KRIYAKALA

INTRODUCTION

• Internal steady state of man is always in a state of unstable equilibrium and flux moves from one
steady-state to another under the impact of the various stresses.
• If man follows right code of conduct then this steady state of equilibrium is maintained and state
of health is preserved.
• The inability of man to achieve and maintain equilibrium results in initiation of disease process
which involves successive stages of pathogenesis.
 INTRODUCTION

• Ayurveda lays emphasis on early diagnosis of pathogenesis to prevent the development of

disease.
• For this various stages of pathogenesis are described elaborately. The series of abnormal
activities (Vikrita Kriya) successively developing to various stages in a span of time (Kala) is
known as Kriyakala (stages of disease evolution).
• As six (Shat) stages are mentioned under Kriyakala, it is also known as Shatkriyakala.
Importance

ज्ञानबुद्धिप्रदीपेन यो नाविशति तत्त्ववित्

आतुरस्यान्तरात्मानं न स रोगांश्चिकित्सति||१२||
 RUDRA

BRAHMA VISHNU
 MOON

SUN
AIR
 HOMOLOGY OF DOSHAS

• :—प्रकु पितस्य खल्वस्य लोके षु चरतः कर्माणीमानि भवन्ति; तद्यथा- शिखरिशिखरावमथनम्, उन्मथनमनोकहानाम्, उत्पीडनं सागराणाम्, उद्वर्तनं सरसां,
प्रतिसरणमापगानाम्, आकम्पनं च भूमेः, आधमनमम्बुदानां[७] नीहारनिर्ह्रादपांशुसिकतामत्स्यभेकोरगक्षाररुधिराश्माशनिविसर्गः, व्यापादनं च षण्णामृतूनां,
शस्यानामसङ्घातः, भूतानां चोपसर्गः, भावानां चाभावकरणं, चतुर्युगान्तकराणां मेघसूर्यानलानिलानां विसर्गः; स हि भगवान् प्रभवश्चाव्ययश्च, भूतानां
भावाभावकरः, सुखासुखयोर्विधाता, मृत्युः, यमः, नियन्ता, प्रजापतिः, अदितिः, विश्वकर्मा, विश्वरूपः, सर्वगः, सर्वतन्त्राणां विधाता, भावानामणुः, विभुः,
विष्णुः, क्रान्ता लोकानां, वायुरेव भगवानिति||८||
 IMPORTANCE OF DOSHAS

Hence it may be safely asserted that no disease can occur without the
direct mediation or intervention of the deranged bodily humours. Yet the
connection(relation) which exists between the two is neither constant nor separable.
As the physical phenomena of lightning, storm, thunder and rain can not happen
independently of the sky (cloud) ; and yet they sometimes do or do not occur with
the presence of a cloud ; again as bubbles^ though in reality but the modifications of
the underlying water, do not swellup on its surface at all times, so the connection
between a disease and the bodily humours is neither universally separable or
inseparable.
 क्रियाकाल

• क्रियाकालः ..कर्मावसरः
• क्रिया – Treatment, Action
• काल – Time

• Time for appropriate action/treatment

• Stages of progressive pathogenesis of a disease
• Allows recognition of the stage of a disease and hence helps to decide appropriate treatment
meausure to be taken.
 क्रियाकाल

ऋतु क्रियाकाल
• Ritu Kriyakala refers to successive changes/events are naturally
according to season (Ritu).

व्याधि क्रियाकाल
• Vyadhi Kriyakala includes the abnormal changes taking place in the
body which finally leads to evolution of disease.
 ऋतु क्रियाकाल

• In Ritu Kriyakala, three stages of Dosha occur Chaya (Stage of accumulation), Prakopa (Stage
of aggrevation) and Prashama (Stage of remission). These stages occur naturally according to
seasonal changes and are continuous in nature.

