Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
The stages of disease formation are called Kriya Kala. They are six in number.
The first three stages are called Dosha Kriya Kala because only doshas are vitiated and spread out in these three stages.
Sanchaya (stage of accumulation of doshas),
Prakopa (stage of aggravation of doshas) and
Prasara (stage of spread of doshas).
It is easy to treat these stages because the tissues are not invaded by vitiated doshas and the disease process has not set in.
The last three stages are called Vyadhi Kriya Kala. This marks the production of disease and complications.
Sthana Samshraya (lodgment of doshas in the tissues),
Vyakta (stage of disease formation) and
Bheda (stage of complications) are the members of vyadhi kriya kala.
From the prognosis point of view these three stages are difficult to treat because the disease has been formed. Bheda stage is impossible to treat or at times can be treated with difficulty.
The entire process right from the exposure to nidanas (etiological factors of the disease) to the formation of disease is called Samprapti. Samprapti explains the pathogenesis of a disease.
The amalgamation of vitiated doshas and weak and susceptible tissues is called dosha dushya samurchan which is an important and mandatory event needed for manifestation of a disease. Dosha dushya sammurchana takes place in the sthana samshraya stage of the kriya kala and completes in the vyakta stage of kriya kala.
Related Reading – Dosha Dushya Sammurchana
If a disease needs to be treated, its pathogenesis or samprapti should be broken i.e. the amalgamation of dosha and dushya should be separated. Breaking the samprapti is called Samprapti Vighatan. Samprapti Vighatana by itself is the treatment of a disease.
The physician needs to take up to different treatment strategies in dealing with samprapti vighatana in dosha kriya kala and vyadhi kriya kala.
Samprapti Vighatana in Dosha Kriya Kala
Dosha Kriya Kala comprises of the first three stages of pathogenesis.
The first 3 stages of pathogenesis of a disease comprises of –
Sanchaya – Sanchaya means accumulation of disturbed doshas in their respective places. It is the first stage of pathogenesis. It is also called as samhati rupa vriddhi i.e. cumulative increase of doshas.
Prakopa – Prakopa means severe vitiation (aggracation) of doshas in their own seats. It is the second stage of kriya kala. It is also called as vilayana rupa vriddhi i.e. liquefaction of doshas.
Prasara – Prasara means spread of vitiated doshas from their seats towards other parts of the body, i.e. overflow of doshas trespassing into the territories of the body not belonging to them. This follows prakopa or liquefaction of doshas. The liquefied doshas leave their seats and spread out in the body in all directions i.e.
upwards (urdhwa gati),
downwards (adho gati)
and side wards (tiryak gati).
The doshas put into flow in prasara are in sought of a place for lodgment. This place may be an organ (koshta, koshtanga), tissue, vital organs (marma), bones or joints.
One should remember that the doshas in dosha kriya kala are either vitiated or put out of place into circulation but they have not yet got lodged in the tissues nor damaged the tissues. Therefore the disease has not yet begun.
Executing Samprapti Vighatana
Executing Samprapti Vighatana in Dosha Kriya Kala
Samprapti is weak in Dosha Kriya Kala – In the first three stages of Kriya Kala, the Samprapti is weak or in steady and slow progression. Here only the doshas are increased gradually until they overflow and reach other parts of the body. These stages are called Dosha Kriya Kala.
Samprapti Vighatan is easier in Dosha Kriya Kala due to weaker Samprapti – For a disease to be formed the vitiated doshas should invade the weaker tissues and the organs made up of these tissues and damage them. Since in the first 3 stages of pathogenesis the doshas are either increasing or spreading without getting into contact of the tissues, the disease is not formed. Therefore treatment of these stages or aborting the samprapti at this stage becomes easier.
Samprapti Vighatan in Dosha Kriya Kala avoids manifestation of Vyadhi Kriya Kala – In these stages if the doshas are taken into control and if they are not allowed to come into contact with the dushyas (tissues), the pathogenesis gets arrested and the vitiated doshas get pacified. They do not progress into successive stages of vyadhi kriya kala (to be explained ahead) and hence the disease is not formed.
Dosha Pratyaneeka Chikitsa in Dosha Kriya Kala – In Samprapti Vighatana during Dosha Kriya Kala, ‘Dosha Pratyanika Chikitsa’ or ‘specific treatments and remedies to pacify the vitiated doshas’ should be adopted. A thorough analysis and study of the vitiated dosha or doshas in a given disease will help in comprehensively carrying out this form of treatment.
Doshas get pacified and samprapti vighatana takes place if the person has good immunity – If the person is immune enough, and if the dinacharya (diurnal regimen) and rutucharya (seasonal regimen) are followed properly, the doshas do not progress from prakopa to prasara. Instead the vitiated doshas undergo spontaneous regression in the following season (season antagonistic to them) even without remedies or little intervention. This is called shamana of doshas.
Samprapti Vighatana initiated in the earlier stages will prevent the formation of successive pathological stages – When samprapti vighatana is done in the sanchaya stage, the doshas don’t proceed towards aggravation (prakopa). Similarly when the doshas are taken into control during the prakopa stage they do not tend to spread (prasara), in fact they get settled down due to suitable interventions or by properly following seasonal regimen.
Just Before Finishing –
In this article we have discussed about breaking or aborting the pathogenesis during different stages of dosha aggravation i.e. in the dosha kriya kala. This forms the basis of an effective initial intervention so as to take the vitiated doshas into control before they attack the tissues and initiate the disease process. Doshas controlled in dosha kriya kala will not progress into the further stages of pathogenesis i.e. vyadhi kriya kala and hence the pathogenesis can be broken at the earliest (samprapti vighatana) and formation of diseases avoided.
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