How does disease start?

Ayurveda doctors and experts answer your questions. 

Everyone knows that there lies a pathology for any disease unless it is categorised under auto-immune. However, Ayurveda has explained the disease manifestation in six different stages which is known as “Shat Kriya Kaala”. Shat means Six, Kriya means Action and Kaala means stages or periods. Hence, understanding Shat Kriya Kaala helps to get an insight into the progression of the disease and take appropriate action to stop the disease manifestation. 

The factors causing the disease can be both intrinsic and extrinsic which will vitiate the dosha balance. Thus vitiated dosha starts accumulating within their space in the first stage which is known as “Sanchaya”. In the second stage, this accumulated dosha gets aggravated but stays within their space which is called “Prakopa”. Thus aggravated dosha then starts spreading to other parts which is called “Prasara” in the third stage. The above three stages are also called Dosha Kriya Kaala which means the phases happening to Dosha.

The last three stages are called the Vyaadhi Kriya Kaala where one can see the different phases of the disease manifestation. The fourth stage is called “Sthana Samsraya” where the dosha that had moved from its original site gets lodged in a dhatu/tissue and starts showing the prodromal symptoms. In the fifth stage, “Vyakteebhava” happens where the disease manifestation starts producing signs and symptoms. The sixth stage is termed “Bheda” where the complication from the disease arises. 

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According to Ayurveda principles, the process of disease manifestation is given utmost importance. Knowing the root cause of disease and the process of its manifestation helps in earlier diagnosis and treatment.

Explanation of pathogenesis starts with the exposure to etiological factors. These factors disturb the equilibrium of the body humors and cause its vitiation. The vitiated humors accumulate and aggravate in their own sites within the body. These aggravated body humors spread to other parts of the body in different directions and gets lodged within the body tissues. Here, the amalgamation of vitiated humors and body tissues begin. The premonitory symptoms of a disease are formed at this stage.

If the disease is not identified and treated at this stage, the vitiated humors cause further damage to the tissues and organs and leads to manifestation of signs and symptoms of the disease. If treatment is delayed further, the disease progresses to a stage of incurability and becomes associated with complications.

The importance of this stage-wise understanding of pathogenesis is that the disease can be identified before it progresses further and the pathogenesis can be intervened by lifestyle changes or medications.

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In Ayurveda the process of starting a disease is termed as ‘Samprapthi’ or pathogenesis, the genesis of the ‘patho’, manifestation of disease. Due to the internal and external causes, the three doshas undergo vitiation and the vitiated dosha get localized in a particular tissue compartment and due to the biological mutual reaction between the vitiated dosha and local tissue, the tissue undergo certain structural and physiological changes, which is manifested as disease. The interaction between the vitiated dosha and the concerned dooshya, it can be either dhathu or malas, and this interaction is termed as “Dosha dooshya samoorchanam” in ayurveda. It is an essential stage for the manifestation of any disease. In all manifestations we can see the “Agni mandyam” (lack of metabolism).

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