Six Stages of Disease in Ayurveda

By Syama Mehta, Franciska F. and Anuradha Rao,

Shata Kriya Kala is the methodical approach to assessing disease progression in Ayurveda. There are six stages in this process by which we can track the movement of the doshas and their expression in the body.

These 6 steps are a crucial way to diagnose the path of a disease or imbalance in the body. Ayurveda, the ancient holistic healing methodology, emphasizes early intervention, prevention, and removal of the problem. Breaking down an imbalance into 6 stages helps in achieving all 3. This is an important part of Ayurvedic Nidana, to arrive at the chain of causation.

Stage 1-Sanchaya

This is the first step wherein the dosha gets accumulated in its own sthana or original place in the body. For eg: Vata may accumulate in its own sthana i.e., lower abdomen/intestines.

This is the stage where doshas start accumulating in their “homes”. Vata accumulates in the colon, pitta in the small intestine, and Kapha in the stomach. If the person pays attention to the body, he/she will recognize the signals given by the body. They will feel an attraction to the opposite qualities of the dosha that has increased.

In the first stage of the process, Sanchaya, the doshas are in their respective sthana and beginning to increase. This mild imbalance can be managed by applying the opposite gunas and pacifying the increasing doshas. However, if the dosha is not pacified and continues to increase in the sthana, then they begin to aggravate the sites further. In the stage of provocation

Stage 2-Prakopa

In the 2nd step, the dosha starts to aggravate in the same place.
Eg: the vata in the lower abdomen aggravates and creates an imbalance in the original place, i.e, abdomen & intestines.
If the doshas are not contained at their sites, they get aggravated and start to overflow from their sites.

Prakopa, the individual may still be able to apply common-sense measures to pacify the imbalance (reducing hot foods when feeling hot, reducing Kapha-inducing foods when feeling heavy, etc). Should these measures not be taken, or inadequate, the imbalance moves to the third stage.

In the stage of provocation, Prakopa, the individual may still be able to apply common-sense measures to pacify the imbalance (reducing hot foods when feeling hot, reducing Kapha-inducing foods when feeling heavy, etc). Should these measures not be taken, or inadequate, the imbalance moves to the third stage, Prasara.

Stage 3-Prasara

This is the SPREAD of the disorder. Here the dosha starts to spread throughout the body after overflowing from its sthana or location. For eg: the above vata imbalance can now move into any part of the body through various srotas that originate from amashaya (stomach).

Once the overflow of doshas happens, they start spreading throughout the body via different channels.

Here the doshas begin to spread beyond their sthana. This is an important stage because it is here that we begin to see “pre-symptoms” of disease (Purva rupa). The doshas begin to roam the body in search of a weak area. Cravings for tastes of the imbalanced doshas often increase in this stage of the disease. Vata is involved in this stage as it carries the doshas. Once they have moved out of their sthana, they have to be managed with targeted therapies to bring the doshas back to the GI tract.

Stage 4-Sthana-Samshraya

(Deposition/Localisation) - The spread dosha then tries to find weak spots or khavaigunyas (weak spots) in order to deposit. For eg: vata can lodge itself in reproductive systems

Once the doshas start moving away from their sites, they start to look for a place to deposit. It can take place at an organ, marma, joint, dhatu, etc. At this stage, premonitory symptoms appear.

Here the disease has found a weak area in the dhatu, khavaigunya, to deposit itself. Once this happens, the offending dosha begins to try to exert its influence upon the dhatu. The dosha will lodge itself into the asthayi dhatu. If the dhatu agni is strong it will keep the dosha’s influence at bay. If it is not, then the dosha will enter the sthayi dhatu. This is dhatu gata dosha, the disease moving into the tissue. It is at this stage that cellular intelligence is affected. Signs and symptoms begin to appear but can still be managed and pacified before the disease moves on to the next phase, Vyakti.

Stage 5-Vyakti

Once the disease progresses to this stage, signs, and symptoms start to appear.
In this stage of manifestation, the newly accumulated dosha imbalance will result in the manifestation of various symptoms. For eg: vata in reproductive systems can manifest in amenorrhea, dysmenorrhea, etc.

In the fifth stage of disease, manifestation, the disease can be clearly seen. At this point, the effect of the dosha (or doshas) has adversely influenced the dhatus, srotamsi, and organs. The function has also been affected.

Stage 6-Bheda

At this stage, the disease becomes chronic and complications may develop and is very difficult to treat.
This is the stage of differentiation and change. The manifested stage can further take any route possible and create various complications or chronic issues in the body. For eg: the above vata manifestation can further result in cysts, fertility issues, and various other symptoms spread throughout the body.

If the disease is not addressed at this time, then the final stage, Bheda, is reached. This is known as differentiation. The doshas have entered the dhatu and affected function, while also affecting the surrounding tissue. This is the most difficult stage to treat as the disease has created so much qualitative change.

DISCLAIMER: Ayurveda is a complementary health system and is not allowed to treat, diagnose or cure any disease. Ayurveda practitioners are holistic health practitioners. The above article is for informational purposes only.

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