्वणमेतेषामवदीणाणनां व्रणभावमापन्नानां षष्ठः क्रियाकालः,

ज्वराततसारप्रभत ृ ीनां च दीघणकालानब ु न्धः |
तत्राप्रततक्रियमाणेऽसाध्यतामप ु याकन्त (Su.Su.21/35)
•It is the most advanced and last stage of Kriyakala
•If not treated , the disease becomes incurable, chronic, complicated or may
gives rise to another disease.
•This is the stage when disease is diagnosed more by its complications along
with the main diseases
Importance of Knowledge of Kriyakala
सञ्चयेऽपृदता दोषा लभन्ते नोिरा गतीः
ते तूिरासु गततषु भवकन्त बलविराः ( Su.Su.21/37)
•Early diagnosis and treatment of diseases, for the prevention and cure.
•Diagnosis of disease.

•To decide the treatment plan as per the intensity of Dosha aggravation :
Alpadosha – Sanshamana
Madhyamadosha – Langhana Pachana
Bahudosha – Shodhana
• To decide the prognosis (whether the disease is curable or not).
• For the prevention of disease.
• To decide appropriate time for the management as treatment not started
at appropriate time ( both early or late) may result in bad prognosis of
even curable diseases.
अप्राप्ते वा क्रियाकाले प्राप्ते वा न कृता क्रिया
क्रिया हीनाऽततरर्ता वा साध्येष्वत्तप न भसध्यतत (
Su.Su.35/26)
Common measures for the maintenance of
homeostasis at different stages

• At first three stages of Kriyakala mainly, there should be 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
Understanding of Kriyakala in view of
contemporary science
Sanchaya and Prakopa : Stage of
susceptibility /prepathogenesis /
Epidermiological triad

Prasara and Sthanasanshraya : Stage

of presymptomatic disease

Vyakti : Stage of clinical disease

Bheda : Stage of diminished capacity

 Understanding of Kriyakala in view of contemporary science with
special reference to Diabetes mellitus
S. Stages Possible pathophysiology
N.
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, adiponectin
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. Bheda Diabetic retinopathy and nephropathy, Diabetic ketoacidosis,Heart stroke,
Multiple organ failure
6. Vyakta Polyuria, Polydipsia, Polyphagia
Understanding of Kriyakala in view of contemporary
science with special reference to bronchial asthama
 Conclusion

 The different stages of Kriyakala gives insight regarding the different state of
Dosha.
 It also provides understanding regarding when and what kind of measures
should be adopted for appropriate management of diseases.
 Adoption of these measure avoids the bad prognosis of disease.
 Implementation of concept of Shatkriyakala in modern medicine will result in
better management of diseases.