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SHATKRIYA KALA
- Dr. Twinkle Joshi
Shatkriya Kaala
• It refers to the recognition of the stages of a disease’s progress
and the appropriate time of treatment.
Shat - Six
Kriya - Treatment
Kala - Time or Stages
• Acharya Sushrut has described Shatkriya kala in vranaprashniya
adhyaya.
•It is very essential for early diagnosis ,prognosis and for adopting
timely preventive and curative measures.
•There are two types of kriya kala- vyadhi and ritu kriya kala.
Sanchaya
Prakopa
Prasara
Sthan
sanshraya
Vyakta
avastha
Bheda
avastha
SANCHAYA
(Stage of Accumulation)
•Accumulation of doshas in their own natural
sites.
•Doshas increase quantitatively but their quality
remains normal.
•Vague and ill defined symptoms characterized
by aversion of similar and attraction towards
opposite quality aahars and vihars.
Types of Sanchaya
Svabhavika
Avasthiki
(According to
age)
Naimittiki
(According to
ritu)
Asvabhavika
Causes of Dosha Sanchaya
•Disturbed
lifestyle
•Genetic
predisposition
Psychological
factors
Improper
diet
Dosha Clinical Features in sanchaya
avastha
Vata Stabdha purna koshthata
Pitta Pitavabhasata, mandoshmata
Kapha Anganam gauravam, alasya
तत्र सञ्चितानाां खलु दोषाणाां स्तब्धपूणणकोष्ठता पीतावभासता मन्दोष्म
ता चाङ्गानाां गौरवमालस्यां चयकारणञ्चवद्वेषश्चेञ्चत ञ्चलङ्गाञ्चन भवन्ति |
तत्र प्रथमः ञ्चियाकालः ||१८||
PRAKOPA
(Stage of Aggravation)
 Accumulated doshas get qualitatively vitiated and are ready
to move from their natural sites by appropriate aetiological
factors.
 Vata aggravating vihara –excessive exercise, being awake at
night ,load carrying
Aharas-intake of bitter ,dry, cold, astringent foods
Pitta aggravating vihara-anxiety,fear,stress,anger
Aharas –sour, salty food, curd, mustard
Kapha aggravating vihara-day sleep, lack of exercise, etc
Aharas –maash (black gram), sesamum ,milk, aquatic meat, etc
• स शीताभ्रप्रवातेषु घमाणिे च ञ्चवशेषतः |
प्रत्यूषस्यपराह्णे तु जीणेऽन्ने च प्रक
ु प्यञ्चत||२०||
• तदुष्णैरुष्णकाले च घनािे च ञ्चवशेषतः |
मध्याह्ने चार्णरात्रे च जीयणत्यन्ने च क
ु प्यञ्चत ||
• स शीतैः शीतकाले च वसिे च ञ्चवशेषतः |
पूवाणह्णे च प्रदोषे च भुक्तमात्रे प्रक
ु प्यञ्चत ||
• यस्माद्रक्तां ञ्चवना दोषैनण कदाञ्चचत् प्रक
ु प्यञ्चत |
तस्मात्तस्य यथादोषां कालां ञ्चवद्यत् प्रकोपणे ||
Doshas Clinical features in
Prakopa avastha
Vata Koshtha toda
Vata Sancharana
Pitta Amla udgar
Pipasa
Paridaha
Kapha Anna dvesha
Hridaya utkleda
•तेषाां प्रकोपात् कोष्ठतोदसिरणाम्लीकाञ्चपपासापररदाहान्नद्वेषहृदयोत्क्लेदाश्च जायिे||
२७
• Types of Dosha Prakopa –
•Achaya Prakopa/ Pathyaja Prakopa • When Dosha jump directly to
Prakopa stage without passing through Chayaavastha
• does not require Samshodhana Chikitsa
• Sanchaya Prakopa /Apathyaja Prakopa
•Gradual increase of Doshas
• Requires Shodhana
PRASARA
(Stage of Spread)
In this stage, doshas aggravated by above factors
start overflowing from their respective seats to
other sites like the overflowing of a mixture of
yeast, water and flour.
Vata being the causative agent, spreads other
doshas like a large accumulation of water, breaks
the barrier and flowing of water takes place in all
the directions.
This spread occurs in 15 types.
