Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa’ B.A.M.S
Kriya Kala i.e. stages through which the diseases are formed or pathogenesis of a disease (samprapti) takes place can be classified into dosha kriya kala and vyadhi kriya kala.
- Dosha Kriya Kala comprises of first three stages of kriya kala i.e. Sanchaya (stage of accumulation of doshas), Prakopa (stage of aggravation of doshas) and Prasara (stage of spread of doshas).
- Vyadhi Kriya Kala comprises of the last three stages of kriya kala i.e. Sthana samshraya (stage of localization of doshas), Vyakta (stage of formation of diseases) and Bheda (stage of formation of complications).
The severity of manifestation of disease will be severe in successive stages, sanchaya being the easiest to treat and bheda being impossible to treat. In dosha kriya kala, only doshas are disturbed. In vyadhi kriya kala, the doshas which are aggravated and put into circulation in dosha kriya kala will get lodged in tissues and form diseases.
Samprapti is pathogenesis of disease and includes all the stages of formation of disease right from the consumption of etiological factors (Nidanas) to the manifestation of disease and its symptoms / complications.
Dosha Dushya Samurchana or amalgamation of vitiated doshas and weak tissues is an important event in the formation of disease, a mandatory one too. It takes place in vyadhi kriya kala.
Related Reading – Dosha Dushya Sammurchana
Samprapti Vighatana means breaking the pathogenesis of disease or breaking the bond between the dosha and dushya and thus aborting the disease process. In short Samprapti Vighatana is synonymous with treatment.
Different strategies of samprapti vighatana should be followed in both dosha kriya kala and vyadhi kriya kala.
Related Reading – Samprapti Vighatana in Dosha Kriya Kala
Samprapti Vighatana in Vyadhi Kriya Kala
Before discussing about the Samprapti Vighatana in Vyadhi Kriya Kala, we shall look into understanding the changes happening in the 3 stages of vyadhi kriya kala.
Vyadhi Kriya Kala comprises of three stages of pathogenesis (final 3 stages of kriya kala).
The last three stages of kriya kala comprises of –
Sthana Samshraya – lodgment of vitiated doshas in the weak and susceptible tissues of the body. The doshas travelling all through the body in various directions and in different channels during the Prasara stage of kriya kala gets lodged in the weak tissues. This lodgment is called Sthana Samshraya of doshas. Here the amalgamation of vitiated doshas and susceptible doshas take place. This reaction between the dosha and dushya is called dosha dushya sammurchana. In fact, in this stage, dosha dushya sammurchana begins marking the beginning of disease. During this stage, due to the dosha dushya sammurchana, the premonitory symptoms of a disease (purvarupas) are formed. These symptoms indicate that a disease would be formed in future. Since Purvarupas are formed, this stage of pathogenesis is also called stage of premonitory symptoms of a disease.
Related Reading – Purvarupas
Vyakta (Vyakti Bhava) – formation of disease with clear cut signs and symptoms peculiar and particular of the disease. In this stage, the dosha dushya sammurchana which had begun in the sthana samshraya stage further progresses and gets completed. With subsequent damage of the tissues (by the vitiated doshas) in larger scales, the premonitory symptoms (purvarupas) in the previous stage mature to form signs and symptoms which define and describe the disease. Since the signs and symptoms of the disease are formed in this stage, this stage of samprapti is also called the stage of manifestation of signs and symptoms of a disease. The disease is completely formed to its full strength in this stage. It is in this stage that the disease can be diagnosed and named.
Related Reading – Rupas
Bheda – complications are formed when the disease remains untreated in all the above mentioned stages of kriya kala. The disease further progresses from the Vyakta stage of pathogenesis causing more insult to the tissues leading to the manifestation of complications. The complications are called as Upadravas. Since Upadravas are formed in this 6th stage of pathogenesis, it is also called as Upadrava Avastha or the stage of complications.
Executing Samprapti Vighatana
Executing Samprapti Vighatana in Vyadhi Kriya Kala
Samprapti is stronger in Vyadhi Kriya Kala – In the last three stages of the Kriya Kala, the pathogenesis will be a strong one in comparison to the first three stages. We can also observe that while only doshas were vitiated in the first three stages setting a perfect platform for the formation of the disease, the disease is formed with varied strengths in the last three stages of samprapti. These three stages of kriya kala are called as Vyadhi Kriya Kala since disease is formed in these stages.
Vyadhi Kriya Kalas are difficult to treat in comparison to dosha kriya kala – Even from the treatment point of view, these three stages are difficult to treat in successive order, the bheda stage or stage of complications being the toughest, impossible to treat to be precise. Alternatively we can tell that since the samprapti is stronger in these stages, the samprapti vighatana or breaking the pathogenesis is difficult or impossible (as in bheda).
Early diagnosis of the pathological states, key for samprapti vighatana – If sthanasamshraya stage is taken care of by meddling with timely treatment, the samprapti will come to a halt and the disease will not be formed i.e. vyakta avastha or the rupas will not be formed. Similarly, if the sthanasamshraya stage and vyaktha stage of samprapti are diagnosed at the earliest and proper interventions done at the right time, the samprapti will be aborted and the disease will not progress to the bheda stage.
Read related: Samprapti Vighatana – Breaking Of Pathogenesis Meaning, Importance
Dosha Dushya Sammurchana Vighatana – In the last three stages, samprapti vighatana should be done by breaking the bond between vitiated dosha and the dushya (tissue), i.e. the morbid amalgamation should be aborted. Thus Samprapti Vighatana in vyadhi kriya kala is nothing but dosha dushya sammurchana vighatana.
Method of samprapti vighatana in vyadhi kriya kala – After the pathological association between dosha and dushyas have been broken by treatment measures like deepana (administering medicines which enhance the digestive and tissue fires), pachana (administering medicines which destroy ama, i.e. immature digestive juices in circulation), langhana (lightening therapies including fasting etc) etc, the doshas shall be expelled from the cells and tissues by administration of snehana (oleation) and swedana (sudation). As an effect of snehana and swedana, the doshas get loosened and flow towards koshta (gut, stomach). From the koshta, these morbid doshas are thrown out from the body by administering cleansing therapies (Panchakarma) including Vamana (therapeutic emesis) and Virechana (therapeutic purgation).
Vyadhi Pratyaneeka Chikitsa – In Samprapti Vighatana during Vyadhi Kriya Kala, ‘Vyadhi Pratyaneeka Chikitsa’ or ‘disease specific treatment’ should be adopted. This can be done by proper understanding of purvarupas, rupas and upadravas and a thorough knowledge of the last three kriya kalas wherein the disease is manifested.
Read related: Vikalpa Samprapti – Understanding Pathogenesis On The Basis Of Fractional Components
Samprapti Vighatana in each stage prevents its successive stage – When Samprapti Vighatana is done in Sthana Samshraya stage, the pathogenesis doesn’t progress to the Vyakta stage. Therefore the disease is not formed, not the signs and symptoms of disease. Similarly when samprapti vighatana is done in vyakta stage, the disease doesn’t progress to involve complications i.e. the bheda stage is avoided.
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