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Abstract
Ayurveda, the Indian art of healing, focuses on maintaining health and preventing disease with care personalized to
the balance of Doshas (humors), Dhatus (tissues) and Malas (waste products). One of the key concepts in Ayurvedic
pathology is Shatkriyakala as explained by Acharya Sushruta in the Sushruta Samhita. Shatkriyakala are the six
stages of disease development: Sanchaya (accumulation), Prakopa (aggravation), Prasara (spread),
Sthanasamshraya (localization), Vyakti (manifestation), and Bheda (complication). Every stage is its own window of
opportunity for intervention and treatment. This paradigm, in addition to serving as a timely diagnosis and
personalized treatment approach, is preventive in nature, capable of halting disease progression prior to clinical
symptomology. This review therefore critically examines classical Ayurvedic literature and modern research to
assess the importance, uses and modern relevance of shatkriyakala. It underscores the significance of detecting early
pathological shifts via Ayurvedic diagnostic tools and describes therapeutic approaches for each stage. We cover
clinical applications in abscess (Vidradhi), allergic rhinitis (Pratishyaya) and even complex diseases like cancer, to
highlight Shatkriyakala’s wide applicability in contemporary integrative medicine. The review investigates
connections between Shatkriyakala and contemporary notions of homeostasis, pathogenesis, and preventive
medicine. As the world turns toward personalized, predictive, and preventive medicine, Shatkriyakala presents a
centuries-proven, systematic framework to decipher disease pathogenesis and interception. When combined with
modern clinical models this idea maintains deep relevance in personal and public health planning.
Keywords : Shatkriyakala, Sanchaya ,Prakopa, Prasara ,Sthanasamshraya
P
ISSN No. : 2584-2757
Volume : 02
Issue : 04
DOI
: 10.5281/zenodo.16044660
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Avinash S. Wade Article Info: Published on : 15/07/2025
Impact Factor : 1.013
Concept of Shatkriyakala: A Review of Disease Progression and Therapeutic
Intervention in Ayurveda
Dr. Avinash S. Wade1, Dr. Subhash Waghe 2
1HOD. And Associate Professor, Nootan Ayurvedic College and Research Centre, Mehsana, (Gujarat).
2Principal and Professor, Sardar Patel Ayurvedic Medical College and Hospital, Dongaroya, Balaghat, (M.P.)
Cite this article as: - Dr. Avinash S. Wade (2025) ; Concept of Shatkriyakala: A Review of Disease Progression and
Therapeutic Intervention in Ayurveda ;Inter.J.Dignostics and Research 2 (4) 137- 143, DOI : 10.5281/zenodo.16044660
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Introduction:
Ayurveda, the ancient wisdom of life, offers a holistic
approach to health through a deep understanding of the
body’s physiological and pathological processes.
Among its core generalities is Shatkriyakala, a regular
model that outlines the six progressive stages of
complaint development. This doctrine, primarily
described by Acharya Sushruta in the Sushruta Samhita
(Sutrasthana Chapter 21), is foundational to Ayurvedic
pathology and cures. The term" Shatkriyakala" is
derived from three Sanskrit words — Shat (six), Kriya
(intervention), and Kala (time), collectively meaning"
the six stages where treatment can be effectively
applied"[1]. Shatkriyakala encompasses the successive
progression of vitiated Doshas — Sanchaya
(accumulation), Prakopa (aggravation), Prasara
(spread), Sthanasamshraya (localization), Vyakti
(manifestation), and Bheda (complication).
Recognizing these stages allows croakers to
intermediate before the complaint becomes fully
expressed, thereby preventing complications and
chronicity [2]. In distinction to modern medicine, which
constantly targets symptoms after complaint
manifestation, Shatkriyakala emphasizes early
discovery and root- cause treatment [3]. This aligns
nearly with contemporary models of precautionary and
predictive medicine. The purpose of this review is to
explore the classical origins, illuminative perceptivity,
and modern connection of Shatkriyakala in clinical
practice and public health, reaffirming its dateless value
in complaint prevention and substantiated care.
Classical Foundation:
Ayurveda, the ancient wisdom of life, offers a holistic
approach to health through a deep understanding of the
body’s physiological and pathological processes.
Among its core generalities is Shatkriyakala, a regular
model that outlines the six progressive stages of
complaint development [4]. This doctrine, primarily
described by Acharya Sushruta in the Sushruta Samhita
(Sutrasthana, Chapter 21), is foundational to Ayurvedic
pathology and cures. The term" Shatkriyakala" is
deduced from three Sanskrit words — Shat (six), Kriya
(intervention), and Kala (time), inclusively meaning" the
six stages where treatment can be effectively applied"[5].