Dosha Sanchaya Prakopa Prasama

Vata Grishma Varsha Sharad
Pitta Varsha Sharad Hemant

Kapha Shishira Basant Grishma

 व्याधि क्रियाकाल

• Description in Su.Su.21st Chapter - Vranaprashnadhyaya

• Vyadhi Kriyakala includes the abnormal changes taking place in the Dosha due to effect of
unsuitable foods and activities which finally leads to evolution of disease.
• If Dosha do not revert back to normal state then a series of events result which ends in disease
manifestation.
• Vyadhi Kriyakala includes of six stages.
• The first four stages permit recognition and elimination of the disease before manifestation of
clinical sign and symptoms.
 सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम् |
व्यक्तिं  भेदं च यो वेत्ति दोषाणां स भवेद्भिषक्  ||३६||

सञ्चय प्रकोप प्रसर

• Stage of • Stage of • Stage of Spread
Accumulation Aggravation

स्थानसंश्रयम् व्यक्ति भेद

• Stage of Stage of • Stage of
localization manifestation complications
 SANCHAYA - STAGE OF ACCUMULATION

• एतानि खलु दोषस्थानानि; एषु सञ्चीयन्ते दोषाः |
प्राक्  सञ्चयहेतुरुक्तः |

• तत्र समासेन वातः श्रोणिगुदसंश्रयः; तदुपर्यधो नाभेः पक्वाशयः, पक्वामाशयमध्यं पित्तस्य; आमाशयः श्लेष्मणः ||६||

• प्राक्  सञ्चयहेतुरुक्तः  - In Ritucharya Adhyaya

 SANCHAYA

• संहतीरूपा वृद्धिश्चयः Dalhana

• चयो वृद्धिः स्वधाम्न्येव (A.H.Su.12/ 22)

• Accumulation of Dosha in their principal abode
• May be in form of quantity(Pramana), quality (Guna) or function (Karma).
 SANCHAYA LAKSHANA

• तत्र सञ्चितानां खलु दोषाणां स्तब्धपूर्णकोष्ठता पीतावभासता मन्दोष्मता चाङ्गानां गौरवमालस्यं चयकारणविद्वेषश्चेति लिङ्गानि भवन्ति |
तत्र प्रथमः क्रियाकालः ||१८||

Vata dosha Pitta dosha Kapha dosha

• स्तब्धपूर्णकोष्ठता • पीतावभासता मन्दोष्मता • चाङ्गानां गौरवमालस्यं
• Sthabdha Koshthta- • Pitavabhasata (appearance • Gaurava (a feeling of
(deacrease movements in of mild yellowish heaviness)
alimentary tract ) discolouration • Alasya (lassitude)
• Purna Koshthta- (a feeling of • Mandoshmata (mild increase
abdomen fullness) of body temperature)
 SANCHAYA NIDANA
Dosha Sanchaya Prakopa Prasama
Vata Grishma Varsha Sharad
Pitta Varsha Sharad Hemant

Kapha Shishira Basant Grishma

Factors Vata Pitta Kapha

Day Afternoon Midday Morning
Night Late night Midnight Early night

Age Old Adult Childhood

Digestion Starting phase Mid phase Late phase
 TREATMENT

•  सञ्चयादावनागताबाधोक्तदन्तधावनादिप्रतीकारैर्निर्हरणं कर्तव्यमित्युक्तम्|
 PRAKOPA - STAGE OF AGGRAVATION

• In this stage Dosha are further aggravated and are ready to leave their primary seats where they
reside.
 VATA PRAKOPA NIDANA
• तत्र बलवद्विग्रहातिव्यायामव्यवायाध्ययनप्रपतनप्रधावनप्रपीडनाभिघातलङ्घनप्लवनतरणरात्रिजागरणभारहरण- गजतुरगरथपदातिचर्या
• कटुकषायतिक्तरूक्षलघुशीतवीर्यशुष्कशाकवल्लूरवरकोद्दालककोरदूषश्यामाकनीवार- मुद्गमसूराढकीहरेणुकलायनिष्पावानशन
• विषमाशनाध्यशनवातमूत्रपुरीषशुक्रच्छर्दिक्षवथूद्गारबाष्पवेगविघातादिभिर्विशेषैर्वायुः प्रकोपमापद्यते ||
• स शीताभ्रप्रवातेषु घर्मान्ते च विशेषतः |
प्रत्यूषस्यपराह्णे  तु जीर्णेऽन्ने च प्रकु प्यति ||२०||

