CONCEPT OF KRIYAKALA Presented by Dr PRIYA GIRIJAN

CONCEPT OF KRIYAKALA Presented by Dr. PRIYA GIRIJAN T Dept. Of Panchakarma

INTRODUCTION �द षध तमल मलम सद दह. . . �Vata, Pitta & Kapha are the 3 vitals, sapta dooshyas, and trimalas responsible for health or ill health of the individual or maintains equilibrium of the body through inter doshic balance and which maintains life. �No disease can exist without the involvement of dosha.

WHAT IS KRIYAKALA �The series or stages of diseases successively developing in periods of kala is Kriyakala. �Recognition of the stage of diseases progress which helps to determine appropriate measure to correct imbalance of dosha.

NIRUKTI OF KRIYAKALA �The word SHAT KRIYAKALA is formed with combination of 2 words SHAT+KRIYAKALA �Shat -6 �Kriyakala Kriya+Kala �Kriya refers to CHIKITSA �Kala refers to AVASARA or Stage of progress of diseases �In short KRIYAKALA is : - Attentivity towards Chikitsa

TYPES OF KRIYAKALA �RITU KRIYAKALA �VYADHI KRIYAKALA

RITU KRIYAKALA �Daily changes happening in particular season is described in ritu kriyakala �Cycle of ritus are natural, so that the changes occurring in doshas are also natural. �It includes 3 stages CHAYA, PRAKOPA, PRASAMA �So it doesn’t cause severe distress to the body, when seasonal regimens are practised properly. �It doesn’t require a drastic remedial measure but need a Ritu sodhana properly. �So that human body will get accustomed to the natural seasonal conditions occurring years after years and abnormalities if doshas will revert back to normal automatically.

SODHANA TREATMENT IN DIFFERENT RITUS ������� ��������� ������������� � Dosa’s attains chaya in Hemantha/Sisira Vasantha Greeshma Varsha Sarat

VYADHI KRIYAKALA � Abnornal changes taking place in dosas due to Ahita ahara, ahita achara and virudha ahara acharas. � The changes are very powerful, unusual, unaccustomed to human body causing severe distress. � Dosas donot revert back to normal condition of their own and continue to become profound, give rise disease and if it remains unchecked it threatens life. � It requires remedial measures at the earliest. � Samprapti gives us an insight into the development of disease and give an exact idea about how etiological factors give rise to the increased formation of doshas, how dosas travels to various sites and the causation of the disease.

The development of disease is described under 6 stages: 1. 2. 3. 4. 5. 6. CHAYA PRAKOPA PRASARA STHANASAMSRAYA VYAKTI BHEDA

�Kriyakala helps in early recognition of the stage of progress of disease and its treatment. �A clear view about Kriyakala is necessary for Diagnosis, prognosis and for adopting preventive and curative measures. �When the deranged dosha got pacified in its chaya avastha itself it prevents disease from gaining strength and intensity of the diseases and further progression of the disease.

� 1 st stage of Kriyakala. �Vikruta doshas starts accumulating at their own sites or accumulation of dosas in its principle abode. �Inceptive phase of a disease when dosa is stated to have accumulated and stagnated in its own place. �Beginning phase of disease characterised by vague and ill defined symptoms.

CLINICAL MANIFESTATION The main sites of Dosha Sanchayam is AMASAYA & PAKVASAYA which is the sarvadaihika samanya sthana of tridosa. Vata Pitta Kapha • Stabdha poorna koshtatha • Pitavabhasat ha • mandoshmat a • Angagourav am • alasyam

TREATMENT �It is important to treat the dosa in its chaya avastha to prevent further spread to next kriyakala and further complications. �Avoid etiological factors – Nidana parivarjanam ALPA DOSA LANGHANAM MADYAMA DOSA LANGAHANA PACHANAM BAHU DOSA AVASECHANAM

2. PRAKOPA (Stage of Provocation) � सथ न त पर क रत त � क पसत (अ. ह ) उनम रगगमनम । ( नरस ह ) परक प उनम रगग म त । � Prakopa is defined as the movement of dosas away from the principal loci. � When dosas are not brought to equilibrium in sanchaya avastha, then the dosas which had previously accumulated and stagnated in its own particular location tends to become swollen and excited. � Vikrita dosa gains vikrita bala due to dosha specific nidana.

�Its of 2 �Achaya poorvaka prakopa : - Without accumulation in their principal seats �Chaya poorvaka prakopa : - With accumulation in their principal seats �Acc to Vaghbata Prakopa is dissemination of dosas from their principle seats �Hemadri compares Sthanasamsraya kriyakala to Prakopa where the symptoms are expressed.

