Ayurvedic kriyakala are the 6 different opportunistic time period for therapeutic intervention stages, which is also correlated with stages of pathogenesis of a disease.

1. PRESENTER : Dr Shravya M
1st Year Pg Scholar, Dept Of Kayachikitsa
Ashwini Ayurvedic Medical College,
Tumkur
GUIDE: Dr C V Rajashekhar
Professor & Hod, Dept Of Kayachikitsa
Ashwini Ayurvedic Medical College,
Tumkur
1

2. TABLE OF CONTENTS
• Introduction
• Ritu kriyakala
• Sanchaya Avastha
• Prakopa Avastha
• Prasara Avastha
• Importance of dosha kriyakala
• Sthanasamshraya Avastha
• Vyakta Avastha
• Bhedha Avastha
• Understanding Of Kriyakala with examples
• Discussion
• Conclusion
2

3. INTRODUCTION
• रोगस्तु दोषवैषम्यं दोषसाम्यमरोगता । निजागन्तुनवभागेि तत्र रोगा निधा स्मृतााः ॥
(अ.हृ.सू. 1/20)
• Samya avastha of Shareerika and manasika dosha is Arogya and vishamaavastha is causes roga.
Doshas don’t undergo vitiation at a time . Disease rather is a gradual process.
• Kriyakala is a unique concept in Ayurveda which gives us an idea of diagnosis and treatment of a
disease .
• It is an important point of view more especially from the perspective of disease control strategy.
• The term kriya refers to नियते अिेि असौ अस्मस्मि् वा |(sha.ka.dru.)
Kriya means – performing, act, action, work, Upaya/karma.
Kala is derived from the root ka+A+la=kala refers to avastha or avasara.
Which means to calculate, to enumerate or time.
• Kriyakala can be considered as chiktsaavasara kala/karmavasra kala i.e. the appropriate time period to
take action.
3

4. 4
Kriyakala
Rutu kriyakala Vyadhi kriyakala
• Acharya dalhana, in the commentary quotes ‘chikitsa avasara’ in the description of kriyakala’s.
I.e. there is a scope of chikitsa in each kriyakaala.
Kriyakala refers to kriya/karma( chikitsa ) to resort measures of bheshaja with a view to
eliminate and correct doshic disturbances, there by interrupting the disease progress.

5. 5
RUTU KRIYAKALA/ PRAKRUTHA KRIYAKALA/ SAWASTHA KRIYAKALA :
• It describes the normal physiological variations of doshas that takes place in different rutus.
• The cycle of shad rutus influence and effect nature of doshas.
• The cycle of shad rutus follows a specific pattern of doshic distribution which plays a vital role in
disease manifestation, if rutucharya is not practiced accordingly.
• It includes 3 stages chaya, prakopa and prashamana
चयप्रकोपप्रशमा वायॊग्रीष्मनदषु नत्रषु ।
वषाानदषु तु नपत्तस्य श्लेष्मणाः नशनशरानदषु ॥
(A.Hr.Su. 12/24)

6. 6
IMPORTANCE OF RUTU SHODHANA & RUTUCHARYA
• The accumulated doshas should be eliminated from the body in the next season when they attain the
stage of prakopa and this is called rutushodhana.
• Always shodhana should be done in sadharana kala,.
• Pravrut, sharat, vasantha are considered as sadharana rutus where basti, virechana and vamana
should be done respectively.
• शीतोद्भवं दोषचयं वसन्ते नवशॊधयाि् ग्रीष्मजमभ्रकाले ।
घिात्पये वानषाकमाशु सम्यक
् प्राप्नॊनत रोगािृतुजान्न जातु ॥
(A.Hr. Su. 4/35)
For example : accumulated kapha dosha in Hemantha and shishira rutu is expelled out in vasantha
rutu, ( if seasonal regimen is not followed kapha aggravation progresses towards prasara stages and
causes kapha disorders instead of getting pacified. If seasonal regimen is followed, kapha naturally
regresses and comes back to normalcy in grishma rutu.
• If rutucharya (seasonal regimes) is practiced properly according to that particular rutu, it does not
cause severe distress to the body also provides long life without affliction of diseases.