Diet Related Factors Lifestyle related Seasonal Diurnal

• Katu, Tikta , • Excessive exercise, Cold and Rainy season Afternoon and late night
• Kashaya Rasa trauma, fall
• Ruksha , Laghu and • Suppression of
Sheeta Dravya • natural urges.
• Adhyashana • Night awakening
• Vishamashana
• Examples : Pulses
 PITTA PRAKOPA NIDANA

• क्रोधशोकभयायासोपवासविदग्धमैथुनोपगमन
• कट्वम्ललवण- तीक्ष्णोष्णलघुविदाहितिलतैलपिण्याककु लत्थसर्षपातसीहरितकशाक- गोधामत्स्याजाविकमांसदधितक्रकू र्चिकामस्तुसौवीरकसुराविकाराम्ल
फलकट्वरप्रभृतिभिः पित्तं प्रकोपमापद्यते ||२१ ||
• तदुष्णैरुष्णकाले च घनान्ते च विशेषतः |
मध्याह्ने चार्धरात्रे च जीर्यत्यन्ने च कु प्यति ||२२ ||

Diet Related Factors Lifestyle related Seasonal Diurnal

• Katu, Amla and Lavana Rasa • Over exertion, • Hot season and • Mid of the
• Teekshna , Ushna, Laghu and Anger, Grief, autumn day and night
Vidahi substances Anxiety
• Taking food in small quantity
• Example : Tila taila, Pinyaka
• During the digestion of meal
 KAPHA PRAKOPA NIDANA

• दिवास्वप्नाव्यायामालस्य
• मधुराम्ललवणशीतस्निग्धगुरुपिच्छिलाभिष्यन्दिहायनकयवकनैषधेत्कट- माषमहामाषगोधूमतिलपिष्टविकृ तिदधिदुग्धकृ शरापायसेक्षुविकारानूपौदकमांसवसाबि
समृणाल- कसेरुकशृङ्गाटकमधुरवल्लीफलसमशनाध्यशनप्रभृतिभिः श्लेष्मा प्रकोपमापद्यते ||२३
• स शीतैः शीतकाले च वसन्ते च विशेषतः |
पूर्वाह्णे  च प्रदोषे च भुक्तमात्रे प्रकु प्यति [२१] ||२४||

Diet Related Factors Lifestyle related Seasonal Diurnal

• Madhura, Amla and Lavana Rasa • Day time sleeping • Cold and Spring • At the starting of
• Sheeta, Snigdha, Guru, Picchila • Lack of exercise season day and night
Substances
• Example : Food items made up of
Pishta ,milk, sugarcane etc.
• Adhyashana, Samasana
• After food intake
 PRAKOPA TYPES

• Dosha aggravation can occur after Dosha accumulation (Sanchaya stage) or can occur without
Dosha accumulation.
• If aggravation occurs after Sanchaya or Dosha accumulation then it is known as Chaya Prakopa
and if aggravation occurs without Sanchaya stage or Dosha accumulation then it is known as
Achaya Prakopa.
 Swabhavika

Chaya Prakopa

Aswabhavika
Prakopa

Achaya Prakopa Balvadnigrahadi

• काठिन्यादूनभावाद्वा दोषोऽन्तः कु पितो महान् ||३२९ ||
• काठिन्यादिति दोषचयरूपसंहतत्वात्| ऊनभावात् अचयप्रकोपात्; अचयेऽपि च दोषाणां प्रकोपो भवत्येव; यथा
बलवद्विग्रहादिभिर्वायोः, पितस्य क्रोधादिभिः, श्लेष्मणश्च दिवास्वप्नादिभिः; अयं चाचयप्रकोपो घनावयवोपचयाकर्तृत्वात् ‘ऊनभावात् प्रकोप’ इत्युच्यते|
 PRAKOPA LAKSHANA

• तेषां प्रकोपात् कोष्ठतोदसञ्चरणाम्लीकापिपासापरिदाहान्नद्वेषहृदयोत्क्ले दाश्च जायन्ते |
तत्र द्वितीयः क्रियाकालः ||२७|

Vata dosha Pitta dosha Kapha dosha

• कोष्ठतोदसञ्चरण • अम्लीका - sour
• Pricking pain and eructation
movement of Vata in • पिपासा - thirst
abdominal region • परिदाह - feeling of
burning sensation
• अन्नद्वेष - aversion to
food
• हृदयोत्क्ले दाश्च - excessive
salivation in mouth
 TREATMENT

• प्रकु पितानामिति प्रशब्दो बहुदोषाणामेव संशोधनमिति दर्शयति; मध्यदोषेषु पाचनादि, अल्पदोषेषु पुनर्लङ्घनपिपासानिग्रहादि यथर्तुविधिसमाचारश्चेति च
कारो दर्शयति| 
 PRASARA - STAGE OF SPREAD

• Prasara literally means spread.

