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Tridosha Theory

The evolution of disease: Shat-Kriyakal (Pathogenesis)

Ayurveda describes the evolution of disease in six stages which describe the whole processes or activities that happen in the body from exposure to the disease causing factors to disease manifestation. The disease causing factors when exposed to the body cause the disturbance of equilibrium of three doshes. The disequilibrium of doshes leads to the increment or decrement of their volume. The increment or decrement of particular Dosha causes the disease. Before manifestation of disease, Ayurveda describes the seven minute stages. First the Dosha get accumulated and then vitiated. The vitiated Dosha starts to spread throughout the body. When it is stopped or it reaches in appropriate place it gets localized. It starts to act. So the primordial signs and symptoms or clinical manifestations of diseases occur. Ayurveda describes signs and symptoms as the result of complication of disease. So it prescribes to treat the disease before its manifestations or complication. The six stages are:

1.Sanchaya (Accumulation of Dosha)
2.Prakopa (Vitiation of Dosha)
3.Prasara (Spreading of Dosha)
4.Sthansamshraya ( Localization of Dosha)
5.Vyakta (stage of clinical manifestation)
6.Bheda ( stage of complications of the diseases)


Sanchaya (Accumulation of Dosha)

At this stage the quantum of dosha increases within the dwelling place and signs and symptoms of the disease are seen and patient wishes to do activities that are opposite to the causative factor.
• Weak digestive power and excess of dosha is responsible for such a condition.
• Toxins (ama) produced by improper digestion collects in the gastro-intestinal (GI) tract.
• Toxins resulting from a Kapha imbalance accumulates in the stomach, those associated with a Pitta imbalance collects in the small intestine, and that related to Vata malfunction amasses in the colon.
• Due to the presence of one of these toxins, mild and ill-defined symptoms may show.
• We should recognize and eliminate the cause instead of ignoring or suppressing it.
• Causes aversion to similar things and attraction for contraries.


This refers to further increase of the in the quantum of dosha, which tends to come out of its ashaya (dwelling place).

• The accumulated, stagnant doshas are now `excited’ by factors as Ahara (Diet), vihara (Conduct) & seasons.
• The toxins amass in such degree to get provoked in the site of production in the GI tract.


This refers to the stage where quantum of dosha increases unto its zenith. Due to which dosha comes out of its ashay (dwelling place) and start circulating through out the body.

• In this stage, the toxins accumulated in the GI tract start overflowing.
• Generally, up to this stage the damage is entirely reversible and restoration of doshic balance can be achieved with proper measures. Or there may be spontaneous prashama (remission) influenced by seasonal changes. Thus there is sanchaya of Pitta in rainy season, prakopa in fall and prasara in early winter. Based on degree of excitation, it might even passed the stages of prashama or prasara.




At this stage the circulating dosha get deposited at particular place of the body where there is obstruction in circulation and disease developed according to the involvement of shrotosha (Channel)

• Overflowing toxins migrate, entering and taking refuge in localized, weak or defective dhatus ( basic components of body) thereby leading to malfunction and structural damage.
• It is from here that specific degenerating disease and susceptibilities to serious infections begin.




This refers to the stage of mixing of dosh with the those factors which helps to generate a disease called dosh dushya sammurchhana. The sign & symptoms developed on the body according to the involvement of dosha (vata, pitta, and kapha) and dushya (rasha, rakta, mans, meda, asthi, majja, shukra)
if dosh dushya sammurchhana takes place between pitta (dosh) and rakta (dushya) then the sign & symptoms developed over the body are small furuncles over the skin which have burning sensation. The sign & symptoms developed at this stage is called purvaroopa of the disease.

• Differentiated symptoms first begin to appear from the location.
• Manifested symptoms being used by modem medicine for classification & diagnosis of disease






At this stage the process of dosh-dushya-sammurchhana is completed and most of the sign and symptoms develop on the body by the help of which disease could be diagnosed. The sign & symptoms developed at this stage are called roopa of the disease

• The disease having taken long time to reach this final stage becomes chronic.
• Offers detailed understanding of the group of symptoms thereby making clear nature of disease.
• Might act as predisposing factors for the spread of other diseases.


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