7. 7
VYADHI KRIYAKALA/ SHAT KRIYA KALA
STAGE OF PROGRESSIVE PATHOGENESIS OF A DISEASE :
संचयं च प्रकोपं च प्रसरं स्थािसंश्रयम् । व्यस्मतं भेदं च यो वेनत्त दोषाणां स भवेस्मद्भषक
् ॥
(सु.सू. 21/35)
SANCHAYA
PRAKOPA
PRASARA
STHANASAMSHRAYA
VYAKTA
BHEDHA

8. 8
SANCHAYA (Accumulation)
चयो वृस्मधाः स्वधाम्न्येव प्रिेषो वृस्मधहेतुषु नवपरीतगुणेच्छा च |(A.H.Su.12/22)
संहनतरूपा वृस्मधश्चय: ( su su 21/18)
• Accumulation of Dosha occurs at their own places.
For example Vata increasing in pakwashaya , kati, sakti etc .
• Represents the first stage of kriyakala.
• Accumulated Dosha resides at their own sites instead of free circulating.
• Subject has aversion against the etiology of Dosha Sanchaya and strong desires towards anti
causes of Sanchaya.
For example : If vata sanchaya takes place we develop aversion towards rukshaadi dravyas and
desire towards snighdhadi dravyas
person will have aversion towards Madhura rasa in kapha sanchayavasta.
• Commonly referred as accumulation of AMA produced during the improper digestion.
DOSHA KRIYAKALA

9. 9
• धीधृनतस्मृनतनवभ्रष्टाः कमा यत् क
ु रुतेऽशुभम् । प्रज्ञापराधं तं नवद्यात् सवादोषप्रकोपणम् ॥
(च.शा. 1 / 102 ).
• Intellectual error i.e. opting for wrong lifestyle, taking unwholesome diet, this
leads to indulgence in variety of causative factors resulting in disease.
• Asatmendriyartha samyoga -imbalance, occurring due to improper bondage of
sense organs with artha also leads to dosha sanchaya.
• Parinama – seasonal variations can trigger disease by unbalancing the doshas.
• इनत कालस्वभावोऽयमाहारानदवशात्पुिाः||२८||
चयादीि् यास्मन्त सद्योऽनप दोषााः कालेऽनप वा ि तु|
(Ah Hr su 12/28)
•चयप्रकोपप्रशमा वायॊग्रीष्मनदषु नत्रषु ।
वषाानदषु तु नपत्तस्य श्लेष्मणाः नशनशरानदषु ॥
(A.Hr.Su. 12/24)

10. 10
VATA स्तब्धपूणाकोष्ठता- Feeling of obstruction
and fullness in the abdominal organs
PITTA पीतावभासता- Yellowish discoloration
of the body
मन्दोष्मता - low digestive fire or low
body temperature
KAPHA चाङ्गािां गौरव -heaviness of bodily
organs
आलस्य - Lethargy or laziness
Features manifested during Sanchayavasatha

11. 11
TREATMENT OF SANCHAYA AVASTHA
 सञ्चयेऽपहता दोषा लभन्ते िोत्तरा गतीाः । ते तूत्तरासु गनतषु भवस्मन्त बलवत्तरााः ॥
(सु.सू. 21/37)
 चयेव जयेत् दोषम् (A H su 13/15)
It is important to treat the doshas in its Chaya avastha to prevent further spread to next kriyakala
and further complications.
• Here, mainly Nidana Parivarjana has been indicated which refers to the removal of causative
factors of the disease is itself Kriya yoga or Chikitsa in this avastha. Avoid viruddhahara,
vegavarodha, and practice dinacharaya and rutucharya.
'संक्षेपताः नियायोगो निदािपररवजािम्"(SU.Utt.1/25)
• Dosha Pratyanika Chikitsa to be adopted here.
Shamana Chikitsa if the dosha's are in the mild form.
Langhana Pachana if the dosha's are in the moderate form.
Shodhana Chikitsa if the dosha's are in the severe form.
"तेषामपहरणं च बहुदोषो शोधिं मध्यदोषे लङ्घिपाचिं अल्पदोषे संशमिनमनत ।" (Dalhana)