CLINICAL MANIFESTATION Vata Pitta Kapha • Kosta toda • Kosta vata sancharana • Amlodgara • Pipasa • Paridaha • Annadwesh a • Hrillasa

ROLE OF AGNI IN PRAKOPA �Charaka states that Agni is responsible for both Prakopa and prasara. �Ayus, bala, varna, swasthya, utsaha, upachaya, prabha, ojus, tejus, and prana are dependent on the normal functioning of agni.

TREATMENT �Line of Rx – For increased doshas �Shouldn’t interfere with other doshas �If prakopa of all 3 dosas occurs which ever is powerful should be treated first. �If 3 dosas are of equal strength first take Rx for Vata, then pitta, and then kapha. �In Achaya poorvaka prakopa SHAMANA Upachara should be done �In Chaya poorvaka prakopa SHODHANA Upachara should be done like Vamana, virechana, vasti etc. .

�Term Prasara means SPREAD. �Dosas vitiated by their concern causes will leave their original places and spread to the other parts of the body either through Urdhwa Adha marga or by koshta sakha marga or marma asthi sandhi marga. �It can be illustrated by the example of soaking starch products for a overnight which ferments and rises up acquiring new and unseen qualities.

�Narasimhacharya defines prasara as pervasiveness of dosas in the entire body-mind complex �Dalhana differentiates Prasara from Prakopa with an analogy, �Just the melting of solid ghee – Prakopa �Overflowing of the ghee with froth on continuous heating – Prasara

FACTORS RESPONSIBLE FOR PRASARA �स ह रज परवरतक �Vikruta भय षट । सरवभ व न । रजशच स. स Dosa got excited due to Rajo guna. �Main cause for Prasara is Rajo guna of vata. �The vitiated dosha circulate throughout the body in association with Vata dosha. �Prasara occurs through sira marga

TYPES OF PRASARA 15 types of PRASARA �Vata �Pittarakta �Pitta �Kapharakta �Kapha �Vatapittakapha �Sonita �Vatapittarakta �Vatapitta �Pittakapharakta �Vatakapharakta �Vatapittakaphasoni �Pittakapha ta

CLINICAL MANIFESTATION VATA PITTA KAPHA • Vimargagamana m • Atopam • • Osha Chosha Paridaha Dhoomayana Arochaka Avipaka Anga sada Chardi

TREATMENT �Neutralising the increased or vitiated dosas by all possible means. �Hetu viparita chikitsa & lakshana viparita chikitsa should be followed.

STHANASAMSRAYA (Stage of Localisation) � परवरपगतष � दहकदश शरयण नस ह चतरथ कर य क ल । सथ नसशरयणम स. स व द । � This stage can also be called as Stage of Localization of the disease at a particular site where there strongly vitiated dosas resides/adhere to the weakened/debilitated dhatus. � This is the level from real pathological process begins. � It triggers local and systemic factors at the biochemistry level.

FACTORS AFFECTING STHANASAMSHRAYA �The vitiated dosas circulated throughout the body in association with Vata dosha. �परसत न सर त वगणय दतर सथ नसमशरय। Dalhan �The पनरद ष ण सग स vitiated doshas get Sthanasamshraya at the place where Kha vaigunya or dusta srotas.

Ahita ahara vihara Excited dosas along with rasa dhatu causes vaigunya of srotas results in Ojo kshaya and agnimandhya failure to give remedial measures to control the doshas Development of sthanasamshraya stage.

HOW POORVAROOPA MANIFESTS �Sthanasamshraya stage is also known as POORVA ROOPA STAGE. �परसत न सर त वगणय दतर सथ नसमशरय Dalhana �Samadosha पनरद ष ण । सग स due to srotovaigunya cant enter the minute srotases and itself get localized and come in direct and intimate contact with dusyas, malas and causes Dosa-Dusya samoorchana and causes Poorvaroopa.

