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Vikriti (Sanskrit: विकृतिः, also spelled as vikruti) means change or alteration of any kind as of purpose, [[Manas|mind]], form, and nature.<ref name="ref1">Monier-Williams (1899), Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press</ref> Vikriti is abnormal, differing from the normal state, structure, or condition.<ref name="ref2">4 Code: SAT-C.84. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda </ref> In the context of [[Ayurveda|Ayurveda]], change from a natural or healthy state to sickness is denoted by the term ‘vikriti’[Cha.Sa.[[Vimana Sthana]] 8/101]. Any alteration in [[Prakriti|prakriti]] leads to disequilibrium and [[Vyadhi|disease]]. This article describes the concept and practical application of vikriti in [[Ayurveda|Ayurveda]].</div>

Vikriti (Sanskrit: विकृतिः, also spelled as vikruti) means change or alteration of any kind as of purpose, [[Manas|mind]], form, and nature.<ref name="ref1">Monier-Williams (1899), Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press</ref> Vikriti is abnormal, differing from the normal state, structure, or condition.<ref name="ref2">SAT Code-C.84. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda </ref> In the context of [[Ayurveda|Ayurveda]], change from a natural or healthy state to sickness is denoted by the term ‘vikriti’[Cha.Sa.[[Vimana Sthana]] 8/101]. Any alteration in [[Prakriti|prakriti]] leads to disequilibrium and [[Vyadhi|disease]]. This article describes the concept and practical application of vikriti in [[Ayurveda|Ayurveda]].</p>

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== Concept of vikriti ==

== Concept of vikriti ==

=== Vikara ===

=== Vikara ===

<div style='text-align:justify;'>Vikriti is a derangement from a natural state. It is also denoted by the term ‘vaishamya’- the [[Sharira|body's]] abnormal unbalanced and pathological state. The manifestation of [[Vyadhi|disease]] in the form of signs and symptoms also comes under this purview. Vikara ^{[Code:SAT-C.8]}<ref name="ref5">&nbsp;</ref> is the condition that causes deviation from an individual's normal physiological state of health.<ref name="ref6">8, 9, Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref> The process of occurrence of [[Vyadhi|disease]] follows a pathway known as ‘[[Shatkriyakala|shatkriya kala]]’ (six pathological stages of treatment).<ref name="ref7">Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> This involves chaya avastha [accumulation of [[Dosha|dosha]]], [[Prakopa|prakopa]] avastha [aggravation of [[Dosha|dosha]]], prasara avastha [spread of vitiated [[Dosha|dosha]] to other parts], sthanasamshraya avastha [localisation of [[Dosha|dosha]] to different sites], vyakta avastha[manifestation of the [[Vyadhi|disease]]] and bheda avastha [chronicity of the [[Vyadhi|disease]]]. These pathological stages are progressive states of vikriti. <br/>Vikriti pariksha [examination] is done based on specific [[Hetu|hetu (etiology)]], [[Dosha|dosha]], [[Dhatu|dhatu]] (ashraya of [[Dosha|dosha]] like tissues), [[Prakriti|prakriti]] (individual constitution), [[Desha|desha (habitat)]], [[Kala|kala (time)]] and [[Bala|bala (strength)]] involved in the [[Samprapti|samprapti (pathogenesis)]] of the [[Vyadhi|disease]]. ^{[Cha. Sa. Vimana Sthana 8/101]}</div>