12. 12
PRAKOPA (stage of aggravation)
कोपस्तून्मागागानमता|
नलङ्गािां दशािं स्वेषामस्वास्थ्यं रोगसम्भवाः (A.H.Su. 12 / 23 )
नवलयि रूप वृस्मध: प्रकोप: | (A H SU 12/23)
Doshas which were previously accumulated and stagnated in their own sites tend to circulate to other
sites.
• The appearance of symptoms indicate the disturbance in homeostasis i.e. health.
• Results due to indulgence in Dosha Prakopaka Aahara (food)-Vihara (regimen). According to
Dalhana, Prakopavastha is extended state of Chayavastha in which Doshas are in liquid or gaseous
forms and tend to leave their sites.
• Though the prakopa phase does not manifest the clearly differentiated clinical symptoms, ayurvedic
physicians confirm the aggravated state of aama through pulse diagnosis and accordingly

13. 13
Diet Life Style Psychological Diurnal and seasonal
VATA PRAKOPA – Food articles katu, tikta, kashaya rasa.
ruksha, laghu and sheeta dravya.
adhyashana, vishamashana, fasting
examples : pulses
PITTA PRAKOPA - Food articles of:
Katu, Amla and Lavana Rasa
Teekshna, Ushna,Laghu and Vidahi substances,Taking food in
smallquantity
Example: Tila taila,Pinyaka
KAPHA PRAKOPA –
Food substances of Madhura, amla and lavana rasa.
Sheetha, guru and Snighdha substances
Example : food items made up of pishta, milk, sugarcane.
Adhyashana
Suppression
of natural
urges. Night
awakening
Over exertion
Day time
sleeping
Lack of
exercise
Grief, anxiety
Anger
Cold season, rainy season.
Rainy season. At the starting
of day and night.
At the mid of the day and
midnight
During the digestion of meal
Hot season and
Autumn
At the starting of day and
night.
Spring season
PRAKOPA

14. 14
Achaya
Prakopa/
Pathyaja
Prakopa
When Dosha reaches directly to Prakopa stage without passing through
Chayaavastha. The causative factors causing this are so strong that they
immediately aggravate the doshas without giving time accumulate .
Does not require any Samshodhana Chikitsa , ie doshas will not increase
in its rutukala because of observing pathykrama of the concerned rutu.
Sanchaya Prakopa
/Apathyaja
Prakopa/Katinyabh
ava(solidified
increase)
This is a typical prakopa where in the doshas undergo chayastha and
gradually progress to the stage of prakopa.It takes time to develop unless
the contributory factors of the diseases are too strong.
Requires Shodhana Chikitsa
Prakopa is basically of two types. They are
क
ु नपता इनत कोपोऽत्र निनवधाः- चयपूवाकोऽचयपूवाकश्च; तत्र चयपूवाक
ं कोपमागतााः संशोधिनवधािेिैव शमनयतव्यााः|
Su.chi.33/3 dalhana

15. 15
Features manifested during Prakopavastha
VATA Koshta toda- pricking type of pain
in abdomen.
Sancharana – movement of vata in
the mahasrotas.
PITTA Amlika – sour eructation's
Pipasa – excessive thirst
Paridaha – burning sensation all
over the body.( pari samantat daha)
KAPHA Annadwesha – aversion towards
food
Hridayotkelsha – heaviness of chest
region and nausea.
तेषां प्रकोपात् कोष्ठतोदसञ्चरणाम्लीकानपपासापररदाहान्निेषहृदयोत्क्लेदाश्च जायन्ते |
तत्र नितीयाः नियाकालाः| SU SU 21/27 dalhana