• देशान्तरसरणमिव प्रसरः Dalhana
• In this stage Dosha leave their own seat and spread or move to other sites.
• If the Dosha are not controlled by proper remedial measures during the second stage, they
undergo increase and spread to the seats of the other Dosha in addition to their own.
• start spreading all over the body with single dosha or with a combination of Dwidosha tridosha
or altogether with rakta.
 15 TYPES OF PRASARA

• तद्यथा- वातः, पित्तं, श्लेष्मा, शोणितं, वातपित्ते, वातश्लेष्माणौ, पित्तश्लेष्माणौ, वातशोणिते, पित्तशोणिते, श्लेष्मशोणिते, वातपित्तशोणितानि, वातश्ले
ष्मशोणितानि, पित्तश्लेष्मशोणितानि, वातपित्तकफाः, वातपित्तकफशोणितानीति; एवं पञ्चदशधा प्रसरन्ति ||२८||
 DIFFERENCE BETWEEN PRAKOPA AND
PRASARA
• प्रकोपप्रसरयोश्च को भेदः? उच्यते- स्त्यानस्य सर्पिषः क्वाथ्यमानस्य प्रथमं सञ्चलनमात्रमेव प्र
कोपः, तस्यैव चातिक्वाथ्यमानस्य फे नमण्डलेनोत्सर्पता देशान्तरसरणमिव प्रसरः|
 PRASARA – ANALOGY 1

• तेषामेभिरातङ्कविशेषैःप्रकु पितानां किण्वोदकपिष्टसमवाय इवोद्रिक्तानां प्रसरो भवति |
अन्योन्यगुणानुप्रवेशाद्यथा किण्वोदकपिष्टानामुद्रेकः

- Acute dosha excitation

 PRASARA – ANALOGY 2

• यथा- महानुदकसञ्चयोऽतिवृद्धः सेतुमवदार्यापरेणोदके न व्यामिश्रः सर्वतः प्रधाव
ति
• Fast Spread of Dosha 
 PRASARA

• कु पितानां हि दोषाणां शरीरे परिधावताम् |
यत्र सङ्गः खवैगुण्याद्व्याधिस्तत्रोपजायते  ||१०||
• खवैगुण्यात् स्रोतोवैगुण्यादित्यर्थः

• तदेतत् स्रोतसां प्रकृ तिभूतत्वान्न विकारैरुपसृज्यते शरीरम्||७||
 PRASARA LAKSHANA

• एवं प्रकु पितानां प्रसरतां वायोर्विमार्गगमनाटोपौ, ओषचोषपरिदाहधूमायनानि पित्तस्य, अरोचकाविपाकाङ्गसादाश्छर्दिश्चेति श्लेष्मणो लिङ्गानि भवन्ति; तत्र
 तृतीयः क्रियाकालः ||३२ ||
Vata dosha Pitta dosha Kapha dosha
• वायोर्विमार्गगमनाटोपौ • ओषचोषपरिदाहधूमायनानि • अरोचकाविपाकाङ्गसादाश्छर्दि
• Vimarggamana- (movement in • Osha- burning sensation • Arochaka (anorexia)
reverse direction or abnormal accompanied with sweating and • Avipaka( indigestion)
movement) restlessness • Angasada (weakness or tiredness
• Atopa- (gurgling sound in • Chosha- kind of pain in which in limb)
abdomen). there is feeling of sucking • Chardi (vomiting)
• Paridaha- feeling of burning
sensation all over the body.
• Dhumayana - feeling of
movement of hot fumes inside
head, neck, throat and palate
 TREATMENT