Types of Prasara
1. Vata
2. Pitta
3. Kapha
4. Rakta
5. Vata-Pitta
6. Vata-Kapha
7. Vata-Rakta
8. Pitta-Kapha
9. Pitta-Rakta
10. Kapha-Rakta
11. Vata-Pitta-Rakta
12. Vata-Kapha-Rakta
13. Pitta-Kapha-Rakta
14. Vata-Pitta-Kapha
15. Vata-Pitta-Kapha-Rakta
• प्रक
ु ञ्चपतानाां प्रसरताां वायोञ्चवणमागणगमनाटोपौ, ओषचोषपररदाहर्ूमायना
ञ्चन ञ्चपत्तस्य, अरोचकाञ्चवपाकाङ्गसादाश्छञ्चदणश्चेञ्चत श्लेष्मणो ञ्चलङ्गाञ्चन भव
न्ति; तत्र तृतीयः ञ्चियाकालः ||
Doshas Prasar lakshanas
Vata Vimarga gaman, atopa
Pitta Osha, chosha, paridaha,
dhomaayan
Kapha Aruchi, avipaka, chardi
STHANSANSHRAYA
(Stage of localisation)
Doshas which are aggravated and spread,now get localised to
the sites where there is presence of ‘Kha vaigunya’
At this site, when the dosha dushya sammurchana takes place,
diseases occur accordingly.
Eg – Localisation in udara- visuchika,atisara
Localisation in Basti- ashmari, mutraghata
Localisation in Guda- arsha,bhagandara
When established in this way, there is appearance of
premonitory symptoms of the diseases.
S.Su.24/10
VYAKTAVASTHA
(Stage of Manifestation)
In this stage, well manifested symptoms of the
disease appear.
It is also known as Vyadhidarshana avastha.
Santapa lakshan – Jwar
Atidrava sarana – Atisara
शोफार्ुणदग्रन्तिञ्चवद्रञ्चर्ञ्चवसपणप्रभृतीना प्रव्यक्तलषणतणता ज्वरातीसारप्र
भृतीनाां च |
तत्र पिमः ञ्चियाकालः ||
BHEDAVASTHA
(Stage of Complications)
In this stage,the disease attains chronicity
(deerghakalanubandha) and also specific signs and
symptoms of the dosha dominant in the disease
manifest.
If not treated properly, they become incurable.
Eg- vranas burst and become ulcers and
fever, diarrhea attain chronicity
•ज्वराञ्चतसारप्रभृतीनाां च दीघणकालानुर्न्धः |
तत्राप्रञ्चतञ्चियमाणेऽसाध्यतामुपयान्ति ||
Importance of Shatkriya kala
Nidana parivarjana-
Avoidance of the causative factors can prevent the occurrence of the
disease.
Helps in arresting pathogenesis in early stage.
It gives an idea of the prognosis of disease, prophylactic treatment and
curative treatment.
तत्र वायोः ञ्चपत्तस्थानगतस्य ञ्चपत्तवत् प्रतीकारः, ञ्चपत्तस्य च कफस्थानगतस्य कफव
त्, कफस्य च वातस्थानगतस्य वातवत् ; एष ञ्चियाञ्चवभागः ||
सियेऽपहृता दोषा लभिे नोत्तरा गतीः |
ते तूत्तरासु गञ्चतषु भवन्ति र्लवत्तराः ||
तेषामपहरणं च बहुदोषे शोधनं, मध्यदोषे लङ्घनपाचनम्, अल्पदोषे संशमनमममत||
Treatment plan according to Shatkriya kala
• Sanchaya
• Prakopa Dosha Pratyaneek Chikitsa
• Prasara
• Sthansanshraya - Ubhay Pratyaneek Chikitsa
• Vyaktavastha
• Bhedavastha Vyadhi Pratyaneek Chikitsa
Measures for maintenance of homeostasis at
different stages
• First three stages of Kriyakala - life style and dietary
modification. •
• At Prasaraavastha treatment according to Sthanika
Dosha
• If the Vata encroaches Pitta Sthana, Pitta should be
managed. If the Pitta encroaches Kapha Sthana, Kapha
should be managed. If the Kapha encroaches Vata
Sthana, Vata should be managed •
• At last three stages : Treatment according to disease,
Rasayana , Shodhana, Shaman , Shastrachikitsa ,
palliative measures or incurable depending upon the
advancement of disease
Correlation between Nidana Panchak and Shatkriya kala
Sanchaya
Prakopa
Nidana
Prasara
Sthansanshraya Purvarupa
Vyaktavastha Roopa
Bhedavastha Upshaya and Anupshaya
Samprapti
Kriyakala in view of contemporary science
• Diabetes mellitus
1. Sanchaya - Predisposing factors like genetic /presence of diseases
like obesity, PCOD/ life style
2. Prakopa - Augmented hepatic glucose production, Decreased
insulin-mediated glucose transport primarily in muscle and
adipose tissues, Impaired beta-cell function
3. Prasara - Hyperlipidemia, Hypercholestremia, Impaired renal
functions, increased various cytokines like leptin
4. Sthanasanshrya - Impaired insulin-mediated glucose transport in
(primarily) muscle and adipose tissues due to altered gene
expression and insulin resistance •Impaired blood glucose level
5. Vyakta - Polyuria, Polydipsia, Polyphagia
6. Bheda - Diabetic retinopathy and nephropathy, Diabetic
ketoacidosis,Heart stroke, Multiple organ failure
Shatkriya Kaala.pptx

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Shatkriya Kaala.pptx

  • 1. SHATKRIYA KALA - Dr. Twinkle Joshi
  • 2. Shatkriya Kaala • It refers to the recognition of the stages of a disease’s progress and the appropriate time of treatment. Shat - Six Kriya - Treatment Kala - Time or Stages • Acharya Sushrut has described Shatkriya kala in vranaprashniya adhyaya. •It is very essential for early diagnosis ,prognosis and for adopting timely preventive and curative measures. •There are two types of kriya kala- vyadhi and ritu kriya kala.