16. 16
TREATMENT OF PRAKOPA AVASTHA
•तयोनवालयिरूपवृद्ध्या वृधा दोषााः संशोधिेि निहाताव्यााः| (su chi 33/3) dalhana
•तत्र चयपूवाक
ं कोपमागतााः संशोधिनवधािेिैव शमनयतव्यााः| (su chi 33/3)dalhana
In Achaya poorvaka prakopa "SHAMANA" chikitsa should be done.
In Chaya poorvaka prakopa "SHODHANA" chikitsa should be done.
दोष प्रकोप निनवधााः पथ्यापथ्य निनमनत्तजाः । तत्रापथ्य निनमत्तो याः स संशोधिमहानत ।।
पथ्योो॒ अत्राः शमीयश्च प्रायाः आगन्तुजश्च याः।
(A.Hr. Su. 3/18)
• Nidana Parivarjana & Dosha Pratyanika Chikitsa should be adopted i.e.; the line of treatment
should be for the increased dosha without interfering with the provocation of other doshas.
• If prakopa of all tri doshas occurs, then whichever dosha is powerful should be treated first.
If all the tri doshas are of equal strength, then treatment for Vata has to be taken first, then for
Pitta and then for Kapha.
• These doshas are in the liquid state can be removed from the site through the proximal route.

17. 17
PRASARA (stage of spread or dissemination)
व्यायामादू ष्मणस्तैक्ष्ण्यास्मधतस्यािवचारणात्|
कोष्ठाच्छाखा [३१] मला यास्मन्त द्रुतत्वान्मारुतस्य च|| (Cha su 28/31)
The term “Prasara” conveys the meaning of spreading.
This stage marks with the dissemination of vitiated Dosha to different parts of the body.
• The aggravated Dosha leave their original path and spread to the other parts of the body through
different channels. Vata which posses the power of movement, is the force behind this process.
• If appropriate management is taken, the pathogenesis stops here otherwise progresses to further
stages.
• The prasara of dosha may occur in the following way which is of 15 types. Such as VP, PK, VPK,VPKR.
• Can be understand from the similes of
अत ऊर्ध्वं प्रसरं वक्ष्यामाः- तेषामेनभरातङ्कनवशेषैाःप्रक
ु नपतािां नकण्वोदकनपष्टसमवाय इवोनद्रतािां प्रसरो भवनत |
यथा-
महािुदकसञ्चयोऽनतवृधाः सेतुमवदायाापरेणोदक
े ि व्यानमश्राः सवाताः प्रधावनत, एवं दोषााः कदानचदेकशो निशाः समस्तााः शोनणतसनह
ता वाऽिेकधा प्रसरस्मन्त |
( Su.Su.21/28)

18. 18
VATA Vimarga gamana- vata moving in opposite direction.
Atopa- gurgling sound in abdomen.
PITTA Osha– sense of boiling, rise of body temperature.(eka
deshiko daha) sha.ka.dru
Chosha – excessive thirst (aachushana Samat vadityeke)
Paridaha – burning sensation all over the body.
Dhumayani - feeling as if fumes coming out of the body
(dhoomodvamanamivangaanam)
KAPHA Arochaka – aversion towards food
Avipaka– indigestion
Angasada – muscle weakness
Chardi - vomiting
Features manifested during Prasaravastha….
प्रक
ु नपतािां प्रसरतां वायोनवामागागमिाटोपौ, ओषचोषपररदाहधूमायिानि नपत्तस्य, अरोचकानवपाकाङ्गसादाश्छनदाश्चेनत श्ले
ष्मणो नलङ्गानि भवस्मन्त; तत्र तृतीयाः नियाकालाः || SU SU 21/32

