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Kriyakala vivechana in prameha

By Dr Amritha. E. PadyDept of PG studies in Kayachikitsa

SKAMC Bangalore.

GUIDE-DR. MURALIDHARA MD (AYU)HOD AND PROFESSORDEPT. OF PG STUDIES IN KAYACHIKITSA,SKAMCH&RC, VIJAYANAGAR, BANGALORE

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Contents

• Introduction• Shadkriyakala• Prameha• Kriyakala vivechana in Prameha• Understanding Sanchaya Prakopa Prasara in prameha• Sthanasamsraya Vyaktha bheda in prameha• Discussion• Conclusion

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Change happens one step at a time

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Life of a plant

6Life of a star

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Every day events & things

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Destructive events like Tsunami

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What about diseases?

Did our acharyas define clear stages for disease manifestation?

Is there any system & process to recognize and reverse the conditions?

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• Ayurveda emphasizing on being healthy gives the detailed description about the initiation of the diseases step by step.

• If one pays special attention to the changes happening inside and out side of the body, any one can be healthy and its easy to get healed early stages.

• Acharya Sushruta explains the initiation of disease by classifying into six stages which are known as kriyakalas or shadkriyakalas.

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क्रि�या + काल = क्रि�याकाल

Kriya = karma,pravruthi.(action)

Kala = time.

चि�क्रिकत्सा अवसर कालः

Time for appropriate action (chikitsa)

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Kriyakala

Gives us the knowledge of

diagnosis prognosis and

the level of intervention.

Time of treatment or interception

in the process of disease

manifestation.

To prevent the establishment

of disease.

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pÉåSurÉ£ü

xjÉÉlÉxÉÇ´ÉrÉ

mÉëxÉUmÉëMüÉåmÉ

xÉÇcÉrÉ

Shadkriyakala

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• cÉrÉÉå वृद्धि�: xuÉkÉqlrÉåuÉ mÉë²åwÉÉå वदृ्धि�WåûiÉÑwÉÑ||A.¾Òû.xÉÑ.(12/22 )

• SÉåwÉxrÉ वदृ्धि�: cÉrÉ:||AÉ.U||

• xÉqWûÌiÉ ÂmÉ वदृ्धि�¶ÉrÉ:||xÉÑ xÉÑ 21/18 QûsWûhÉ||

• The stage represents the inceptive phase of the disease, when dosha is stated to have accumulated in its own place.

• Aversion towards vrudhi hetu.

Sanchaya

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सं�य

स्वाभाक्रिवक- prakrutha

नैमि�त्ति�क-ऋतुजन्य

आवस्तिस्तक-आयुजन्य

अस्वाभाक्रिवक-vaikrutha

प्रञापराध-मि�थ्याहारक्रिवहार

असात्�ेद्धिन्*यार्थ, संयोग

Sanchaya types

•गौरव�ालस्यं

•पीतावभासता �न्दोष्�ता Pitta dosha

•Çस्तब्धपूर्ण,कोष्ठVata dosha16

Sanchaya lakshanas

Kapha dosha

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• MüÉåmÉxiÉÑlqÉaÉïaÉÉÍqÉiÉ||A.¾Òû.xÉÑ.12/22||

• xuÉxjÉÉlÉÇ irÉYiuÉÉ SÉåwÉxrÉ rÉiÉç mÉÑlÉqÉaÉÉïliÉUaÉqÉlÉqÉç

xÉ MüÉåmÉ CirÉÑcrÉiÉå||Arunadatta||

• क्रिवलयनरूपा वृद्धि�ः प्रकोपः।(सु.सू.२१\१८डल्ह)

• Doshas which had previously accumulated in sanchayavastha

become excited to move to other locations.

Prakopa

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प्रकोप

�यप्रकोप

स्वाभाक्रिवकऋतुजन्य आयुजन्य

अस्वाभाक्रिवकमि�थ्याहारक्रिवहार

अ�यप्रकोपबलवक्रि?ग्रहादिद

Prakopa types

Prakopa lakshana

•अन्न?ेष हृदयोत्क्लेदाश्चKapha dosha

•अम्लीका क्रिपपासा परिरदाहPitta dosha

•कोष्ठतोदसं�रर्णVata dosha19

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• क्रिकण्वोदकक्रिपष्टस�वाय इवोदि*क् तानां प्रसरो भवक्रित ॥(सु.सू.२१\२८)

• यर्था �हानुदकसं�योऽक्रितवृ�: सेतु�वदया,पररे्णोदकेन व्यमि�श्र: सव,त: प्रधावक्रित ॥ ( सु.सू.२१\२८)

Prasara

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• Dosha sanchaya take place in very high quantity so that it

increases from its own site and start spreading all over the

body with single dosha or with a combination of Dwidosha

tridosha or altogether with rakta.