  • 3.
  • 5. SANCHAYA (Stage of Accumulation) •Accumulation of doshas in their own natural sites. •Doshas increase quantitatively but their quality remains normal. •Vague and ill defined symptoms characterized by aversion of similar and attraction towards opposite quality aahars and vihars.
  • 6. Types of Sanchaya Svabhavika Avasthiki (According to age) Naimittiki (According to ritu) Asvabhavika
  • 7. Causes of Dosha Sanchaya •Disturbed lifestyle •Genetic predisposition Psychological factors Improper diet
  • 8. Dosha Clinical Features in sanchaya avastha Vata Stabdha purna koshthata Pitta Pitavabhasata, mandoshmata Kapha Anganam gauravam, alasya तत्र सञ्चितानाां खलु दोषाणाां स्तब्धपूणणकोष्ठता पीतावभासता मन्दोष्म ता चाङ्गानाां गौरवमालस्यां चयकारणञ्चवद्वेषश्चेञ्चत ञ्चलङ्गाञ्चन भवन्ति | तत्र प्रथमः ञ्चियाकालः ||१८||
  • 9. PRAKOPA (Stage of Aggravation)  Accumulated doshas get qualitatively vitiated and are ready to move from their natural sites by appropriate aetiological factors.  Vata aggravating vihara –excessive exercise, being awake at night ,load carrying Aharas-intake of bitter ,dry, cold, astringent foods Pitta aggravating vihara-anxiety,fear,stress,anger Aharas –sour, salty food, curd, mustard Kapha aggravating vihara-day sleep, lack of exercise, etc Aharas –maash (black gram), sesamum ,milk, aquatic meat, etc
  • 10. • स शीताभ्रप्रवातेषु घमाणिे च ञ्चवशेषतः | प्रत्यूषस्यपराह्णे तु जीणेऽन्ने च प्रक ु प्यञ्चत||२०|| • तदुष्णैरुष्णकाले च घनािे च ञ्चवशेषतः | मध्याह्ने चार्णरात्रे च जीयणत्यन्ने च क ु प्यञ्चत || • स शीतैः शीतकाले च वसिे च ञ्चवशेषतः | पूवाणह्णे च प्रदोषे च भुक्तमात्रे प्रक ु प्यञ्चत || • यस्माद्रक्तां ञ्चवना दोषैनण कदाञ्चचत् प्रक ु प्यञ्चत | तस्मात्तस्य यथादोषां कालां ञ्चवद्यत् प्रकोपणे ||
  • 11. Doshas Clinical features in Prakopa avastha Vata Koshtha toda Vata Sancharana Pitta Amla udgar Pipasa Paridaha Kapha Anna dvesha Hridaya utkleda •तेषाां प्रकोपात् कोष्ठतोदसिरणाम्लीकाञ्चपपासापररदाहान्नद्वेषहृदयोत्क्लेदाश्च जायिे|| २७ • Types of Dosha Prakopa – •Achaya Prakopa/ Pathyaja Prakopa • When Dosha jump directly to Prakopa stage without passing through Chayaavastha • does not require Samshodhana Chikitsa • Sanchaya Prakopa /Apathyaja Prakopa •Gradual increase of Doshas • Requires Shodhana
  • 12. PRASARA (Stage of Spread) In this stage, doshas aggravated by above factors start overflowing from their respective seats to other sites like the overflowing of a mixture of yeast, water and flour. Vata being the causative agent, spreads other doshas like a large accumulation of water, breaks the barrier and flowing of water takes place in all the directions. This spread occurs in 15 types.