19. 19
TREATMENT OF PRASARA AVASTHA
 चयलक्षणा प्रकोपलक्षणा च; तत्र संहनतरूपावृस्मधाः चयाः, नवलयिरूपा वृस्मधाः प्रकोपाः; तयोनवालयिरूपवृद्ध्या वृ
धा दोषााः संशोधिेि निहाताव्यााः| (su.chi.33/3)
 Dosha Pratyanika Chikitsa should be advocated here.
 Hetu Viparita Chikitsa should be followed here
 Aganthu Dosha- Sthanika Dosha Chikitsa should be included here.
 Neutralizing the vitiated doshas by all possible means to be advocated here i.e;
वायो: नपत्तस्थािगतस्य नपत्तवत् प्रनतकाराः ।
नपत्तस्य च कफस्थािगतस्य कफवत्।
कफस्य च वातस्थािगतस्य वातवत् ॥ (SU, Su, 21 / 31 )
➤ Since the Dosha's have more pronounced by moving all over the whole body,so the
Tiryakgata dosha's should be bought to koshta and then should be eliminated.

20. 20
Why sanchaya, prakopa, prasara (Dosha kriyakala) is
important………..?
Substantiating with an example of clinical course of Parkinson's disease stated in the below
article
An article published by Michela E Johnson et al. proposed a new model for
Parkinson's disease pathogenesis in which 3 phases of PD have been
mentioned. They are triggers, facilitators and aggravators.

21. 21
Triggers ( viral
infections)
Facilitators
Aggravators
Potential outcomes of triggering events
include long term gut dysfunction.
Facilitators like this gut inflammation
spread pathology to impact the CNS.
This results in the onset of PD motor
symptoms.
Aggravators like neuroinflammation
continue to increase cell loss and
neuropathology, causing worsening
symptoms .

22. 22
The hallmark of Parkinson's disease is the presence of Lewy bodies composed of alpha-
synuclein aggregates in the CNS. But it is interesting to notice that earlier presence of
alpha – synuclein outside CNS has been demonstrated in the gut, which is more
prevalent in PD, leading to early symptoms.
This synucleinopathy may be transmitted from the gut to the brain via the vagus nerve.
The initial occurrence of the pathological hallmark is at one site.
When, manifested it appears at a different site.( doshas from koshta to shaka)
It is concluded that targeting premotor intestinal stages of PD for the therapeutic intervention may
hold the potential to slow or halt the progression of the disease and also found that proper bowel
habits, lifestyle modifications, and dietary habits delay or prevent the progress of the disease.

23. 23
STHANASAMSHRAYA ( stage of localization)
क
ु नपतTिां नह दोषाणां शरीरे पररधावताम |
यत्र सङ्ग: खवैगुयद्भ्यनधस्तत्रोपजायते | (Su.Su 24/10)
नक्षप्यमाणाः खवैगुयाो॒द्रसाः सज्जनत यत्र साः
करोनत नवक
ृ नतं तत्र खे वषानमव तोयदाः (As. Hru. Sha.3/69)
The aggravated Doshas, starts circulating to whole body and resides in the Srotas where there is any
kind of Khavaigunya i.e. anatomical or physiological abnormality gets localized. It marks the
beginning of specific diseases
In this state, Dosha Dushya Sammurchana i.e. involvement between Dosha and Dushya takes place at
the site of Srotovaigunya.
स्थािसंश्रनयणाः ि
ु धा भानवव्यानधप्रबोधकम्
दोषााः क
ु वास्मन्त यस्मिङ्ग
ं पूवारूपं तदुच्यते’ (Chakrapani on Su. Su. 21/37)
The sign and symptoms produced in this stage are on the basis of sites where Dosha Dushya
Samurchhana takes place.
In this stage, all the prodromal symptoms of diseases appear. So this stage is also called the
Poorvarupa of diseases.
यिक्ष्यनत ज्वरगमकपूवारूपमनभधाय ‘सामायतो नवशेषात्तु जृम्भाऽत्यथं समीरणात्’ (सु.उ.३९) इत्यानद|

24. 24

25. 25
TREATMENT OF STHANASAMSHRAYA AVASTHA
The Chikitsa to be adopted in this stage involves both Dosha Pratyanika Chikitsa as
well as Dushya Pratyanika Chikitsa to correct the Dosha, Dushya and both in
combination and also srotoshodhana chikitsa.
चतुथा: नियाकाल इनत चतुथा: नचनकत्सावसराः ।
नचनकत्सा चात्र दोषस्य दू ष्यस्य च इनत उभयानश्रता ।।(Su.Su. 21/34)
दोषााः कदानचत् क
ु प्यस्मन्त नजता लङ्घि पाचणैाः ।
नजता: संशोधिैाः तु ि तेषां पुिरुध्भवाः ।। (cha. Su.16/20)
Here, Samshodhana chikitsa is considered to be the best as to prevent
further manifestation of disease process as well as to eliminate the vitiated Dosha's
and to correct the Dushya's involved in the same( samprapti vighatana chikitsa).