• How fermentation of surabeeja occurs likewise in this stage

Prakupita doshas gets spreaded to other sites.

• Vayu is the main Prasarana hetu.

• अरो�क अक्रिवपाक अङ्गसादश्छर्दिदTश्लेष्�ार्णो Kaphadosha

• ओष �ोष परिरदाह धू�ायनाक्रिन क्रिप�स्यPittadosha

• वायोर्विवT�ाग,ग�न आटोपौ,Vatadosha

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Prasara lakshana

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स्थान संश्रमियर्णः �ुध्दाः भाक्रिवव्यामिधप्रबोदक�्। दोषाः कुव,न्तिन्त यल्लिल्लङं्ग पूव,रूपं तदुच्यते।(�ा.क्रिन.१.�धु)• स्थानसंश्रयः दोषदूष्यस्य संश्रयः।(सु.स.ू२१\३३ ��पात्तिर्ण)

• The excited dosha having moved to other parts of body become

localized and it marks the beginning of manifestation of specific

diseases pertaining to those structures.

• In this stage Dosha-dushya sammoorchana happens.

Sthanasamsraya

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• कुक्रिपतानां क्रिह दोषार्णां शरीरे परिरधावनात्। यत्र सङ्ग: खवैगुण्यात् व्यामिधस्तत्रोपजयते॥ ( सु सु २४/१८)डल्हर्ण।

The prakupita doshas will spread all over the body, where there is a kha

vaigunya dosha will accumulate there and produce disease.

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व्याधे प्रव्यकं्त रूपं व्यचिक्त।(सु.सू.२१\३४.डल्ह )•अत ऊध्वh व्याधेद,शनं वक्ष्या� :• प्रव्यकं्त -mÉëMüwÉåïhÉ urÉ£Çü Vyadhi upalabdi from their pravyaktha lakshanam.For eg:• xÉÇiÉÉmÉ sɤÉhÉÇ euÉU• xÉUhÉ sɤÉhÉÇ AÌiÉxÉÉU||• –प्रभूत आक्रिवल �ूत्रत प्र�ेह• पूरर्ण लक्षर्ण�ुदरमि�क्रित

Vyakta

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• अत ऊध्व,�ेते षां अवदीर्णा,नां व्रर्णाभाव�ापन्नानां षष्ठ: क्रि�याकालः ,

ज्वराक्रितसार प्रभृतीनां � दीर्घ,कालानुबन्धः ॥ (सु.सू. २१/३५)

तत्राप्रक्रितक्रि�या�ारे्ण असाध्यता�ुपयान्तिन्त॥(सु.सू.२१\३५) • वातादिदलक्षरं्णभेदाद्धिqन्नत्वं भेद: (QûsWûhÉ)

Bheda

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• Attains Vranabhava

• Deerkhakaalanubandha

• Chronic stage.

• If we left untreated it goes to asadhya stage.

• Classification of diseases depends on dosha predominance

• When the disease reaches this stage, they may act as predisposing

causes for other diseases.

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PRAMEHA

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Prameha

Pra = Excess

Mihyathe = Pass urine

NIRUKTI

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• क्रित्रदोषकोपक्रिनमि��ा विवTशक्रित: प्र�ेहा भवन्तिन्त क्रिवकारश्चापरेऽपरिरसंख्येया: । (�.क्रिन.४/३)• Due to vitiation of all the three doshas causing prameha.

• Depending on the dominance of one or the other dosha

Prameha is classified.