• तत्र प्रसरं यावद्दोषाणामेव हेतुलिङ्गचिकित्सा, तदनन्तरं व्याधेरिति|
 STHANASANSARAYA - STAGE OF
LOCALIZATION
• प्रसृतानां पुनर्दोषाणां स्रोतोवैगुण्याद्यत्र सङ्गः स स्थानसंश्रयः
• स्थानसंश्रयःदोषदूष्यस्य संश्रयः

• This stage marks the actual onset of disease process as the interaction between dosha and dushya begins.
• SthanaSamsraya literally means ‘localisation’ or ‘getting settled at one place’. Dosha which have spread over the body
in above stages get localised at some places due to derangement of local channels or Srotasleading to their interaction
with the Dushya. This stage represents the prodromal state of the disease which is yet to be manifested properly.

• तेषामेवमभिसन्निविष्टानां पूर्वरूपप्रादुर्भावः 
 • “स्थानसंश्रयिणः क्रु द्धा भाविव्याधिप्रबोधकम्| 

दोषाः कु र्वन्ति यल्लिङ्गं पूर्वरूपं तदुच्यते| (Chakrapani on Su.Su.21/37)

• तत्र सामान्यं येन दोषदूष्यसम्मूर्छनावस्थाजनितेन भाविज्वरादिव्याधिमात्रं प्रतीयते, न तु वातादिजनितत्वादिविशेषः| Madhukosha
• एवं प्रकु पितातांस्ताञ् शरीरप्रदेशानागम्य तांस्तान् व्याधीन् जनयन्ति |
• ते यदोदरसन्निवेशं कु र्वन्ति तदा-  गुल्म विद्रध्युदराग्निसङ्गानाहविसूचिकातिसारप्रभृतीञ्जनयन्ति; 
• बस्तिगताः प्रमेहाश्मरीमूत्राघातमूत्रदोषप्रभृतीन्; 
• मेढ्र गता निरुद्धप्रकशोपदंशशूकदोषप्रभृतीन्; 
• गुदगता भगन्दरार्शःप्रभृतीन्; 
• वृषणगता वृद्धीः; 
• ऊर्ध्वजत्रुगतास्तूर्ध्वजान्; 
• त्वङ्मंसशोणितस्थाः क्षुद्ररोगान् कु ष्ठानि विसर्पांश्च; 
• मेदोगता ग्रन्थ्यपच्यर्बुदगलगण्डालजीप्रभृतीन्; 
• अस्थिगता विद्रध्यनुशयीप्रभृतीन्; 
• पादगताः श्लीपदवातशोणितवातकण्टकप्रभृतीन्; 
• सर्वाङ्गगता ज्वरसर्वाङ्गरोगप्रभृतीन्
• कृ त्स्नेऽर्धेऽवयवे वाऽपि यत्राङ्गे कु पितो भृशम् |
दोषो विकारं नभसि मेघवत्तत्र वर्षति ||२९||
नात्यर्थं कु पितश्चापि लीनो मार्गेषु तिष्ठति |
निष्प्रत्यनीकः कालेन हेतुमासाद्य कु प्यति  ||३०||
 TREATMENT

• चतुर्थः क्रियाकाल इति चतुर्थश्चिकित्सावसरः| चिकित्सा चात्र दोषस्य दूष्यस्य चेत्युभयाश्रिता|
 VYAKTI - STAGE OF MANIFESTATION

• Vyakti refers to full manifestation of the disease. If proper treatment is not under taken in above
stage then ongoing pathological process undergoes further aggravation and ends up in
manifestation of Roga (disease) along with characteristic feature.
• व्याधेः प्रव्यक्तं  रूपं व्यक्तिः
• अत ऊर्ध्वं व्याधेर्दर्शनं वक्ष्यामः- शोफार्बुदग्रन्थिविद्रधिविसर्पप्रभृतीनां प्रव्यक्तलक्षणता ज्वरातीसारप्रभृतीनां च |
तत्र पञ्चमः क्रियाकालः ||३४
 VYAKTI