<div style='text-align:justify;'>Vikriti is a derangement from a natural state. It is also denoted by the term ‘vaishamya’- the [[Sharira|body's]] abnormal unbalanced and pathological state. The manifestation of [[Vyadhi|disease]] in the form of signs and symptoms also comes under this purview. Vikara ^{[Code:SAT-C.8]}<ref name="ref2"></ref> is the condition that causes deviation from an individual's normal physiological state of health.<ref name="ref6">Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref> The process of occurrence of [[Vyadhi|disease]] follows a pathway known as ‘[[Shatkriyakala|shatkriya kala]]’ (six pathological stages of treatment).<ref name="ref7">Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> This involves chaya avastha [accumulation of [[Dosha|dosha]]], [[Prakopa|prakopa]] avastha [aggravation of [[Dosha|dosha]]], prasara avastha [spread of vitiated [[Dosha|dosha]] to other parts], sthanasamshraya avastha [localisation of [[Dosha|dosha]] to different sites], vyakta avastha[manifestation of the [[Vyadhi|disease]]] and bheda avastha [chronicity of the [[Vyadhi|disease]]]. These pathological stages are progressive states of vikriti. <br/>Vikriti pariksha [examination] is done based on specific [[Hetu|hetu (etiology)]], [[Dosha|dosha]], [[Dhatu|dhatu]] (ashraya of [[Dosha|dosha]] like tissues), [[Prakriti|prakriti]] (individual constitution), [[Desha|desha (habitat)]], [[Kala|kala (time)]] and [[Bala|bala (strength)]] involved in the [[Samprapti|samprapti (pathogenesis)]] of the [[Vyadhi|disease]]. ^{[Cha. Sa. Vimana Sthana 8/101]}</div>

=== Vikriti as dhatuvaishamya ===

=== Vikriti as dhatuvaishamya ===

=== Vikriti as arishta lakshana ===

=== Vikriti as arishta lakshana ===

<div style='text-align:justify;'>[[Arishta|Arishta]] are the features of impending death, the deviation from natural physiological state ([[Prakriti|prakriti]]). Such vikriti can be [[Lakshana|lakshana]] nimitta (past deeds of life being the etiology for the symptoms at specific time. e.g. appearance of some bodily marks and specific signs) lakshya nimitha (described and identifiable etiological factors. e.g: features manifesting in a patient due to the specific [[Nidana|nidana]] for vatadi dosha kopa) or nimittanuroopa (the manifestations in a patient which resemble the etiological factors, but in fact, they are not etiological factors in nature. They appear without any apparent cause. E.g. symptoms which indicate death as a result of diminution in life span) ^{[Cha.Sa. [[Indriya Sthana|Indriya Sthana]] 1/6]} <br/>All these [[Arishta|arishta]] [[Lakshana|lakshana]] are deviation from the normalcy and without the understanding of this vikriti, the physician may lose [[Dnyana|knowledge]], wealth, and success in their career.<ref name="ref9">&nbsp;</ref></div>

<div style='text-align:justify;'>[[Arishta|Arishta]] are the features of impending death, the deviation from natural physiological state ([[Prakriti|prakriti]]). Such vikriti can be [[Lakshana|lakshana]] nimitta (past deeds of life being the etiology for the symptoms at specific time. e.g. appearance of some bodily marks and specific signs) lakshya nimitha (described and identifiable etiological factors. e.g: features manifesting in a patient due to the specific [[Nidana|nidana]] for vatadi dosha kopa) or nimittanuroopa (the manifestations in a patient which resemble the etiological factors, but in fact, they are not etiological factors in nature. They appear without any apparent cause. E.g. symptoms which indicate death as a result of diminution in life span) ^{[Cha.Sa. [[Indriya Sthana|Indriya Sthana]] 1/6]} <br/>All these [[Arishta|arishta]] [[Lakshana|lakshana]] are deviation from the normalcy and without the understanding of this vikriti, the physician may lose [[Dnyana|knowledge]], wealth, and success in their career.^{[Cha.Sa. [[Indriya Sthana]] 12/90]}</div>

== Assessment of vikriti (vikriti pariksha) ==

== Assessment of vikriti (vikriti pariksha) ==

=== Vikriti at the level of kala (time/season), artha (objects) and karma (actions) ===

=== Vikriti at the level of kala (time/season), artha (objects) and karma (actions) ===

<div style='text-align:justify;'>Variations in the characteristics of [[Kala|kala (season)]], artha (object of sense organ) and [[Karma|karma]] (actions) comes under this aspect. Visual exposure towards bright light, dim light and improper light exposure can be considered as vikriti factors at the level of darshanendriya (sense of visual perception). Similarly vikriti can also be understood at other [[Indriya|indriya]] levels like that of ears, nose, tongue and skin.<ref name="ref10">&nbsp;</ref></div>

