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{{#seo:
{{#seo:
|title=Shat-kriya Kala
|title=Shat-kriya Kala
|titlemode=append
|titlemode=append
|keywords= Shat-kriya Kala, Shat-kriya Kala in Ayurveda, Six progressive stages of disease for treatment interventions, charak samhita, caraka samhita, Indian system of medicine, pathogenesis of disease
|keywords= Shat-kriya Kala, Shat-kriya Kala in Ayurveda, Six progressive stages of disease for treatment interventions, charak samhita, caraka samhita, Indian system of medicine, pathogenesis of disease
|description=Prevention of disease occurrence and recurrence
|description= These are six stages of progression of disease important to prevent disease occurrence and recurrence.
|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=carak samhita
|image_alt=carak samhita
|type=article
|type=article
}}
}}
Shatkriyakala means six stages of disease evolution for treatment interventions.
{{Infobox
{{Infobox
|title = Contributors
|title = Contributors
|label1 = Section/Chapter/topic
|label1 = Section/Chapter/topic
|data1 = [[Nidana]] / [[Vyadhi]] / Shatkriyakala
|data1 = Concepts and Contemporary Practices-[[Nidana]] / [[Vyadhi]] / Shatkriyakala
|label2 = Authors
|label2 = Authors
|data6 = carakasamhita@gmail.com
|data6 = carakasamhita@gmail.com
|label7 = Date of first publication:
|label7 = Publisher
|data7 = August 31, 2020
|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
|label8 = Date of first publication:
|data8 = August 31, 2020
|label9 = DOI
|data9 = [https://doi.org/10.47468/CSNE.2020.e01.s09.028 10.47468/CSNE.2020.e01.s09.028]
}}
}}
<p style="text-align:justify;">The diagnosis and therapeutics in Ayurveda are based on clinical observation and assessment. Diagnosis at an early stage of the disease is emphasized, when abnormalities in body-mind functions are vague and non-specific. In current times, the diseases are diagnosed when pathological, biochemical manifestations have surfaced. However, at this stage, many times it is difficult to reverse the pathogenesis and restore health. Clinical diagnosis at an early stage can provide great input to manage a disease and prevent it from being untreatable.
<div style = "text-align:justify;">
<br/>More than 30 centuries ago, Sushruta - the father of Surgery in his compendium Sushruta Samhita has given the concept of shatkriyakala (six stages of disease evolution for treatment interventions). In this compendium, after careful study of the inflammatory process in open wounds (vrana)<ref name="Sushruta Samhita">Sushruta. Sutra Sthana, Cha.21 Vranaprashnam Adhyaya. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.99-107</ref>, he conceptualized the natural history of disease evolution. The concept of kriyakala (stage of treatment intervention or strategy) describes the mode and stages of the development of the disease.
The diagnosis and therapeutics in Ayurveda are based on clinical observation and assessment. Diagnosis at an early stage of the disease is emphasized, when abnormalities in body-mind functions are vague and non-specific. In current times, the diseases are diagnosed when pathological, biochemical manifestations have surfaced. However, at this stage, many times it is difficult to reverse the pathogenesis and restore health. Clinical diagnosis at an early stage can provide great input to manage a disease and prevent it from being untreatable.
More than 30 centuries ago, Sushruta - the father of Surgery in his compendium Sushruta Samhita has given the concept of shatkriyakala (six stages of disease evolution for treatment interventions). In this compendium, after careful study of the inflammatory process in open wounds (vrana)<ref name="Sushruta Samhita">Sushruta. Sutra Sthana, Cha.21 Vranaprashnam Adhyaya. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.99-107</ref>, he conceptualized the natural history of disease evolution. The concept of kriyakala (stage of treatment intervention or strategy) describes the mode and stages of the development of the disease.
There are six distinct formative patterns or stages of manifestation of diseases. Each stage has its own characteristic symptoms to enable a treating physician to recognize the disturbance at the early formative stage of the disease.
There are six distinct formative patterns or stages of manifestation of diseases. Each stage has its own characteristic symptoms to enable a treating physician to recognize the disturbance at the early formative stage of the disease.
<br/>
It also helps with prognosis and adopting preventive and curative measures.
It also helps with prognosis and adopting preventive and curative measures.
