Shatkriyakala – 6 stages of disease formation

Shatkriyakala – 6 stages through which doshas travel and create a disease – the changes that occur in doshas that create disease. To create disease, change in doshas + kha vaygunya (weakness in body) must both be present for disease to take place. Ex. Some joint impact, say a fall or injury, then later in winter maybe knee starts to ache. Because the patient hasn’t healed area fully, so as doshas increase, then the vitiated doshas attack that particular point later. Western medicine calls it arthritis. Even knee replacement or surgery touches the organ and therefore will later have problems with the knees. In some cases, orthopedic surgery can be very helpful – breaking off the head of the femur for example. But of course then you have to do things to reinforce. In case of old people, without the surgery they may not be able to walk and therefore couldn’t do those ayurvedic things to improve bone density. So better to do the surgery than not in this case. Looking at the patient, we can understand bones need strength – is it something we can give through nutrition or lifestyle, is it due to aama or an obstruction?, these are issues to understand for treatment. Some mechanical exercises can help to train the bones in a specific manner to help.

 

So when a particular impact or disease has happened to a specific organ, either internal or external, congenital, etc. if remains untreated, that particular organ remains weak. Then next time anything happens, vitiation occurs, that is the organ that becomes affected. The treatment isn’t finished just because the symptoms are gone. We need to help the organ to regain its strength – that is rasayana treatment. Treatment should always be in such a manner that there shouldn’t be any weakness in body – even srotas should be in order. Srotovaygunya/Kha-vaygunya – weak srotas.

Being weak doesn’t mean disease – only weakness doesn’t create disease, but if doshas are aggravated – say eating a lot of vata aahara and doing a lot of vata vihara activities, will aggravate the weak spot. If doshas are increasing, will show some signs of vata prakop, but that won’t be considered a disease. Some kind of stiffness in body due to vata prakopa, but if agni is strong enough and we’re back on regimen, will come back into balance. Only doshas or only weak spot are not sufficient to generate disease, only the both together are sufficient to create disease.

 

There are ways that we weaken our srotas – taking naps every day can weaken medavaha srotas. If you eat heavy meals and stay away from exercise and drink alcohol, all that excess kapha will get stuck in the medavaha srotas. So classic siesta lifestyle is guaranteed to weaken the medavaha srotas. The aahara rasa will always be heavy and bulky beginning at gross digestion, and then kapha will be qualitatively and quantitatively increased/vruddhi.

 

If you have injury or weakness it is possible to heal so that will not cause weakness in future. So with knee injury, oleation with medicated oils, then specific herbs – bala, mahanarayan externally, then eat internally bala, mahanarayana. Ex. Amashaya if sthanavaygunya – must replenish with lots of aap mahabhuta. Remove weakness as a prevention for disease. Weakness can occur when vruddhi is present as well as with a kshaya/depletion. Ex. Rasa dhatu increased- why? Is it because rasa agni is low, work on increasing that agni so that it can maintain proper balance. Sometimes herbs will help to heal individual dhatu agni. (shunthi for overall agni)

 

If both weakness and vitiation are present, then chance of disease formation is higher.

 

  • Sanchaya (Natural accumulation of Doshas) – Ex. Seasonal: In Northern Solstice – spring and summer solstice. When sun rays increase, increases tej and vayu guna. In Southern Solstice – fall and winter – pruthvi and aap increasing – cooling properties of kapha coming to the surface – accumulation of kapha due to seasonal. Whatever kapha is accumulated in body, when sun comes out in spring will travel from sanchaya to prakopa. Spring is the season kapha increases from sanchaya to prakopa, summer is the season kapha decreases from prakopa to sanchaya through prashama.
  • Prakopa (More accumulation) – and comes back to Sanchaya and Prasara levels. This process of natural reduction is called Prashama. At the level of Prakopa, it returns to natural levels if we follow certain rules. Specifically in winter, eat good amounts of good food to increase strength. It’s the time of year to replenish dhatus and gain overall strength – agni is good and whatever we eat gets more easily digested, but also requires proper amount of exercise so that excess kapha isn’t created. Exercise helps to limit the kapha in the body and then when the next season comes, kapha liquefies and tries to get out of body. People blame on allergies, but really its excess accumulation of kapha without exercise. So follow seasonal regimen and come back to Prasara naturally. Eating fermented yeasty things helps increase kapha. Not always related to the season – even in summer if you eat heavy things, sleep in the daytime etc, kapha can over accumulate and overflow and reach the weak spots in the body which can form disease.
  • Prasara (Overflow level) – Prasara (Leave and spread phase):- It is the third stage of Shat kriya kal in Ayurveda. This third phase of disease formation literaly means to leave and spread. At this phase aama accumulates to such a degree that it finally starts to overflow in the gastrointestinal tract. The doshas transport along with the important nutrients to the dhatus. Its stickiness stops it from being transported back to the gastrointestinal tract. It is the stage of migration.
  • Sthana Samshraya (Stage of disease augmentation) – It is the fourth phase of Shat kriya kala. In Ayurveda it is also known as the Dosha-Dushaya samurchana stage or Samprapti stage or stage of disease augmentation. Sthana samshraya literaly means taking shelter in a place. The aama that has migrated from the gastrointestinal tract enters and lodges in a defective and weak dhatu. Once the aama accumulates in an area of low immunity, its basic qualities overwhelm the Dhatu and it causes dysfunction and structural damage of the body. It is the stage in which specific susceptibility to serious infections or degenerative diseases start. Several factors determine which specific Dhatus are predisposed to accept and be damaged by aama. A combination of the common factors like effects from previous illnesses, seasonal changes, stress, effects from past diet and behavioral choices, radiation and chemical pollutants, etc. produces weakness which opens certain tissues to diseases.
  • Vyakta (Stage of symptom
    manifestation) – It is the fifth stage of Shat kriya kal in Ayurveda and it literally means something which can be seen. This stage is the one in which clearly differentiated symptoms first appear. It is the stage of symptom manifestation. The disease process overwhelms the ability of the body to maintain immunity and healthy functioning. At this stage, structural dysfunctions or damages have progressed to the point where the illness actually activates. The disease proces manifests the symptoms that are used by the Western system for classification and diagnosis.
  • Bheda (Stage of complications)– It is the sixth and final stage of Shat kriya kala in Ayurveda. This final phase is also known as the stage of complications. Bheda literally means differentiation. Stage five that is Vyakta confirms general diagnosis and the sixth stage confirms differential diagnosis. This phase offers a detailed understanding of the group of symptoms that have surfaced the fact that all the doubts regarding the nature of the disease are eliminated. This sixth stage is characterized by severe impairment of dhatu function, serious damage to the Srotas (the vessels within each dhatu) and the complications that involves related dhatus. The entire disease process can be aggravated by the toxic side effects of the drugs that are used to cure it. At this final stage, many of the diseases become a bit difficult to treat completely. Degenerative conditions and susceptibility to several infectious diseases do not develop overnight, it takes many years and the seeds of dysfunction occur as a result of inappropriate lifestyle and diet. Shat kriya kal or the six significant stages of disease formation in Ayurveda provides the knowledge of how illness originates and manifests step by step. Ayurveda uses these six stages to remove both the signs as well.
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