<div style='text-align:justify;'>Variations in the characteristics of [[Kala|kala (season)]], artha (object of sense organ) and [[Karma|karma]] (actions) comes under this aspect. Visual exposure towards bright light, dim light and improper light exposure can be considered as vikriti factors at the level of darshanendriya (sense of visual perception). Similarly vikriti can also be understood at other [[Indriya|indriya]] levels like that of ears, nose, tongue and skin.<ref>Vagbhata. Ashtanga Hridaya. Sharira Sthana Chapter 5, Verse 6</ref></div>

== Importance of knowledge of vikriti ==

== Importance of knowledge of vikriti ==

<div style='text-align:justify;'>Paul J Mill’s et. Al. made an attempt to examine the relationship among imbalances in the [[Dosha|dosha]] (termed Vikriti) reported via questionnaire and Western measures of psychological states. The 60 item vikriti questionnaire assess vikriti of each of the three [[Dosha|dosha]]. The 101 participants were asked to rate the symptoms as “very often”, “sometimes”, or “not often” with a score of 5, 3, and 1, respectively. A higher vikruti score equates to more imbalance, or accumulation, of that respective [[Dosha|dosha]]. PROMIS Anxiety Scale, Centre for Epidemiology Studies-Depression (CES-D), Perceived Stress Scale (PSS), Mindful Attention Awareness Scale (MAAS), Rumination-Reflection Questionnaire (RRQ), Ryff Scale of Wellbeing scales were used as western measures of psychological states. Study concluded that symptoms of mind-body imbalances in [[Ayurveda|Ayurveda]] are differentially associated with western assessments of psychological states. Ayurvedic [[Dosha|dosha]] assessment may be an effective way to assess physical as well as emotional wellbeing in research and clinical settings. </div>

<div style='text-align:justify;'>Paul J Mill’s et. Al. made an attempt to examine the relationship among imbalances in the [[Dosha|dosha]] (termed Vikriti) reported via questionnaire and Western measures of psychological states. The 60 item vikriti questionnaire assess vikriti of each of the three [[Dosha|dosha]]. The 101 participants were asked to rate the symptoms as “very often”, “sometimes”, or “not often” with a score of 5, 3, and 1, respectively. A higher vikruti score equates to more imbalance, or accumulation, of that respective [[Dosha|dosha]]. PROMIS Anxiety Scale, Centre for Epidemiology Studies-Depression (CES-D), Perceived Stress Scale (PSS), Mindful Attention Awareness Scale (MAAS), Rumination-Reflection Questionnaire (RRQ), Ryff Scale of Wellbeing scales were used as western measures of psychological states. Study concluded that symptoms of mind-body imbalances in [[Ayurveda|Ayurveda]] are differentially associated with western assessments of psychological states. Ayurvedic [[Dosha|dosha]] assessment may be an effective way to assess physical as well as emotional wellbeing in research and clinical settings. </div>

=== Development and validation of vikrti measuring scale – A pilot study<ref name="ref13">https://www.ijaim.in/citation.asp?issn=27726010;year=2021;volume=2;issue=2;spage=78;epage=85;aulast=Patil;aid=IndianJAyurvedalntegrMed_2021_2_2_78_331491</ref> ===

=== Development and validation of vikrti measuring scale – A pilot study<ref>Patil SS, Singh A, Nagarathna R, Nagendra H R. Development and validation of vikrti measuring scale – A pilot study. Indian J Ayurveda lntegr Med [serial online] 2021 [cited 2023 Jan 28];2:78-85. Available from: http://www.ijaim.in/text.asp?2021/2/2/78/331491</ref> ===

<div style='text-align:justify;'>Suchitra S Patil et al has developed a tool for assessing pathology of [[Tridosha|tridosha]] in a group of [[Vyadhi|diseases]] using ayurvedic concepts. The 97 item [[Tridosha|tridosha]] diagnosis scale was developed and administered in 35 samples. Scale can be used in assessing the pathological state of [[Dosha|dosha]] and aid in decision of appropriate medications.</div>

<div style='text-align:justify;'>Suchitra S Patil et al has developed a tool for assessing pathology of [[Tridosha|tridosha]] in a group of [[Vyadhi|diseases]] using ayurvedic concepts. The 97 item [[Tridosha|tridosha]] diagnosis scale was developed and administered in 35 samples. Scale can be used in assessing the pathological state of [[Dosha|dosha]] and aid in decision of appropriate medications.</div>