Relationship between Samprapti and Shat Kriya Kala

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
When a disease forms in the body it goes through a series of pathological changes occurring in the body following the consumption of or exposure to etiological factors (causative factors of a disease) to the manifestation of the disease with its characteristic signs and symptoms. The entire process or story of the formation of a disease is called as Samprapti in Ayurveda. 

Related reading – Samprapti

Shat Kriya Kala

Shat Kriya Kalas are the 6 stages in which the disease is formed. They include –

• Sanchaya – Stage of accumulation of doshas in their seats of predominance is called Sanchaya.
• Prakopa – Stage of aggravation of the doshas in their seats of predominance is called Prakopa.
• Prasara – Spread of doshas throughout the body, in all directions is called Prasara.
• Sthana Samshraya – Stage of lodgment of vitiated doshas in weak and susceptible organs and tissues is called Sthana Samshraya. In this, the dosha dushya sammurchana or amalgamation of vitiated doshas and susceptible tissues take place. This also leads to manifestation of premonitory symptoms (Poorvarupas) of the disease. Since the Purvarupas are manifested in this stage, this stage of pathogenesis is called Purvarupa Avastha (Purvarupa=Premonitory symptoms, Avastha=stage).
• Vyakta or Vyakti Bhava – The doshas which have lodged in the tissues in the Sthana Samshraya stage of the disease will cause further insult and damage of the tissues and organs and will cause diseases therein. The disease is clearly manifested in this stage with its clear cut signs and symptoms (Lakshanas). Since the symptoms are manifested, this stage is also called as Rupa Avastha (Rupa=symptoms, Avastha=stage).
• Bheda Avastha – When the disease is not treated in proper time even in Vyakta Avastha the disease progresses further and causes various Complications. This stage of the disease is called Bheda Avastha.

The above said are the 6 stages of the disease. They are also the appropriate time for treatment. Each preceding stage is easier to treat than its successive stage. Therefore Sanchaya is the easiest stage of pathogenesis to treat and Vyakta is difficult. Bheda Avastha is most difficult stage to handle, because many times the disease is out of control of any interventions due to the presence of complications. This stage is also considered as impossible to cure.

The six stages of Kriyakala also represent various steps of the formation of the disease, i.e. story of formation of the disease and hence constitute the definition of Samprapti.

In this article we will see the relation between Kriya Kala and Samprapti by blending both the concepts into one.
Related Reading – Shat Kriya Kala

Samprapti, Shat Kriya Kala relation

Relation between Samprapti and Kriya Kala
As discussed above, Samprapti is the story of the disease formation and Shat Kriya Kalas are the successive chapters of that story. This can well be understood if both these concepts are studied simultaneously. The relationship between Samprapti and Shat Kriya Kala, which in spite of being different terminologies complement and supplement each other’s explanation (interchangeably), can be explained by putting together the ‘steps in which the samprapti occurs’ and ‘the six stages of kriya kala or stages of disease formation’.

The steps in which Samprapti occurs in relation to Shat Kriya Kala

Nidana sevana

Exposure to causative factors and dosha vitiation
Consumption of causative factors of a disease is a must for the initiation of disease process in the body. They may be in the form of incompatible and unwholesome foods, erratic lifestyle, exposure to pollutants and allergens, infections, stress etc. These factors create an initial disturbance on entering or on coming in contact with the body. This initial disturbance is the starting point or beginning of a disease process. According to Ayurveda, the consumption of these factors will lead to the disturbance of doshas which will get vitiated. The vitiated doshas will tend to initiate the disease process. Therefore the vitiation of doshas is the starting point of the beginning of pathogenesis.

Related reading – Nidana
We are regularly exposed to various causative factors of a disease which begin the pathogenesis of a disease. Several etiological factors contributing to the diseases and vitiation of the doshas attack the body every now and then. Some causative factors may be avoided by adopting proper precautionary measures while some more factors like
kala (effect of time factor),
krimi (pathogens, microbes, germs, infection),
desha (effect of residing land, contaminated land) etc are mostly inevitable.

If the vyadhi kshamatva (immunity) is high and if the dhatus (tissues), srotas (channels) and agni (metabolic fire) are functioning well in the body, the body fights against the etiological factors successfully, thus maintaining the health.

On the other hand, if the etiological factors are stronger than the vyadhi kshamatva of the body, they will vitiate the doshas and dushyas (tissues) leading to the beginning of the disease process.

Dosha Dushti

Vitiation of Doshas (dosha dushti)
Due to the exposure of causative factors, the doshas will get vitiated. The doshas may get vitiated individually or in combinations. The vitiation of doshas depends on the quality and quantity of the etiological factors to which one is exposed to and the type of reaction they set in the body.

The vitiation of doshas also takes place in many types. Example, prakrita dushti (natural vitiation), vaikruta dushti (abnormal or severe aggravation due to consumption of etiological factors), anubandha dushti (vitiation of one or many doshas, example vata getting vitiated with kapha, here kapha is associated vitiation for vata) etc.