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Kriyakala vivechana in Prameha

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Sanchaya in prameha

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Kaphaja Sanchaya

hetu

शयनासनप्रसङ्ग:

नवान्नपानं,ग्राम्यानूपौदक

�ांस

क्रिपष्टन्न,पायस

इक्षुक्रिवकार,गुडवैकृतं

सेवनं

क्षीर,नव�द्य,�न्दक,दमिध*व

म्रुजाव्यया�वज,नं,

दिदवास्वप्नं

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Mechanism in body during Sanchaya

AÉqÉ LuÉ AɳÉUxÉÉå

गौरव�ालस्यं

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Prakopa in prameha

Further indulgence

in kaphakara nidana

Aggravation of

kaphadosha along with aamarasa

Kapha prakopa

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qÉkÉÑUiÉU UxÉ

अन्न?ेष हृदयोत्क्लेदाश्च

Prasara in prameha

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Due to nidana dosha vishesha

त्तिक्षपं्र श्लेष्� प्रकोप

Causes शरीर शैचिर्थल्यता

Prakupita kapha- त्तिक्षप्र�ेव शरीरे क्रिवसंृवितT

अक्रितस्नेहान्�ेदान्जनयक्रित

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Prasaralakshana

अक्रिवपाक

अङ्गसाद स्तिwग्बाहुजन्ङ्र्घासु वृद्धि�

छर्दिदT

स्निस्नग्धान्ङ्गत उदरपर्श्व, वृद्धि� अरो�क

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Understanding of sanchaya prakopa prasara in prameha

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Physiological changes in body during Ritu

Ritu Vata Pitta kaphaGreeshma Chaya - Prashama

Varsha Prakopa Chaya -

Sharath Prashama Prakopa -

Hemantha - Prashama -

Shishira - - Chaya

Vasantha - - Prakopa

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Avasthika SanchayaKaala vata Pitta Kapha• Balyavatha• Dina pradthama• Rathri prathama• Bhukta aadi

Predominance

• Madhyamavastha• Dina madhyama• Rathri madhyama• Bhukta madhyama

Predominance

• Vrudhavastha• Dina antima• Rathri antima• Bhukta antima

Predominance

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• This particular stage of sanchaya prakopa over a period of time will

trigger the kha vaigunyatha of particular srothas and manifest disease.

Sanchaya prakopa lakshnas

In Prakrutha avastha

End up in prashamavastha

In vikruthavastha due to

mithyahara vihara

goes to prasaravatha

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Sthanasamsraya in prameha

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Prakupita Dosha -dushya

sammoorchana

• Here प्रकुक्रिपत कफ does sammoorchana with अब��ेद, शरीरक्लेद, �ांस

शरीरक्लेदं पुनदू,षयन् �ूत्रत्वेन

परिरर्णा�यक्रित

• Disturbance in dhatuparinaama prakriya• �ेदश्चापरिरपक्वं• क्लेद�ांसयोरक्रितप्र�ार्णात्तिभवृ�त्वात्• Dooshita shareerakleda turns to mootra

Lodges in बस्तिस्त • �ूत्रवहार्णां � स्रोतसां

वङ्क्षर्णबस्तिस्तप्रभवार्णां doshas lodges in बस्ति��

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• जदिटलीभावं केशेषु माधुर्य�मा�र्य�र्य करपादर्यो: सुप्�दाहौ मुख�ालुकण्ठशोषं पिपपासं आल�र्यं �लंकाये कायल्लि�*ेषुपदेहं परिरदाहं सुप्��ां चाङेषु षट्पदक्रिपपीचिलकात्तिभश्च शरीर�ूत्रात्तिभसरर्णं �ूत्रे � �ूत्रदोषान् पि"स्रं शरीरगन्धं

पि'दं्र �न्दं्र च स"�कालमिमपि�॥(च.पि'.(४/४७)• �"ेदोऽङ्गगन्ध:ÍzÉÍjÉsÉÉ…¡ûiÉÉ � शय्यासनस्वप्नसुखे रक्रितश्च। ह्रुन्नेत्रद्धिजह्वश्रवर्णोपदेहो र्घनाङ्गता केश'खापि�"ृद्धि2:॥ शीतक्रिप्रयत्वं गलतालुशोष �ाधुय,�ास्ये करपाददाह:। भक्रिवष्यतो �ेहगदस्यरूपं�ूत्रेऽत्तिभधावन्तिन्त क्रिपपीचिलकाश्च॥(�्.चि�.६/१४)

Sthanasamsraya lakshana

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Vyakta in prameha

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•तत्राक्रिवलप्रभूत�ूत्रलक्षर्णा: सव, एव प्र�ेहा भवन्तिन्त॥(सु.क्रिन.६/६)• तत्राक्रिवलत्वं �ूत्रस्य प्र�ेहदूष्यार्णांदूष्यस्यावयवमि�श्रीभवात्। तेषा�ेव � दूष्यर्णां*वैरेकीभूतत्वान्�ूत्रप्रभूतत्वं।(डल्हर्ण)

Vyakta lakshana

Aavila mootrata

Prabhoota mootrata

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•Depending on the dosha dushya sammorchana there will

be variations in sparsha,ganda, varna, rasa and aavilatha

of mootra.