26. 26
VYAKTA ( stage of manifestation)
अत ऊर्ध्वं व्याधेदाशािं वक्ष्यामाः- शोफाबुादग्रस्मिनवद्रनधनवसपाप्रभृतीिां प्रव्यतलक्षणता ज्वरातीसारप्रभृतीिां च | तत्र
पञ्चमाः नियाकालाः||
व्याधेाः प्रव्यतं रूपं व्यस्मताः |( Su. Su. 21/34)
This stage occurs after the manifestation of the fully developed disease.
Disease manifests their cardinal symptoms after interaction between Dosha and Dushya.
Symptomology exhibits so that one can diagnose the ailment,
• For example
Increased body temperature is observed in Jwara
Excessive watery stool in Atisara
Abnormal enlargement of abdomen (purana) in Udara Roga
• प्रव्यतलक्षणता व्याधीिां व्यस्मतररत्यथााः ( Chakrapani on Su. Su. 21/33)

27. 27
TREATMENT OF VYAKTA AVASTHA
The pratyatma lakshanas of vyadhi to be considered for proper diagnosis and treatment.
Samprapti Vighathana Chikitsa and Vyadhi Pratyanika Chikitsa
has been indicated here.
• अत्र व्याधे: प्रत्यिीक
ै व नचनकत्सा ।।
(Su.Su. 21/34) Dalhana
The treatment should serve the purpose of checking the pathogenesis i.e;
• Dosha-Dushya Sammurchana
• SrotoShodhana
• Dosha Vilayana and DoshaShodhana.
• In this Avastha Roga Avasthanusara Chikitsa Krama should be advocated including
teekshna shamana and shodhana.

28. 28
BHEDHA ( stage of differentiation)
अत ऊर्ध्वामेतेषामवदीणाािां व्रणभावमापन्नािां षष्ठाः नियाकालाः, ज्वरानतसारप्रभृतीिां च दीघाकालािुबन्धाः |
तत्राप्रनतनियमाणेऽसाध्यतामुपयास्मन्त || (Su.Su.21/35)
It is the most advanced and last stage of Kriyakala
Vyadhi becomes deerghakaalanubandhi, in this stage disease becomes subacute, chronic, or
incurable or severe complications leading to death or may cause permanent disability.
• Doshas when settle for a long duration without proper intervention of treatment may
become asadhya or maraca if not treated. The manifested vyadhi may act as nidanarthakara
roga.
• If not treated, the disease becomes incurable, chronic, complicated or may gives rise to
another disease.
This is the stage when disease is diagnosed more by its complications along with the main
diseases.

29. 29
TREATMENT OF BHEDA AVASTHA
• If the disease has become Deerghakaalaanubandhi, then treat the nidana as well as the
Pradhana Roga.
• Self limiting disorders, the disease may get cured itself by body and rehabilitation will be
required.
• If the disease has produced Upadrava's related to that particular Vyadhi, then treat the
Upadrava if prominent otherwise treat the Pradhana vyadhi.
• The manifested vyadhi may act as a Nidhanaarthakara Roga.
• Vyadhi pratyanika, upadrava chikitsa and rasyana chikitsa can be opted.
• Prevent genetic transmissions to offspring's, rehabilitation of disabilities .

