The disturbed biological response after invasion of etiological factors alter normal state of body leading to the more accumulation of disease causative entity inside the body this can be correlated with Prakopa of Shatkriyakala. Prakopa stage has unusual cell proliferation due to oxidative stress which may have increased DNA mutations or induced DNA damage and genome instability.
3) Stage of Spread (Prasara)
In this stage the Doshas are hyper activated and they leave their site and start spreading throughout the body.
a) In Vata-Prasara 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 falling for nausea is developed.[6]
How Prasara stage is formed?
If milk is kept for boiling in a vessel, after some time it comes up to the brim and then if not removed spills out. Similarly Doshas leave their place and spread throughout the body.
When water and Kodrava (type of cereal) are mixed and kept in closed vessel for some time, then fermentation takes place and this mixture spreads rapidly everywhere. Similarly, Doshas spread rapidly throughout the body.
The stage of Prasara can be correlated with the cell migration as oxidative stress can augment tumor growth and metastasis by causing profound alterations in the morphology and adhesive properties of the cells.
4) Stage of Localization (Sthanasamshraya) In this stage the aggravated Doshas attack the Dushya or weak tissues or waste products & disease is manifested. In these stages the prodromal symptoms (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 disease like diarrhea, kidney stone, fever etc. occurs. To prevent this stage Rasayana treatment is very beneficial.
Stage of disease augmentation in which causative entity accumulated at different body parts can be correlates with Sthanasamsraya in which aggravated and spreaded Dosha gets localized to many body parts.
Sthanasamshraya may be called as homing process of the cells. This homing process takes place through multiple steps, which includes progression, invasion and settling of cells into a distant organ.
5) Stage of Manifestation (Vyakti) In this stage the disease expresses itself. Here, the disease can be diagnosed easily. e.g. pyrexia, colitis (diagnosed by type of feces). Sushruta has described this stage as occurrence of disease.
In this stage proper symptoms or Rupa appears, therefore particular disease expresses particular symptoms.
Stage of manifestation of symptom can be considered as Vyakti in which disease diagnosis can be possible accurately on the basis of sign and symptoms. It is considered as acute stage of disease manifestation.
6) Stage of Differentiation (Bheda) This is the last stage of Shat-Kriyakala. In this stage the disease can be diagnosed correctly and its Doshaja type can be decided e.g. Pittaja diarrhea (where Pitta Dosha is predominant).
Stage of complications of disease can be correlates with Bheda stage in which chronic or incurable condition may persist if proper treatment options not adopted.
Significance of Shat-Kriyakala
1. Understand the stage in a definite sequence before the disease is diagnosed.
2. We can prevent the formation of disease if the initial stage are diagnosed correctly.
3. Different type of treatment can be given for different stage.
4. The physician can successfully cure the patient and prevent the recurrence of the disease.
Discussion
Kriyakala can be subdivided in two stages: 1) Doshaja Kriya Kala: The treatment is given according to the involvement of Doshas, it includes Sanchaya, Prakopa, Prasara
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