I'm a final year medical student pursuing BAMS from RK.Ayurvedic Medical College, Azamgarh. I had created this PPT for my seminar. I had selected this topic because kriyakaal are useful to know the prognosis of the disease and in the decision of treatment strategy.

1. SHAT KRIYA KALA
IN SURGICAL PRACTICE
Presented By :
Tanu Shriya Srivastava
BAMS 4th Year
Department of Shalya Tantra

2. INTRODUCTION
• Shatkriya kaal is defined as the six main stages of
disease manifestation
SHAT KAAL
KRIYA
SIX (6) AVSAR
CHIKITSA
Sanchayam Cha Prakopam Cha prasaram Sthanasamsrayam;
Vyakti Bhedam Cha Yo Vetti Roganam Sa Vadedbhishak.

3. SIX STAGES OF DISEASE IN THE BODY
BHEDA
VYAKTA
STHANA
PRASARA
PRAKOPA
SANCHAYA Stage of Accumulation
Stage of Inclination/Aggravation
Stage of Spreading/Migration
Stage of Localization/Deposition
Stage of Manifestation
Stage of Complications/Differentiation

4. 1. SANCHAYA (ACCUMULATION)
• Sanchaya is the first stage of shat kriya kal meaning
collection,putting together ie accumulation of doshas
due to various nidan factors.
• In this stage, doshas get accumulated but they do not
leave their own place.
• Sanchaya is primarily associated with the imbalance of
biological water, Kapha which accumulates in the
amasya (stomach).
• According to Ayurvedic system of medicine, when ama
is product of the imbalance of the biological fire, Pitta, it
accumulates in the ksudrantra (small intestine) and in
the colon ama gets connected to the dysfunction of the
biological air, Vata.
• Aama disturbs the smooth functioning of the three
biological doshas resulting in mild symptoms which can
be easily detected, which is a signal of physiological
imbalance.

5. 2. PRAKOPA (AGGRAVATION)
• Prakopa is the 2nd stage of the shat kriya kal.
• It is generally translated as aggravation or provocation.
• Although prakopa phase of the shat kriya do not
manifest the differentiated clinical signs and symptoms
that modern system of medicine is not in a position to
recognize.
• When the doshas are in sanchaya condition, if Nidan
intake persist dosha PRAKOP stage follows.
• Prakopa stage is limited to the state of readinessof
dosha to move from its own place.
• This means that dosha increases in quantity and is
ready to move.
• Accordingly, the Ayurvedic doctor prescribes some
behavioural and dietary changes in order to reverse
stage of the prakopa.

6. 3. PRASARA
(Liquefaction/Spreading)
• Prasara is the 3rd stage of shat kriya kal as per
Ayurveda.
• Prasara means to leave and spread. If nidan intake
continued and prakopa avastha is not encountered, the
dosha will move to the next stage of prasar.
• In prakopa state, doshas get excited and are ready to
move, whereas in Prasar they overflow or spread or will
move out to other organs.
• Hetu Lingam chikitsa of dosha is advised upto prasar
avastha, after which vyadhi chikitsa is followed.
• Spread of dosha aggravated by the aforeside causes
take place on overflowing like the mixture of yeast, water
and flour. As the large accumulation of water further
excessively increased,breaks the barrier and mixed with
other pool of water runs in all directions.

7. 4. STHANA SANCHAYA
(RELOCATION)
• Sthana sanchaya is the 4th phase of shat kriya kal.
• It is also known as stage of disease relocation or
augumentation.
• Sthana refers to raking shelter in some place.
• If continuation of etiological factor persists in
prasavastha, dosha will move into the next stage of
sthan sanchaya.
• The ama from the prasra stage enters in a feeble and
defective tissue.
• Vitiated dosha settle wherever shrotas vagunya is
present. This settlement is sthana sanchaya.
• When the doshas are established in this way, there is a
appearance of premonitory signs and symptoms as per
the view of Acharya Shushrut.
• This is the stage which can invite some dehenerative
disorder or infective disease.

8. 5. VYAKTA (MANIFESTATION)
• Vyakta is the 5th stage of shat kriya kal.
• Vyakta means which can be visualized.
• In this stage, well differentiated and clear-cut symptoms
appear on first basis.
• Vyakta can be defined as the stage of symptom
manifestation.
• The process of the disease overpowers the capability of
the human-body to maintain harmostasis and immunity.
• At this juncture, structural and functional dysfunctions
progress to such stage where the illness has actual
start.
• The process of the disease results in the manifestation
of the clinical symptoms which are used by the
Allopathic doctors for diagnosis of the disease.

9. 6. BHEDA (DISRUPTION)
• Disruption is the final and 6th stage of shat kriya kal as
per Ayurvedic system of medico.
• Bheda is also defined as stage of updrava or
complications Vyakta, the 5th stage gives or rather
confirms the general diagnosis and 6th stage stands for
the sakshepa nidana or differential diagnosis.
• Bheda provides a detailed information and
understanding of the group of clinical symptoms.
• Bheda is characterized by severe depletion of the tissue
function, serious damage to the channels of circulation
or srotas, and the upadrava which involves the related
tissue.
• The whole disease cycle is aggravated by the
unpleasant and toxic (sometimes) side-effects of the
medicines that are employed to cure the disease.

10. Importance of Kriya Kaal
• Doshas if eliminated in this stage of accumulation do
not attain succissve stages.
• They become stronger as they proceed further.
• Treatment in earlier stages is easier than in later
stages.
• Kriyakaal are useful to know the prognosis of the
disease and in the decision of treatment strategy.

11. THANK YOU !