<br/>
Ayurveda advocates that if the deranged dosha is checked or subdued in their primitive evolutionary phase (chayavastha), they may not be able to proceed with subsequent changes. [Su.Sa. Sutra Sthana 21/37]<ref name="Sushruta Samhita"/> However if left unresolved, they may gain strength and intensity. Therefore, good knowledge of the concept of kriyakala (stage of treatment intervention or strategy) is necessary for the recognition of the disease process at an early stage, viz. the stage of accumulation (chayavastha) to arrest further developments.
Ayurveda advocates that if the deranged dosha is checked or subdued in their primitive evolutionary phase (chayavastha), they may not be able to proceed with subsequent changes. [Su.Sa. Sutra Sthana 21/37]<ref name="Sushruta Samhita"/> However if left unresolved, they may gain strength and intensity. Therefore, good knowledge of the concept of kriyakala (stage of treatment intervention or strategy) is necessary for the recognition of the disease process at an early stage, viz. the stage of accumulation (chayavastha) to arrest further developments.
</p>
== Six stages of pathogenesis ==
== Six stages of pathogenesis ==
=== VI. Stage of differentiation/ termination (bheda)===
=== VI. Stage of differentiation/ termination (bheda)===
[[File:Stages of disease progression.jpg|500px|'''Figure 2: Six Stages of disease evolution and management interventions'''|thumb]]
This is the stage of differentiation/ termination/ rehabilitation of symptomatology. In this stage, disease becomes sub-acute, chronic, or incurable. When disease further progresses, it may produce complications becoming incurable or severe complications leading to death or may cause temporary/ permanent disability. Otherwise in self-limiting disorders, the disease may get cured itself by body and rehabilitation will be required. This is the last opportunity of the management, where all the possible management is to be applied.
This is the stage of differentiation/ termination/ rehabilitation of symptomatology. In this stage, disease becomes sub-acute, chronic, or incurable. When disease further progresses, it may produce complications becoming incurable or severe complications leading to death or may cause temporary/ permanent disability. Otherwise in self-limiting disorders, the disease may get cured itself by body and rehabilitation will be required. This is the last opportunity of the management, where all the possible management is to be applied.
* With strong therapeutic interventions, the health might be restored without disability.
* With strong therapeutic interventions, the health might be restored without disability.
====Suggested as rehabilitative therapies or prakriti Sthapana====
====Suggested as rehabilitative therapies or prakriti sthapana====
* Prevent/limit the complications
* Prevent/limit the complications
* Prevent genetic transmissions to offspring
* Prevent genetic transmissions to offspring
* Rehabilitation of disabilities
* Rehabilitation of disabilities
* Rejuvenation for nonoccurence of diseases
* Rejuvenation for nonoccurrence of diseases
===Summary===
Thus the clinical observations, pathological events, treatment interventions and intensity of host:antigen interactions can be summarized as shown in figure 2. The Ayurvedic concept of the six stages of disease is one of the most important factors distinguishing Ayurveda from Allopathy. During the first four stages, disease symptoms may be subtle or nonexistent. In Allopathy, in these stages when there is no clear feature of diseases and symptoms are subjective, the patients are usually labeled as "functional," "hypochondriac" or "neurotic" until the full manifestations of the disease develop. However, in Ayurveda, the physician can identify the imbalance at an early stage. These Ayurvedic assumptions are not just baseless ideologies. Modern science bears out the validity of these assumptions.<ref>Basisht GK. Symbiohealth-Need of the hour. AYU [serial online] 2011 [cited 2020 Sep 21];32:6-11. Available from: http://www.ayujournal.org/text.asp?2011/32/1/6/85715</ref> The three body types with dominance of dosha are validated by a biostatistical study of large populations with 90 percent certainty.<ref>Joshi RR. A biostatistical approach to Ayurveda: Quantifying the Tridosha. J Altern Complement Med 2004;10:879-89.</ref> Certain genetic traits are more susceptible for diseases is shown by genome research. This principles applies to suitability of a person to certain drugs, too.<ref>Anne Barton, MRCP, Ph D, E Text book, Available from: http://www.Uptodate.com [Last cited on 2011 Jan 28]</ref> Just as Ayurveda has been able to predict which people are more likely to suffer from a particular disease. Recent research has also shown that lifestyle changes can "turn off" and "turn on" certain genes, and thus, with effort, we can turn off bad genes and turn on the good ones. <ref>Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, et al. Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet 1990;336:129-33.</ref> Therefore, understanding concept of shatkriyakala is highly important in clinical practice.
=== Abbreviations ===
=== Abbreviations ===
[[Kha vaigunya]]
[[Kha vaigunya]]
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== References ==
== References ==
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