Samprapti and Shat Kriyakala: writing the pathogenesis
Samprapti is the story of how a disease forms: which dosha is vitiated, where it travels, which tissue it affects, and where it settles. Sushruta's Shat Kriyakala gives that story six stages, each with its own window for intervention.
The six stages (Shat Kriyakala)
- Sanchaya: accumulation of a dosha in its own site.
- Prakopa: aggravation, where the accumulated dosha becomes excited.
- Prasara: spread, as the dosha moves beyond its site.
- Sthana Samshraya: localisation, where it lodges in a weakened tissue or channel.
- Vyakti: manifestation of the recognisable disease.
- Bheda: differentiation and complication, including chronicity.
What a Samprapti statement should name
- Dosha (and subtype where relevant)
- Dushya: the dhatu or mala affected
- Srotas involved and the type of srotodushti
- Agni status and presence of ama
- Adhishthana: the site of manifestation
- Current Kriyakala stage
A compact format
Many practitioners write Samprapti as one sentence: dosha, cause, path, site, stage. For example: 'Vata, aggravated by irregular meals and travel, with mandagni and ama, lodged in sandhi of the knees; Sthana Samshraya moving toward Vyakti.'
A consistent format makes it possible to compare visits and see whether the plan is moving the condition back through the stages.
Questions practitioners ask
- Why record the Kriyakala stage?
- It frames the intent of treatment. Earlier stages are usually managed with lighter measures; later stages call for more intensive plans and closer follow-up.