30. 30
Understanding of kriyakala in view of contemporary science

31. 31
Correlation between shatkriyakala and nidana panchaka
sanchaya
prasara
prakopa
sthanasamshraya
vyakta
bheda
nidana
poorvaroopa
Roopa,upashaya,
anupashaya
samprapti

32. 32
Understanding of Kriyakala in view of contemporary science with special reference
to Diabetes Mellitus.
STAGE PATHOPHYSIOLOGY
SANCHAYA Predisposing factors like genetic /presence of diseases like obesity, PCOD/ life style
PRAKOPA Augmented hepatic glucose production, Decreased insulin-mediated glucose transport primarily
in muscle and adipose tissues, Impaired beta-cell function
PRASARA Hyperlipidemia, Hypercholesteremia, Impaired renal functions, increased various cytokines like
leptin, adiponectin
STHANASAMSHRAYA Impaired insulin-mediated glucose transport in (primarily) muscle and adipose tissues due to
altered gene expression and insulin resistance
VYAKTA
Polyuria, Polydipsia, Polyphagia
BHEDHA Diabetic retinopathy, nephropathy and Diabetic ketoacidosis, Heart stroke, Multiple organ failure

33. 33
Understanding of Kriyakala in view of contemporary science with special reference
to bronchial asthma.
STAGE PATHOPHYSIOLOGY
SANCHAYA Increased leakiness of tight junction (Causes: Allergens, genetic predisposition)
PRAKOPA Increased sensitiveness of bronchioles epithelium (due to repeated exposure to allergens or
aggravating factors)
PRASARA Mast cell degranulation
STHANASAMSHRAYA Release of inflammatory mediators, stimulation of irritant receptors, bronchoconstriction,
oedema.
VYAKTA Breathlessness, wheezing, coughing, diurnal variation in PEF more than 20%, lowest in early
morning
BHEDHA Deterioration in lung function and increased airway inflammation
Reduced PEF(33-50%), Increased RR and HR
Nocturnal symptoms, needs reliever treatment for more than twice a week Deterioration of lung
function test
Respiratory arrest, deterioration of arterial blood gas tension, exhaustion, confusion
drowsiness,coma
Formation of Curschmann's spirals, Charcot-Leyden crystals, thickened bronchia wall.

34. 34
WHY AYURVEDA EMPHASIZES KRIYAKALA………….
When there is no clear feature of diseases and symptoms are subjective, the
patients are usually labeled as “functional”, “hypochondriac” until the full
manifestations of disease develop.

35. 35
STAGE PATHOPHYSIOLOGY
SANCHAYA Over indulgence in ruksha, laghu and alpa ahara
Atichesta, ativyayama, abhigata, aptarpana
chaya of vata dosha
Chintha shoka bhaya krodha
PRAKOPA Further intake of vatavardaka nidana leads to vata prakopa and agnivaishamya also it leads to
kapha kshaya leading to dhatu kshaya
PRASARA circulation through srotas, shleshaka kapha kshaya and asthi dhatu kshaya. Due to diminution
of Sneha, khavaigunya occurs in asthi and sandhi
STHANASAMSHRAYA Sthana samshraya of prakupitha vata in sandhi where kha – vaigunya already exisits
Dosha dushya samurchana takes place in asthi sandhi, asthivaha, medhivaha and
majjavahasrotas ---destruction of shleshmadhara kala , asthi leads to vyakta avastha
VYAKTA
Vata poornadruti Sparsha, sandhi sopha, shotha, hanti sandhi , asthi sosha, sandhi aatopa,
prasarana kunchanapravritisavedana .
BHEDHA Sandhi vikruti is noted as complication.
Probable understanding of Kriyakala in Sandhigata vata