The vitiated doshas will sequentially undergo 6 stages of vitiation. This is called Kriya Kala.

Sanchaya of doshas

In the first stage, the doshas get vitiated in small quantities in their respective seats of predominance. This is called Sanchaya or Chaya.

Prakopa of doshas

In the second stage of vitiation, the doshas will increase in excessive proportions in their respective seats of predominance and also will tend to leave their places and spread to other areas of the body (which do not belong to them). This is called Prakopa.

(The other 4 states will be explained ahead, as per the context and progression of the Samprapti)
Related Reading – Shat Kriya Kala

Dosha Gati

Movement of vitiated doshas (dosha gati)
The vitiated doshas will move in different directions, pervading and encroaching all over the body. These movements of doshas are called dosha gati. The vitiated doshas will have three directions to move i.e. urdhwa gati (upward movement), adho gati (downward movement) and tiryak gati (sideward or oblique movement). Doshas can have more than 2 gatis at a time.

Prasara of Doshas

This movement of doshas will follow the initial states of dosha vitiation i.e. Sanchaya (accumulation of doshas) and Prakopa (severe vitiation of doshas) and is called Prasara (spread of vitiated doshas. This constitutes the 3^rd stage of Kriya Kala.

Sthana samshraya of Doshas

Lodgment of Doshas in the tissues (dosha-dushya sammurchana, sthana samshraya)
The vitiated doshas which have started traveling all over the body will find the weaker dhatus (tissues) and get lodged therein. These vitiated doshas contaminate the tissues and organs where they get lodged and produce the diseases at the place of lodgement.

Sthana Samshraya of Doshas – The vitiated doshas gets lodged in the weaker and susceptible dhatus and invades them. Gradually the vitiated doshas damage the tissues. This amalgamation of vitiated doshas and weak dhatus is called dosha dushya sammurchana. Dosha Dushya Sammurchana marks the Sthana Samshraya (lodgment of doshas in the sthana i.e. tissues and organs of the body), the 4^th stage of Kriya Kala or Samprapti. This stage shows the premonitory symptoms of a disease.
Related Reading – Purvarupa

Vyakta Avastha

Manifestation of the disease
Following the lodgment, the doshas tend to damage the tissues after contaminating them. If the tissues are strong enough to defend selves against this invasion, they will fight back, would resist and recover from the damaging effect caused by the morbid doshas. It is a continued stage of pathogenesis from sthana samshraya.

Following the lodgment, the doshas tend to damage the tissues after contaminating them. If the tissues are strong enough to defend selves against this invasion, they will fight back, would resist and recover from the damaging effect caused by the morbid doshas. It is a continued stage of pathogenesis from sthana samshraya.

Vyakta Avastha or Vyakti Bhava – Vyakta means to get manifested. This forms the 5^th stage of Kriya Kala wherein the premonitory symptoms of the Sthana Samshraya stage get clearly manifested and the disease is manifested its clear cut signs and symptoms. This is a stage wherein we diagnose and name a disease. If the disease is not treated even in this stage, it leads to complications. This stage shows the symptoms which define and represent that disease.
Related Reading – Rupas or Lakshanas of a disease

Samprapti

Thus Samprapti is the sequence of changes that take place in the body right from the consumption of the etiological factors or exposure to them to the manifestation of the disease. This includes the first 5 stages of Kriya Kala (as explained above).

Consumption of Nidanas (etiological factors) → Disturbance and accumulation of doshas in their respective locations (Sanchaya) → Severe vitiation of doshas in their respective sites (Prakopa) → Spread of doshas from their sites to the other parts of the body (Prasara) → Lodgment of the vitiated doshas in the weak and susceptible dhatus (tissues), leading to their damage and insult, manifestation of early symptoms of a disease (premonitory symptoms or purvarupas) i.e. Sthanasamshraya of doshas → Further damage of the cells and organs leading to the manifestation of diseases with their full blown classical signs and symptoms (Vyakta Avastha or Vyakti Bhava or Rupa Avastha) = Samprapti

Bheda Avastha

What happens next?
Manifestation of Complications
When the disease is not treated properly even after it gets manifested, the disease will slowly grow to become chronic, stubborn and will involve multiple tissues and organs, lower the immunity, cause severe damage and lead to life threatening complications. At this stage the disease will become impossible to treat or pacify.

Bheda Avastha – Bheda means complications. This forms the 6^th stage of pathogenesis according to Ayurveda, i.e. sixth stage of Kriya Kala. Here the disease has gone to an extent of being incurable and has association of lot of upadravas or complications.
Related Reading – Upadravas

This may or may not be included in the story of formation of disease i.e. Samprapti. But ideally I feel that it should be included in the timeline of Samprapti because diseases will lead to one or the other complications if neglected or untreated.
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