Shatkriyakala encompasses the consecutive progression
of vitiated Doshas — Sanchaya (accumulation),
Prakopa (aggravation), Prasara (spread),
Sthanasamshraya (localization), Vyakti (incarnation),
and Bheda (complication). Feting these stages allows
croakers to intermediate before the complaint becomes
completely expressed, thereby precluding complications
and regularity. In distinction to ultramodern drug, which
constantly targets symptoms after complaint incarnation,
Shatkriyakala emphasizes early discovery and root-
cause treatment. This aligns nearly with contemporary
models of preventative and prophetic drug [6]. The
purpose of this review is to explore the classical
origins, interpretive perceptivity, and ultramodern
connection of Shatkriyakala in clinical practice and
public health, reaffirming its dateless value in complaint
forestallment and substantiated care. The generality of
Shatkriyakala forms the backbone of Ayurvedic
understanding of complaint progression and remedial
timing. First detailed by Acharya Sushruta in the
Sutrasthana (Chapter 21, Vranaprashna Adhyaya) of the
Sushruta Samhita, Shatkriyakala outlines the six distinct
stages through which a complaint develops, furnishing
multiple openings for timely medical intervention. It's an
emulsion term where ―Shat‖ means six, ―Kriya implies
remedial action, and ―Kala signifies time or phase.
Therefore, it represents six time- bound openings to
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intermediate in the complaint process before it
completely manifests or leads to complications. The six
stages are:
1. Sanchaya – Accumulation of Doshas in
their natural sites.
2. Prakopa – Aggravation or excitation of
accumulated Doshas.
3. Prasara – Displacement or systemic spread
of aggravated Doshas.
4. Sthanasamshraya – Localization of
Doshas in vulnerable tissues
(Dhatus), initiating preclinical
changes.
5. Vyakti – Clinical manifestation of disease
signs and symptoms.
6. Bheda – Complication, differentiation, or
chronic transformation of disease.
Each stage is marked by subtle changes in
physiological balance and requires different remedial
responses [7] - from salutary regulation and life
correction in early stages to detoxification (Shodhana)
and specialized treatments in advanced stages. This
model highlights the dynamic and evolving nature of
complaint. Unlike ultramodern pathology, which
frequently waits for visible symptoms, Ayurveda’s
emphasis is on early discovery through doshik
assessment, therefore making Shatkriyakala a visionary
rather than reactive frame. Classical textbooks similar
as Charaka Samhita and Ashtanga Hridaya also plump
the significance of intermediating before the Vyakti or
Bheda stage to achieve better prognostic [8]. The
classical foundation of Shatkriyakala therefore
provides a structured, prophetic model of complaint
progression that remains clinically applicable indeed
in contemporary integrative drug.
Clinical Significance:
The conception of Shatkriyakala holds immense
clinical applicability in Ayurvedic practice, serving as
both an individual frame and a companion for
remedial intervention. Its primary significance lies in
relating the stage of complaint progression, enabling
croakers to intermediate at the most applicable point to
help farther deterioration. Unlike numerous
ultramodern individual models, which frequently
concentrate on the characteristic stage (Vyakti),
Shatkriyakala emphasizes early discovery and
preclinical opinion, offering a substantial advantage in
complaint forestallment. Each of the six stages suggests
specific signs and symptoms that a professed Ayurvedic
guru can descry using tools similar as Nidana
Panchaka (five-fold individual approach). For case,
Sanchaya and Prakopa stages may not show overt
clinical symptoms but are frequently indicated by
subtle changes in digestion, mood, or energy
situations. Addressing these early changes through
diet, life, and herbal interventions can frequently
reverse the complaint line without the need for
ferocious treatment. At the Prasara and
Sthanasamshraya stages, the complaint process begins
to internalize, and targeted curatives similar as
Langhana (lightening), Deepana (digestive
instigations), and Pachana (digestive aids) can arrest
farther spread. In the Vyakti stage, clinical symptoms
come apparent, challenging further defined treatment
protocols, including Shamana (palliative) or Shodhana
(purificatory) curatives. The final stage, Bheda,
frequently indicates regularity or complications and
requires personalized operation strategies [9].
Shatkriyakala also plays a vital part in complaint
prognostic (Sadhyasadhyata) and treatment planning.
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By determining the stage of the complaint, a croaker
can estimate its reversibility, plan the treatment
consequently, and advise cases really. This stratified
approach promotes perfection drug within Ayurveda,
echoing ultramodern individualized drug models [10].In
summary, Shatkriyakala offers a structured clinical tool
that enhances individual delicacy, optimizes treatment,
and reinforces the preventative substance of Ayurveda.