• व्याधेर्दर्शनं व्याध्युपलब्धिः, शोफादीनां ज्वरादीनां च प्रव्यक्तलक्षणता व्यक्तिः; प्रव्यक्तलक्षणता च व्याधिजातिलक्षणकथनं; तद्यथा- शोफार्बुदादीनां त्वङ्मां
सस्थानस्य दोषस्य सङ्घातता, तथा सन्तापलक्षणो ज्वरः, सरणलक्षणोऽतीसारः, पूरणलक्षणमुदरमिति| अत्र व्याधेः प्रत्यनीकै व चिकित्सा||३४||
• Increased body temperature is observed in Jwara
• • Excessive watery stool in Atisara
• • Abnormal enlargement of abdomen in Udara Roga
 TREAMENT

• अत्र व्याधेः प्रत्यनीकै व चिकित्सा|
 BHEDA - STAGE OF COMPLCATIONS

• This is the final stage of Kriyakala.

• If proper and effective treatments are not done to control the Dosha in the fifth kriyakala- the
dosha undergo further abnormal increase (vriddhi) and give rise to the sixth kriyakala known as
Bheda. अत ऊर्ध्वमेतेषामवदीर्णानां व्रणभावमापन्नानां षष्ठः क्रियाकालः, ज्वरातिसारप्रभृतीनां च दीर्घकालानुबन्धः |
तत्राप्रतिक्रियमाणेऽसाध्यतामुपयान्ति ||३५
 BHEDA

• Disease bheda
• Progression
• Chronicity
• Complications
• Relief/Restoration
• Arishta Lakshana
RELATIONSHIP BETWEEN KRIYAKALA AND
NIDANA PANCHAKA

Sanchaya, prakopa • Nidana Sevana

Sthanasanshraya • Purvarupa

Vyakti • Rupa

Bheda • Upadrava/Chirakarita/Asadhyata
 Sthanasan
Sanchaya Prakopa Prasara Vyakti Bheda
sraya

SAMPRAPTI
• यथादुष्टेन दोषेण यथा चानुविर्सपता |
निर्वृत्तिरामयस्यासौ सम्प्राप्तिर्जातिरागतिः ||१०||
• आगतिर्हि उत्पादकारणस्य व्याधिजननपर्यन्तं गमनम् Chakrapani
 IMPORTANCE OF KNOWLEDGE OF KRIYAKALA

• सञ्चयेऽपहृता दोषा लभन्ते नोत्तरा गतीः |
ते तूत्तरासु गतिषु भवन्ति बलवत्तराः ||३७||

• .If the disease is treated in earlier stages of Shatkriyakala, there is effective reduction in
the drug doses as well as time period required for treatment.
• Abnormalities taking place in the six successive stages of evolution become powerful
successively and thus eventually become difficult to treat.
 TREATMENT PRINCIPLE

• At first three stages of Kriyakala mainly, there should be life style and dietary
• modification.
• • At Prasaraavastha treatment according to Sthanika Dosha
• • If the Vata encroaches Pitta Sthana, Pitta should be managed. If the Pitta
• encroaches Kapha Sthana, Kapha should be managed. If the Kapha encroaches
• Vata Sthana, Vata should be managed
• • At last three stages : Treatment according to disease, Rasayana , Shodhana,
• Shaman , Shastrachikitsa , palliative measures or incurable depending upon the
• advancement of disease
 TREATMENT PRINCIPLE

• तत्र वायोः पित्तस्थानगतस्य पित्तवत् प्रतीकारः, पित्तस्य च कफस्थानगतस्य कफवत्, कफस्य च वातस्थानगतस्य वातवत्  ; एष क्रियाविभागः ||३१||
 IMPORTANCE OF KNOWLEDGE OF KRIYAKALA

• For the prevention of disease

• For diagnosis of disease
• To decide the prognosis (whether the disease is curable or not).
• To decide appropriate management
KASA SHATKRIYAKALA
 HETU (CAUSES)

• Causes:- Exposure to smoke as well as to dust particles, excessive bodily

exercise, intake of dry ((non fatty) food, entry of food into wrong pathway
and suppression of natural urges like sneezing are the main causative
factors for Kasa (Cough).
• This vitiates the Prana vayu along with Udana vayu, that produces a loud
noise as from a cracked Bell metal (vessel) come out of the mouth
suddenly with expectoration the condition is called as Kasa.
 SANCHAYA KALA

• It is the first step towards disease

• Due to causative agents as described earlier. It aggravates prana vayu & Udana vayu that causes
fullness of stomach and patient likes to adopt things that are exact opposite of disease producing
factors.
 PROKOPA KALA

• It is the second step of disease.