36. 36
STAGE PATHOPHYSIOLOGY
SANCHAYA Viruddha dushta amla vidahi pittakopi pana, virrudha ahara, adhyashana, uncooked milk
kulatta,ushna ruksha, amla ahara atisevana.
Bhukte bhukte snana, avagaha, divaswapna, vegdharana, chikitsa vyapat
Chinta, shoka, krodha, bhaya – pittolbana sanchaya –agni mandya (leads to pittolbana in
pittasthana)
PRAKOPA Further indulgence in nidana sevana, the consumed ahara attains vidagdhata due to improper
pachana of ahara by dushita agni, due to prolong stasis in amashaya, it attains shuktatvam acts
like amavisha
PRASARA Rasa dhatu formed from vidagdha ahara also becomes dushya and this vitiated rasa dhatu
starts to circulate there by the involvement of annavaha srotas & rasavaha srotas.
STHANASAMSHRAYA The sthana samshraya occurs in annavaha srotas and amashaya leading to dosha dushya
sammurchana of pachakapitta, samana vata, kledaka kapha, rasadhatu
VYAKTA
Avipaka, klama, utkelsha, tiktaamla udgara, gourava, hrutkantadaha, aruchi.
BHEDHA Upekshana of this avastha leads to upadravas like jwara, atisara, pandutha, shola, grahani,
bhrama, aruchi, shotha, parinama shola, annadrava shola.
Probable understanding of Kriyakala in Amlapitta

37. 37
DISCUSSION
• Any branch of medical science which deals with preventive and curative aspects should have
deep knowledge about the stages of pathogenesis
• Acc to ayurveda, diagnosis of the disease is not always in the terms of the name of the disease
but in terms of nature of phenomenon of the disease.
नवकारिामाक
ु शलो ि नजह्रीयात् कदाचि|
ि नह सवानवकाराणां िामतोऽस्मस्त ध्रुवा स्मस्थनताः||cha su 18/44
• Kriyakala provides understanding regarding when and what kind of measures should be
adopted for appropriate management of diseases. Adoption of these measure avoids the bad
prognosis of disease.
• If Doshas are at the first stage, a simple line of treatment can prevent the condition from
progressing to the next stage in the manifestation.

38. 38
यथा ह्यल्पेि यत्नेि निद्यते तरुणस्तरुाः ।
स एवानतप्रवृधस्तु निद्यतेऽनतप्रयत्नताः ॥
एवमेव नवकारोऽनप तरुणाः साध्यते सुखम् ।
नववृधाः साध्यते क
ृ च्छ
र ासाध्यो वाऽनप जायते ॥ (च.नि. 5 / 14-15)
Its easy to pluck a plant when its still a sapling and not when it becomes
a tree., in same manner treatment at the earliest helps to prevent the
complications of the disease. Early diagnosis of disease forms the key to
unravel the secrets of effective and comprehensive treatment.
 On the other side, it is also the responsibility of the patient to keep
track of subtle pathological changes that takes place in the body and
not to neglect these indications.

39. 39
CONCLUSION
• The magnitude of illness and clinical presentation vary because each person has different
patterns of exposure to pathogens and dynamic changes in the functioning of Dhatus.
• Interestingly, even before the appearance of external symptoms, ayurveda has the ability to
detect and treat the underlying cause of the disease.
• PREVENTION IS BETTER THAN CURE has always been a golden standard and underlined
principle for health.
• Dinacharya & Rutucharya, balanced ahara, nidra, brahmacharya all these are one dimension
of the prevention of illness. The other dimension of prevention is early diagnosis of the
disease in its budding stage itself.
• The validation of the shat kriyakala model with the help of modern science could be
remarkable achievement in medicine.

40. 40
SANCHAYA AVASTHA Stage of
accumulation
Nidana Parivarjana
Dosha Pratyanika Chikitsa
PRAKOPA AVASTHA Stage of
provocation
Dosha Pratyanika Chikitsa
PRASARA AVASTHA Stage of
Spreading
Dosha Pratyanika Chikitsa Hetu-
Aganthu-Sthanika Dosha Chikitsa
STHANASAMSHRAYA AVASTHA Stage of
Localization
Dosha-Dushya Pratyanika Chikitsa
Samprapti-Vighatana Chikitsa
VYAKTAAVASTHA Stage of
manifestation
Samprapti-Vighatana Chikitsa
Vyadhi Pratyanika Chikitsa
BHEDHA AVASTHA Stage of chronicity Nidanarthakara Roga Chikitsa
Upadrava Chikitsa

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