  • 13. Types of Prasara 1. Vata 2. Pitta 3. Kapha 4. Rakta 5. Vata-Pitta 6. Vata-Kapha 7. Vata-Rakta 8. Pitta-Kapha 9. Pitta-Rakta 10. Kapha-Rakta 11. Vata-Pitta-Rakta 12. Vata-Kapha-Rakta 13. Pitta-Kapha-Rakta 14. Vata-Pitta-Kapha 15. Vata-Pitta-Kapha-Rakta
  • 14. • प्रक ु ञ्चपतानाां प्रसरताां वायोञ्चवणमागणगमनाटोपौ, ओषचोषपररदाहर्ूमायना ञ्चन ञ्चपत्तस्य, अरोचकाञ्चवपाकाङ्गसादाश्छञ्चदणश्चेञ्चत श्लेष्मणो ञ्चलङ्गाञ्चन भव न्ति; तत्र तृतीयः ञ्चियाकालः || Doshas Prasar lakshanas Vata Vimarga gaman, atopa Pitta Osha, chosha, paridaha, dhomaayan Kapha Aruchi, avipaka, chardi
  • 15. STHANSANSHRAYA (Stage of localisation) Doshas which are aggravated and spread,now get localised to the sites where there is presence of ‘Kha vaigunya’ At this site, when the dosha dushya sammurchana takes place, diseases occur accordingly. Eg – Localisation in udara- visuchika,atisara Localisation in Basti- ashmari, mutraghata Localisation in Guda- arsha,bhagandara When established in this way, there is appearance of premonitory symptoms of the diseases.
  • 17. VYAKTAVASTHA (Stage of Manifestation) In this stage, well manifested symptoms of the disease appear. It is also known as Vyadhidarshana avastha. Santapa lakshan – Jwar Atidrava sarana – Atisara शोफार्ुणदग्रन्तिञ्चवद्रञ्चर्ञ्चवसपणप्रभृतीना प्रव्यक्तलषणतणता ज्वरातीसारप्र भृतीनाां च | तत्र पिमः ञ्चियाकालः ||
  • 18. BHEDAVASTHA (Stage of Complications) In this stage,the disease attains chronicity (deerghakalanubandha) and also specific signs and symptoms of the dosha dominant in the disease manifest. If not treated properly, they become incurable. Eg- vranas burst and become ulcers and fever, diarrhea attain chronicity •ज्वराञ्चतसारप्रभृतीनाां च दीघणकालानुर्न्धः | तत्राप्रञ्चतञ्चियमाणेऽसाध्यतामुपयान्ति ||
  • 19. Importance of Shatkriya kala Nidana parivarjana- Avoidance of the causative factors can prevent the occurrence of the disease. Helps in arresting pathogenesis in early stage. It gives an idea of the prognosis of disease, prophylactic treatment and curative treatment. तत्र वायोः ञ्चपत्तस्थानगतस्य ञ्चपत्तवत् प्रतीकारः, ञ्चपत्तस्य च कफस्थानगतस्य कफव त्, कफस्य च वातस्थानगतस्य वातवत् ; एष ञ्चियाञ्चवभागः || सियेऽपहृता दोषा लभिे नोत्तरा गतीः | ते तूत्तरासु गञ्चतषु भवन्ति र्लवत्तराः || तेषामपहरणं च बहुदोषे शोधनं, मध्यदोषे लङ्घनपाचनम्, अल्पदोषे संशमनमममत||
  • 20. Treatment plan according to Shatkriya kala • Sanchaya • Prakopa Dosha Pratyaneek Chikitsa • Prasara • Sthansanshraya - Ubhay Pratyaneek Chikitsa • Vyaktavastha • Bhedavastha Vyadhi Pratyaneek Chikitsa
  • 21. Measures for maintenance of homeostasis at different stages • First three stages of Kriyakala - life style and dietary modification. • • At Prasaraavastha treatment according to Sthanika Dosha • If the Vata encroaches Pitta Sthana, Pitta should be managed. If the Pitta encroaches Kapha Sthana, Kapha should be managed. If the Kapha encroaches Vata Sthana, Vata should be managed • • At last three stages : Treatment according to disease, Rasayana , Shodhana, Shaman , Shastrachikitsa , palliative measures or incurable depending upon the advancement of disease
  • 22. Correlation between Nidana Panchak and Shatkriya kala Sanchaya Prakopa Nidana Prasara Sthansanshraya Purvarupa Vyaktavastha Roopa Bhedavastha Upshaya and Anupshaya Samprapti
  • 23. Kriyakala in view of contemporary science • Diabetes mellitus 1. Sanchaya - Predisposing factors like genetic /presence of diseases like obesity, PCOD/ life style 2. Prakopa - Augmented hepatic glucose production, Decreased insulin-mediated glucose transport primarily in muscle and adipose tissues, Impaired beta-cell function 3. Prasara - Hyperlipidemia, Hypercholestremia, Impaired renal functions, increased various cytokines like leptin 4. Sthanasanshrya - Impaired insulin-mediated glucose transport in (primarily) muscle and adipose tissues due to altered gene expression and insulin resistance •Impaired blood glucose level 5. Vyakta - Polyuria, Polydipsia, Polyphagia 6. Bheda - Diabetic retinopathy and nephropathy, Diabetic ketoacidosis,Heart stroke, Multiple organ failure