• In this kala vitiated doshas increased in their ashaya, of particular doshas, and they try to expel
out.
• In kasa as the main vitiated dosha is Vata, symptoms of cutting pain in abdomen, sensation of
something revolving in stomach are observed, further symptoms of vata vridhi are observed
 PRASARA

• In this kriya kala, vitiated and increased doshas expels out of their ashayas due to persistent
intake of disease causing factors.
• These increased and vitiated doshas goes in three dimensions viz, urdhva, adhah, tiryaka and
produces symptoms as, increase bowl movement (Atopa).
 STHANA SAMSHRAYA

• In this kala, vitiated and increased doshas get seated in body where Sthan
Vaigunya i.e weak tisues.
• In kasa main seat is pranvaha srotasa. In this kala prodromal symptoms of
disease are observed as
During their prodromal stage, one feels as if his oropharyngeal region is
full of bristles.
There is itching sensation in throat as well as difficulty in swallowing
food.
 VYAKTI

• In this kala, prodromal symptoms of the disease are observed more clinically significant.
• As early mentioned symptoms of grittiness, itching occur more prominently.
 BHEDA AVASTHA

• During prasara avastha vitiated vayu, sometimes get collaborated with other doshas as pitta,
kapha or both of them producing 5 types of kasa as Vataja, Pitaja, kaphaja, khshataja, kshayaja
 SYMPTOMS OF KASA IN BHEDA AVASTHA
Vataja kasa:-
There is pain in the precordial & temporal region, head, abdomen & flanks. The face shows
anxious appearance and there is loss of strength, voice & vitality.
Bouts of cough are continuous and voice hoarse and the cough is dry.
 CONTD

• Pittaja kasa
Patient has complains of burning sensation in chest, fever, dryness of mouth and bitter taste.
He feels thirsty and brings out yellow and acrid (Bilious) vomitus.
There is a pallor & burning sensation all over the body.
 CONTD

• Kaphaja kasa:-
In kaphaja kasa, there is stickiness in oral cavity, headache, excess of kapha in the body.
Loss of appetite, feeling of heaviness as well as itching sensation.
Gets severe bouts of cough producing a thick expectoration.
 CONTD

• Ksahtaja kasa:-
• During initial stage, he has unproductive cough, followed by haemoptysis
associated with a severe pain in throat & chest.
• He suffers from pricking pain as if being pierced by sharp needles,
hyperesthesia due to pain, a feeling of dismemberment, burning sensation,
pain in joints, fever.
• Dyspnoea, thirst and hoarsness of voice and produces a sound likecoing of
pigeons during attacks of Kshataja kasa.
 CONTD

• Kshayaja kasa:-
• Body ache, fever, burning sensation, attacks of fainting and loss of vitality.
• Gradually gets emaciated, becomes weaker & weaker along with wasting of muscles.
• Expectorates blood with pus, has features of vitiation of all the three doshas and is certainly very
difficult to manage by treatment.
 QUES.

• A male patient aged 30 years has come in October at your clinic with complaint
of excessive thirst, burning sensation in whole body and sour blenching; diagnose
the state of disease process…….
• A male child aged 5 years has come with his guardian at your clinic in August
month with complaint of excessive blenching with foul smell and distended
abdomen; diagnose the state of disease process …….
• A female patient aged 39 years has come in August at your clinic with complaint
of minor yellowish discoloration only present in her skin; diagnose the state of
disease process …….
 QUES.

• A female patient aged 48 years has come in April at your clinic with complaint of
vomiting, indigestion, heaviness in whole body and altered taste; diagnose the state
of disease process …….
• A male patient aged 13 years has come in December in your clinic with complaint
of heaviness, lethargy and low temperature of the body; diagnose the state of
disease process …….
• A female patient aged 57 years has come in May in your clinic with complaint of
discomfort to watch food (sometimes nausea after looking food) and heaviness in
heart ;diagnose the state of disease process …….
Thank you for your attention!