Applications in Specific Diseases:
The practical utility of Shatkriyakala extends across
various disease conditions, offering stage-wise
management strategies that align with both preventive
and therapeutic objectives. In conditions like Vidradhi
(abscess), early identification at the Sanchaya or
Prakopa stage enables interventions such as Langhana
(fasting) and Deepana-Pachana (digestive therapies),
preventing suppuration and reducing the need for
surgical procedures [11].In Pratishyaya (allergic
rhinitis), identifying Dosha aggravation in the Prasara
and Sthanasamshraya stages allows for timely
correction through nasal therapies like Nasya and
lifestyle modifications, thereby averting chronic
symptoms [12]. The Shatkriyakala framework is also
increasingly being correlated with cancer
pathogenesis. The Sthanasamshraya and Vyakti stages
resemble the cellular localization and clinical
emergence of neoplasms. Ayurvedic interventions at
these stages focus on correcting Dosha-Dhatu
imbalance and improving immunity, forming a
complementary approach to conventional oncology
[13].Moreover, conditions such as valvular heart disease
and autoimmune disorders have also been analyzed
through the lens of Shatkriyakala to understand their
progression and to design stage- specific treatments
that may prevent complications [14]. Thus, the model
offers not only early intervention but also improves
disease outcomes across a broad spectrum of
disorders.
Contemporary Relevance:
In the era of personalized and preventive medicine, the
ancient Ayurvedic concept of Shatkriyakala holds
remarkable contemporary relevance. Modern
healthcare increasingly emphasizes early diagnosis,
risk stratification, and stage-wise intervention—
principles that are inherently embedded within
Shatkriyakala. Its framework allows clinicians to
identify disease at a preclinical stage, enabling
intervention before symptoms emerge or irreversible
damage occurs. The progression of disease described
in Shatkriyakala parallels the natural history of disease
in biomedicine, making it a bridge between traditional
and modern approaches. For instance, the Prasara and
Sthanasamshraya stages are comparable to systemic
inflammation and tissue susceptibility in
pathophysiology, respectively [15]. By recognizing
early imbalances in Doshas and intervening with
lifestyle, diet, or herbal medicines, physicians can
manage diseases proactively rather than
reactively.Furthermore, with rising interest in
integrative medicine, Shatkriyakala provides a
structured model that complements modern
diagnostics, offering a time-tested system for
monitoring disease evolution and tailoring
interventions. It is particularly relevant in managing
chronic diseases, metabolic disorders, and lifestyle-
related conditions where early interventions are crucial
for long-term outcomes[16]. In this way, Shatkriyakala
remains not only a philosophical model but a clinically
actionable framework compatible with the goals of
modern evidence-based medicine.
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Integration with Public Health:
The concept of Shatkriyakala provides a valuable
framework for public health planning, emphasizing
early detection, prevention, and individualized care—
key principles that align with the goals of modern
public health systems. In Ayurveda, disease does not
occur abruptly but develops progressively through six
identifiable stages. This stepwise understanding can be
effectively used to design preventive strategies and
screening programs at the community level. Early
stages such as Sanchaya and Prakopa often present
with subtle, non-specific symptoms like indigestion,
fatigue, or emotional imbalance. Through community-
based screening using Ayurvedic assessment tools
(e.g., Nidana Panchaka, Rogi Pariksha), health
workers can detect these signs and initiate preventive
interventions like dietary regulation, seasonal routines
(Ritucharya), and health education on Dinacharya
(daily regimen). Such approaches are cost-effective
and culturally appropriate, especially in rural and
resource-limited settings. Additionally, Shatkriyakala
facilitates risk stratification for chronic and lifestyle
diseases. For instance, individuals in the Prasara or
Sthanasamshraya stages may be prioritized for
targeted interventions, thereby reducing the burden on
tertiary care facilities. The model also emphasizes the
role of health promotion, encouraging balanced living,
stress management, and regular detoxification, which
are vital for reducing the incidence of non-
communicable diseases. Furthermore, integrating
Shatkriyakala into public health policies can enhance
community resilience by empowering individuals with
knowledge of their own health states and preventive
measures. It aligns with the World Health
Organization’s focus on traditional medicine as a
component of Universal Health Coverage. By bridging
traditional wisdom with public health systems,
Shatkriyakala offers a holistic, sustainable, and
community-centered model of disease prevention and
health promotion that can significantly contribute to
modern healthcare delivery.
Conclusion:
Shatkriyakala is a foundational concept in Ayurveda
that provides a systematic understanding of disease
progression through six distinct stages. Its emphasis on
early diagnosis, preventive care, and stage-specific
treatment aligns closely with modern principles of
personalized and predictive medicine. Clinically, it
empowers practitioners to intervene before disease
fully manifests, improving outcomes and reducing
complications. In public health, it offers a cost-
effective model for screening, education, and risk
stratification. As interest in integrative medicine
grows, Shatkriyakala continues to serve as a timeless
and practical framework for both individual care and
community health initiatives.
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ISSN: 2584-2757
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