CLINICAL MANIFSTATIONS �Udara visuchika, : Gulma, vidradhi, udara, agnisanga, anaha, atisara �Vasti : Prameha, asmari, mutradosa �Medra : Nirudhaprakasa, upadamsa, shukadosa �Guda : arsas, bagandhara �Vrishana : Vridhi mutraghata,

�Urdwajatru : Urdwajatrugada vikaras �Tvak : Kshudra roga, visarpa, kusta mamsa rakta �Medas : Granthi, apachi, arbuda, galaganda, alaji �Asthi : Vidradhi, anushayi �Pada : Sleepadam, �Sarvangagata : Jwara, sarvanga roga vatasonitam, vatakantakam

�मजजशकरगत न वय धय न न रद षट सवलपतव त. . . �Acc द ष ण , to Dalhana the omission of majja & sukra doshaja vyadhis from the list is because of its rare occurance and vagueness of symptoms exhibited

TREATMENT �SNEHANA & SWEDANA plays an important role �Snehana – Klinnata of sookshma srotas �Svedana – Dravikarana of dosas �These 2 karma bring back the dosas from sakha to koshta. �Principal treatment : Treating local dosha simultaneously keeping in mind that the causative dosha is not

�The stage in which fully aggravated dosha assume the severe form known as VYADHI, manifesting clearly with all its characterestics features hence this stage called as VYAKTHI. �Roopa, Samsthana, Vyanjana, Linga, Lakshana, Chinna, Akruti are its synonyms.

�Here the lakshanas of morbid factors causing the disease and as well as the symptoms of the disease can be seen. �The dosa-doosya samoorchana gets completed and roopa, the actual symptoms of the disease appear. �Eg: In Jwara – santapa lakshana In atisara – Dravamla pravruthi

TREATMENT �Disease oriented treatment should be pursued in this state. �ie: - Vyadhipratyaneeka chikitsa

BEDHA AVASTHA (Stage of Complication or Chronicity) �It is 6 th or final kriyakala. �The persistent lingering of a disease should be deemed as BHEDA, which is an indication of bad prognosis. �In this stage the process of pathogenesis completes and patient develops the individual diseases like Dosha pratyaneeka vyadhi. �Here diseases tend to become subacute or chronic.

�The importance of recognising this stage lies not only in its being a valuable aid in prognosis but also in the fact that when disease reach this stage the may act as the predisposing causes of other diseases. �ie : - Nidanarthakara rogas. �Eg: - When a vidradhi bursts, it exhibits the characterestics symptamatology of vrana.

APPLIED ASPECT OF KRIYAKALA IN PANCHAKARMA त न उपसथ त द ष ण सनहसवद पप दन । पञचकरम ण करव त म तर क ल व च रयन॥ �In upasthitha dosa, snehana-swedana should be done and thereafter Panchakarma with due consideration of dose and time.

क ल ह न तयगशच वसथ क शच ततरवसथ क व क रमपकषत न तयगसत ॠतस तमय पकष �The ॥ kala is divided into Nitya & avasthika �Ayurveda has postulated the concept of Ritusandhi, where the acharyas advices the usage of proper ahara, vihara and achara to eliminate the vitiated dosas accumulated as a result of seasonal variations. �The dosas accumulated in these seasons are eliminated through the practice of ritusodhana inorder to maintain the homeostasis of the body.

�AVASTIKA KALA �Here the progress of the disease is taken into consideration. The utilisation of kriyakala aims in arresting the disease progression further. �Acharya Susrutha advices to tackle the progress of disease from chaya avastha itself. �Acc to Dalhana, prathamakriyaakaalaa aadya karmaavasara �If the disease is arrested in chaya avastha itself, it helps to prevent further progression

�Eventhough the progress of disease is from chava-prakopa-prasara then to sthanasamshraya, the diseased (patient) usually identifies this condition only in the poorvaavastha ie: when the disease attain the sthanasamshraya stage of kriyakala. At this stage if proper sodhana could be administered acc to condition and further progression is arrested. �If the disease further progress to rogaavastha, the actual treatment ie: vyadhivipareeta chikitsa has to be done.

� नसय श र ग रवशलषमहरम नदर यब धनम ज रणजवर रच कर ददय ननसय व रचनम॥ सनह क शनयश रस द ह रत प ततन शन। � In । the vyaktavasta of diseases, different panchakarmas are explained in the curative aspects. � Panchakarmas can be attributed for brimhana also. In various diseases � eg: Punaraavarthaka jwara yapana vasti is indicated. � Beda avastha refers to chronicity of the disease and to prevent the disease from leading to chronicity.

�Different regimens in Dinacharya and ritucharya helps in periodic elimination of the accumulated dosha. Hence has preventive aspects. eg: Abhyanga (jara, srama, vatahara(. . . Udwartana in vasanta kaphaharam medasa pravilaayanam Virechana & Raktamokshana in sarat Jentaka sweda and paadaaghata in Hemanta 14 Pratimarsa nasya kala �The judicial administration of Panchakarma in appropriate kriyakala helps in the preventive and curative

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