•Based on the dosha predominance and utkarsha

apakarsha of rasaadi dhatu dushti, there will be getting

the vyaktha lakshana through mootra.

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Bheda in prameha

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• Stage of differentiation of the subtype of prameha.

•Manifest vishesha lakshana of prameha.

•Manifestation of prameha upadravas.

• Prameha is classified depends upon the nidana, dosha- dushya

vishesha and mootra avilatha.

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•Combination of one or more gunaas of kapha

dosha gives the special feature to mootra in 10

types of kaphaja meha.

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Kaphaja prameha vishesha lakshana

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उदकमेह अ�ं बहु

चिसतं

उदकोप�ं

क्रिनग,न्धं

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इक्ष"ुालिलकरसमेह अत्यर्थ,

�धुरं शीतं

काण्डेक्षुरससङ्गाशं

आक्रिवलं

ईषन्तित्पल्लि�लं

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सान्द्रमेह पयु,क्रिषत�ूत्र�्

सान्*ीभवक्रित भाजने

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सान्द्रप्रसादमेह

यस्य संहन्यते �ूत्र�् क्रिकस्तिन्�त्

क्रिकस्तिन्�त् प्रसीदक्रित

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शुक्ल�ेह शुक्लंक्रिपष्टक्रिनभं

�ूत्र�भीक्ष्र्णं य प्र�ेहक्रित

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शु��ेह शु�ाभं

श�ुमि�श्रं

�ुहु��हक्रित

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शीत�ेह अत्यर्थ,�धुरं

शीतं �ूतं्र �ेहक्रित

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चिसकत�ेह �ूता,न्�ूत्रगतान्

दोषानर्णून् �ेहक्रित

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शनै�ेह �न्दं

�न्दवेग�्

�ृच्छ्र�ूत्र् शनै:

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अलाल�ेहतन्दुब�ं

अलालं

क्रिपल्लि�लं

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Upadravas of Prameha

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Kaphaja prameha upadrava

�ात्तिक्षकोपसप,र्ण

अरो�कअक्रिवपाका:कफप्रसेक

कासर्श्वास

छर्दिदT

प्रक्रितश्याय:

अङ्गशैचिर्थल्य�ांसोप�य:

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Prameha pidaka

zÉUÉÌuÉMü xÉwÉ

ïÌmÉMü

ÌuÉlÉiÉÉ

mÉŅ̃ÉÍh

É

qÉxÉÔËUMüÉ AsÉÎ

eÉ

ÌuÉSÉËUMü

É

ÌuÉSìÌSMüÉ

MücNûÌmÉMü

eÉÉÍsÉÌlÉ

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In Avarana

कफ�ेदोक्रिनरु��ाग,त्वात् -Srothorodha

वातप्रकोप

Ojas attracted towards basthi

Due to increased rookshatwa of vata

�धु�ेह�धुस�ं

कषाय�धुरं

पाण्डु रूक्षं �ेहक्रित

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Discussion

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• The concept of shatkriyakala is applicable in all

disorders or disease condition.

• Proper diagnosis of particular stage help us to

plan the treatment.

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• For the understanding of kriyakala one should require

good intelligence, good clinical skill and good textual

knowledge.

• The practical application and analysis of kriyakala is

highly essential to frame disease control and

prevention strategy.

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Conclusion

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र्यथा ह्यल्पे' र्यत्'े' लि<द्य�े �रुण��रु:स ए"ापि�प्र"ृ2��ु लि<द्य�ेऽपि�प्रर्यत्'�:॥ए"मे" पि"कारोऽपिप �रुण: साध्र्य�े सुखं

पि""ृ2: साध्र्य�े कृच्छ्रादसाध्र्यो "ाऽपिप जार्य�े॥(च.पि' 5/14)

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• It is easy to pluck a plant when it is still a sapling, but it is

impossible when it becomes a tree.

• If some attention is paid towards the simplest of clinical

symptoms several disease can be handled successfully by

doing xÉqÉrÉÉlÉÑMÔüsÉ ÍcÉÌMüixÉ (timely action).

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• In case of Prameha the management will be very easy, only

when the disease is handled during the Sthanasamsraya

stage or little earlier.

• No creature in this earth is immortal. It is impossible to

prevent death but it is possible to prevent diseases so one

should try for that which is preventable.

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