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Introduction

The prime factors in the pathogenesis of diseases are dosha and dushya. We know that physiology is the study of normal functioning of the body, it is study of dosha, dhatu and mala. The term Kriyakal made up of two words kriya and kal, where kriya means the choice of treatment used to correct disturbance of doshas and kala means stages of disease progression. The concept of kriyakal recognize recognized various stages of disease progression Sushruta mentioned concept of kriyakal in Varnaprashnadhyaya. The word shatkriyakal where shad means six .Shatkriyakal helps to understand the stages in definite sequence before the disease is diagnosed .It helps to prevent the formation of disease if the initial stages are diagnosed correctly .Different types of treatment can be given for different stages. The imbalance of doshas can be corrected as per the kala or severity of disease,  thus patient get early relief ,disease cured completely. Acharya Sushrut's shat kriyakala approach not only makes it possible to track the development of any illness overtime ,but it also provides guidance on how to prevent it before it manifests as a clearly identifiable illnes. Shat means six there are six stages of kriyakal explained by Acharya Sushruta.

Aims & Objective :-

a) To understand the concept of Shatkriyakal

b)To understand the importance of Shatkriyakal

c) To describe the shatkriyakal in preventive aspects.

Discussion

Material and Methods:- Review of Literature regarding Shatkriyakal is collected from Sushrut Smhita & Ashtang hruday.All the compiled matter is recognised and anaylized.

Shatkriyakal :- To cure the diseases completely knowledge of Shatkriyakal is essential .Shat means six and kriyakal means stages of disease. Samprapti has six stages from the accumulation doshas till the disease is completely manifested Sushrut has described these stages in Sushrut Samhita Sutrasthana that are sanchay prakop, prasar, sthansanshray, vyakti and bheda.

1)Sanchay (Stage of Accumulation )

 In this stage the disturbed doshas start accumulating in their own sites.

a) In vata chaya the person senses abdominal bulging due to Vata accumulation and then becomes lethargic .

b) In Pitta chaya yellowness of nails,eyes and urine is observed .

c) In Kapha chaya body temperature is lowered.The person starts developing nausea. Chaya is increased in its own sites and produces dislike for things which are the causes of increase and liking for things of opposite qualities . In this stage mild symptoms are seen .Thus it is very beneficial to cure the person in this first stage itself . If we treat the disease at the stage of sanchaya ,the disease does not spread further .This is the reason why it is said that if we treat this stage correctly we can win over the disease .  The doshas should be conquered by effective treatment in the stage of chaya.

*Table showing the symptoms of Chaya Avastha

 2) Prakop ( Stage of Aggravation )

a) In Vata prakopa,hyper peristalsis is observed i.e food passes very rapidly through the stomach and intestine .

b) In Pitta prakop,water brash, polydypsia and burning sensation is observed .

c) In Kapha prakopa the person feels nauseated about food and heaviness in chest is observed .

Vaghbhat has said that in this stage dosha spread through out the body howthis is quite correct .

3) Prasar (Stage of spread )

 In this stage the doshas are hyper activated and they leave their site and start spreading      In this stage the doshas  go on accumulating further in their own sites. throughout the body.

a) In Vata prasar doshas change their place and move in any part of the body .A person experiences tympanitis.

b) In Pitta prasara body temperature is raised and burning sensation is sensed.

c) In Kapha prasara the person experiences fatigue indigestion and tastelessness. Also a felling for nausea is developed .

*How prasara stage is formed ?

  If milk is kept for in vessel after some time it comes up to the brim and then if not removed spills out .Similarly doshas leave their place and spread through out the body .

 4) Sthansamshraya (Stage of Localization)

In this stage the aggravated doshas attack the dushya and disease is manifested .In this stage the prodromal symptoms i.e Purvarupa starts appearing. In this stage the disease starts progressing. The type of disease depends on where the doshas have accumulated. Depending on the type of channel these doshas attack, various diseases like diarrhea, kidney stone, fevetc. occurs.

5) Vyakti (Stage of Manifestation )

 In this stage the disease expresses itself .Here the disease can be diagnosed easily e.g pyrexia, colitis. Sushruta has described this stage as occurrence of disease. In this stage proper symptoms or Rupa appears, therefore particular disease expresses particular symptoms .

6) Bheda ( Stage of Differentiation)

This is the last stage of shatkriyakala. In this stage the disease can be diagnosed correctly and it's doshaja type  can be decided e.g Pittaja diarrhea.

Significance of Shatkriyakala :-

1) Understand the stages in definite sequence before the disease is diagnosed .

2) We can prevent the formation of disease if the initial stages are diagnosed correctly .

3) Different type of treatment can be given for different stages .

4) The physician can successfully cure the patient and prevent the recurrence of the disease

Conclusion

Shatkriyakal is one of the most important topic of Ayurveda .The six stages of disease progression described as Shatkriyakal in Ayurveda and this concept helps greatly towards the prevention and management of diseases.The illness process can be stopped at an early stage and the chances of complecations by understanding the shatkriyakal. The physician can choose course of treatment by understanding and recognising the vitiated dosha situation. Acharya Sushrut mentioned Shatkriyakal in sutrashtan which helps in early stage prevention and further progression of the disease .