The imbalance of doshas and the course they follow to cause disease is termed samprapti or pathogenesis. Since diseases develop in distinct stages, a good knowledge of those helps in early recognition of disease. Ayurveda thus elaborates a six stage process for diagnosis called kriya (action) kal (time). The first 4 stages being unique to Ayurveda in that they permit recognition and elimination of the disease before it ventures into differentiated clinical symptoms.
One who knows the various stages of pathogenesis accumulation (sanchaya), provocation (prakopa) spread or migration (prasara), deposition or augmentation (sthana samshaya), manifestation (vyakti) and the differentiation (bheda) is entitled to be a physician.
Stage One: Accumulation (Sanchaya)
• Weak digestive power and excess of dosha is responsible for such a condition.
• Here 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.
Stage Two : Aggravation (Prokapa)• The accumulated, stagnant doshas are now `excited? by factors as ahara, vihara & seasons.
Stage Three : Spread (Prasara)• In this stage, the toxins accumulated in the GI tract start overflowing.
Stage Four : Agumentation (Sthana Samshraya)• Overflowing toxins migrate, entering and taking refuge in localized, weak or defective dhatus thereby leading to malfunction and structural damage.
Stage Five : Symptom Manifestation (Vyakti)• Differentiated symptoms first begin to appear from the location.
Stage Six: Complications/Differentiation (Bheda)• The disease having taken years or even decades to reach this final stage, becomes chronic.