Kriyakala & Its Clinical Importance

Guided By –
Dr. Vasantha
Presented By –
Yashas M Gowda
 Introduction
• There are two objectives of Ayurveda first one is to maintain healthy life
and second to treat the diseased person when there is progression of
disease.
• It follows six consecutive steps which are described as Kriyakala by
Acharya Sushruta in 21st chapter of Sutra Sthana.
• It includes the entire pathogenesis of the disease from Nidan sevan upto
appearance of sign and symptoms, chronicity and complications of
disease.
• Knowledge of these stages help to start the treatment timely before it
becomes Kashtasadhya.
As the Doshas get vitiated it doesn’t directly lead to disease manifestation rather it
follows Sanchaya, Prakopa, Prasara etc.. different consecutive stages to develop
disease
सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम।्
व्यक्ति भेदं च यो वेत्ति दोषाणां स भवेद्भभषक् ।। (सु.सू. 21/36)
These are six in numbers ie.
1. Sanchaya
2. Prakopa
3. Prasara
4. Sthansanshriya
5. Vyaktawastha
6. Bhedawastha

The steps which Dosha and Dushya follow with the involvement of Agni and Ama
successively appear as disease is known as Kriyakala
 Kriyakala

Dosha Kriyakala Shat Kriyakala

1. Sanchaya
1. Sanchaya
2. Prakopa
2. Prakopa
3. Prasara
3. Prasara
4. Sthansanshriya
5. Vyaktawastha
6. Bhedawastha
 Sanchaya (Stage of accumulation)
चयोवद्
ृ ्धिःस्वधाम्न्येव
• Sanchaya (Stage of accumulation) Sanchaya, the first stage of Kriyakala, describes the collection or
accumulation of Doshas due to various causative factors.
• In this stage, Doshas accumulates but do not leave their own place (e.g. Vata builds up in the bones, Pitta in the
blood and Kapha in the lymph and muscles).
• The etiology of Sanchaya can be of either Kala Swabhava (natural) or Trividha Hetu (three causative factors).
• The three causative factors are Prajnaparadha (misleading), Asatmendriyartha Samyoga (improper use of
sensory organs) and Vyapanna Hetu (inherent cause), which include seasonal changes, day-night changes and
changes in food and regimen.
• In this stage there will be hatredness towards the similar Gunas as that of the Sanchitha Dosha and desire
towards the opposite one.
• For instance in case of Vata Sanchaya there will be hatredness towards Ruksadi Dravyas and desire towards
Snigdhadi Dravyas. Due to which Sanchitha Dosha can be assessed.
 Prakopa (Stage of aggravation)
त्तवलयनरूपावद्
ृ ्धिःप्रकोपिः
• Prakopa (Stage of aggravation) In Prakopa (vitiation) stage, the accumulation stage has persisted for a long time
and the responsible factors have been continuously present.
• This stage occurs while the Dosha are ready to move from their own place to another.
• On the basis of this observation, it is assumed that the Prakopa stage is developed due to continuous intake of
improper Ahara (food), Vihara (regiment) and Aushadha (medicine).
• The Dosha Vriddhi occurs in a liquid state at its own place which is of two types, i.e., Chayapurvaka and
Achayapurvaka Prakopa.
• Chayapurvaka describes reaching Prakopa after passing through Sanchaya, whereas Achayapurvaka Prakopa is
characterized by reaching Prakopa without prior accumulation.
• In Achayapurvaka Prakopa, although Doshas become abnormal, the damage caused by these abnormal
Doshas can be curable. The Prakopa stage can be diagnosed on the basis of continuous Chaya Lakshanas , desire
for opposite Gunas and aversion to similar Gunas.
 Prasara (Stage of spread)
दे शा्िरसरणमेवप्रसरिः
Prasara is a stage of spreading, Now in Prasara stage, the Doshas overflow and spread or move to other areas or
organs of the body.
• Acharya Sushrutha explains this stage by giving simile of “Kinvodaka- Pista Samyoga”. Kinva, Udaka and grinded
rice grains are mixed and kept in a vessel all over the night leading to fermentation process. This fermentation
leads to spreading of the contents out of the vessel in the same way the aggravated Doshas starts spreading
from its abode.
• The pathogenesis of Prasara stage has been described in most of the Samhitha due to its significance in the
manifestation of a disease.
• In this stage, Doshas spread all over the body starting from sole to the cerebrum. Pitta and Kapha Doshas, as
well as dhatus and malas are inert substances and can be increased in quantity but cannot move from one place
to another.
• Vata Dosha, on the other hand, helps to move Pitta, Kapha, Dhatus and Malas to other places. Thus, it appears
that the Vata is a key factor that mediates the Prasara stage in the disease manifestation process.
• In Prasara stage, diagnosis can be made with the help of clinical involvement.
Chaya prakopa prasama according to rutu
वय प्रकोप प्रशमा वायोग्रीष्मादिषु त्रिष।ु
वषाादिषु तु पपतस्य श्लेष्मणः शशशशरादिषु ।।
Vyadhi Kriyakala and Dosha Lakshanas
Dosha Sanchaya Prakopa Prasara
Stabhakosta (tympanitis) Kostatoda (pricking pain Vimargagamana Atopa
Vata Poorna Kosta (fullness of in GIT) Doshasancharana (fullness of abdomen)
GIT (movement of doshas in
GIT)
Peetavabasa (yellowish Amlika (sour belching) Osha (increased body
Pitta discolouration) Pipasa (thirst) Paridaha temperature) Chosha
Mandoshma (burning sensation) Paridaha (burning
(lowdigestion) sensation) Dumayana
Anga gourava (bodyache) Annadwesha (aversion Arocaka (anorexia)
Kapha Alasya (tiredness) towards food) Avipaka (indigestion)
Hrudayotkleda (fullness Angasada (body pain)
of heart) Chardi (vomiting)
 Sthanasamshraya (Stage of localisation)
स्थानसंश्रययणा क्रुद्धा भात्तवव्या्ध प्रबोधकम ्
भलङ्गम ् कुववयि यद्दोषां पव ू वरूपम ् िदच्ु यिे ।
• Sthanasamshraya (localization) or the settlement of Doshas at a particular place occurs when vitiated Doshas
are circulating and settle in areas of Srotovaigunya (depletion of tissue).
• Certain causative factors which have enough potential to cause damage are responsible to settle Doshas at a
particular site.
• There are only few sites called Khavaigunya (weak or defective site), which are prone to the settlement of
Doshas. These weak or defective sites may have tissue depletion or certain disturbances in their normal surface.
Furthermore, a specific causative factor may have an affinity towards particular channels or tissues, which leads
to a defective site on the manifestation of a disease.
• The localization of Doshas at sites in the abdomen produces disorders related to the stomach and urinary
bladder. When the Doshas are localized in the skin, muscle or blood, the condition may lead to skin diseases like
leprosy, whereas localization in fatty tissues of the body causes cysts, tumor and goitre.
• It suggests that a particular disease is produced by the localization of Dosha at a particular site of the
body. the union of Doshas/ Dushyas at a particular site is called Sthanasamsraya.
 Vyaktha (Stage of manifestation)
व्याधेिः प्रव्यति रूपं व्यक्तििः । ड-सु.स.ू २१/३३
• Vyaktha (Stage of manifestation) If the causative factors present in
Sthanasamsraya are not treated and continue, Dosha enters into Vyakthi
(manifestation) stage, in which all the symptoms of a disease appear, hence
called Rupa Avastha.
• A particular disease depends upon the vitiation of a particular Dosha and the
interaction of a particular Dhatu (body tissue), as well as the extent of their
mixture.
 Bheda (Stage of chronicity)
• Bheda (Stage of chronicity) Bedha is the final stage where the progression of
a disease reaches an end.
• Complications from living with a disease may bring about other diseases,
and finally may lead to death.
• In this stage, the disease is usually diagnosed by its complications; the
treatment of both the disease and its complication has to be done otherwise
the treatment may not be possible.
• However, in Bedha, the survival rate is generally decreased.
 Conclusion
• The proper knowledge of Shatakriyakala helps in understanding the process of
manifestation of various diseases as well as to diagnose the diseases.
• The physician who is capable of differentiating and understanding these six stages of
Dosha; diagnose and treat the disease accurately according to Shatakriyakala will become a
Bhishak i.e., successful practitioner.
• The knowledge of Shatakriyakala is helpful for knowing what kind of treatment should be
administered in respective stage of Dosha.
• It precisely gives idea of the Sadhyaasadhyatva of disease.
• After all the elaboration about the topic Acharyas warn the physician not to procrastinate
Kriyakala in any way that it will lead to Asadhyata of Vyadhi and failure in Chikitsa.
• Hence, the concept of Shatkriyakala delineated in classical treatises of Ayurveda are of
great significance.
 Importance
संचये अपहृिे दोषा लभ्िे न उिरा गि िः।
िे िु उिरासु गयिषु भवक््ि बलविरािः ॥ स.ु सू २१

• Earlier the diagnosos easirer the treatment. If the

diseases progress to further stages then it will be difficult
to treat.
• Which is compared with a simile that is …
• The smaller plants are easier to uproot, the same plant is
difficult to uproot when it has grown into a big tree,
similar in case of disease too.