Six Stages of Disease

by Candis Cantin Packard

Vedic wisdom gives us the understanding of the significance of our daily life. Even the slightest discomfort can tune us into a doshic imbalance.Slight doshic changes are pre-pathological conditions. First, the dosha gets impure and deranged and then starts affecting the dhatus (tissues). The word dosha literally translated means that which rots.  When the doshas are no longer serving as a physiological function, they become disturbed and create symptoms.In Western medicine these disturbances would be recognized as non-specific in origin.  For example, a fever of non-specific origin. But in Ayurveda terminology, one may say “high Pitta in the rakta dhatu (blood tissue)”.

As the doshas start to become rebellious in the system, they go through six stages that can be easily recognized through observation, questioning and also with the use of medical diagnosis.

The six stages of disease are:
1. Sanchaya (Accumulation)
2. Prakopa (Aggravation, provoked)
3. Prasara (Overflow, spread)
4. Sthana samsraya (Relocation, depositing)
5. Vyakti (Manifestation - can be labeled at this point)
6. Bheda (Diversification, complications, damage to organs as in rheumatoid arthritis) Note: the first two stages of disease takes place in the digestive system; Kapha in the stomach, Pitta in the small intestine, and Vata in the colon. Ayurveda says that it is very important to handle the doshic imbalance at its point of origin, the digestive system and try not to let it go beyond the first two stages. Various herbs, enemas, cleansing, awareness of food choices and relationship choices help to keep the dosha from going way out of hand. It should be noted that certain life situations could bring the dosha directly into a later stage of disease. Accidents, ingestion of poisons and so forth, move things rapidly to a more serious and deeper condition.

Vata and the Six Stages

1. Sanchaya: The vata attribute of cold is evident at this stage. Apana vayu is affected which is the downward moving vata responsible for bowel movements, urination, menstruation, child birth, and ejaculation. The person may have some gas or constipation and there will be an aversion to the cause.

2. Prakopa: The attributes of cold, dry, and mobile are involved in the imbalance now. The gas starts to rise and comes to the ascending colon causing abdominal distention, burping, hiccups and breathlessness.

3. Prasara: The vata attributes of mobile, light, agitated and subtle come into play and vata now moves out of the colon, penetrates the mucus membrane, goes through the capillaries and enters the blood. Vata begins moving throughout the body and the person may have some of the following symptoms: cold hands and feet, generalized body aches, irregular appetite, rajasic vata activity (unable to focus the mind), dry hair or nails, cracking joints, stiffness of the muscles, anxiety, insomnia, fear, and low agni which causes discomfort after eating.

4. Sthana samsraya: All the other attributes plus the attributes of rough and dispersing are now present. The dosha now goes to a defective or weak body part. This may be due to trauma (physical or emotional), memory of illness, or genetic factors. All these things make fingerprints in the body and make a place for future disease to occur. Even emotions will accumulate in the tissues and create puddles in which the depositing stage happens. In other words, the dosha lodges in the defective space. The manifested doshic imbalance can also be seen in the tissue.

For example, Vata in the:

5. Vyakti: All the attributes of Vata are now in full swing. The condition can now be labeled as epilepsy, Parkinson’s disease, spastic colon, and so forth. 6. Bheda: At this stage the disease begins to cause damage to the organ and body parts. It seems to have a life of its own and projects itself like an entity. There may be, for example, arthritic deformities, loss of function of an organ, atrophy, etc.

Pitta and the Six Stages

1. Sanchaya: The attributes that are first evident are hot and liquid. Pitta is fire and water (hot and damp); hot water can put out our agni as can alcohol, and coffee. These substances can dilute enzymes and hydrochloric acid. The person may feel a little heat in the small intestinal region and will have an aversion to the cause.

2. Prakopa: The next attribute that gets stirred up is sour. This can manifest as acid indigestion, dark urine and dry yellow feces. Remember, the dosha is still in the digestive system at this stage and can be easily pacified through herbs and other corrective measures.

3. Prasara; The dosha leaves the small intestines and enters the circulation. Now the attributes that are added are light and spreading. The person may experience a rash, acne, burning hands eyes, feet, desire to have cold things, irritation, and the head may be hot (the brain does not tolerate heat very well). Emotionally, this may manifest as being hypercritical, lacking discrimination, engaging in unhealthy competition, expressing jealousy, anger and violence. The normal emotional functions of pitta are quick comprehension, appreciation and sharp intelligence.

4. Sthana samsraya: The attributes of sharp, penetrating qualities are now present and the dosha moves into the dhatu. There may be fever, inflammation, bacterial infection, and inflammation of the stomach wall, (pitta in the mamsa dhatu or muscle of the stomach).

5. Vyakti: All the attributes are now activated and the next stage is the labeling of the disease. Now the dosha has become an entity that is recognized as a specific pathological condition such as hepatitis, encephalitis, or meningitis.  The suffix, itis, equates with inflammation or Pitta.

6. Bheda: The disease now starts to cause a breakdown in the system. Pitta being so aggressive can cause perforation, abscesses, coma and aneurysm. My teacher said,   “Never fiddle faddle with Pitta!”

Kapha and the Six Stages

1. Sanchaya: The kapha attribute of liquid and heavy begin to accumulate in the stomach. These create a feeling of heaviness after eating, slow digestion and a weighted feeling in the stomach.

2. Prakopa: The attribute of cool now enters the picture and the symptoms will start to increase. There may be poor digestion, excess saliva, mucus diarrhea, or coolness in the stomach region.

3. Prasara: The kapha dosha now leaves the stomach (digestive system) and circulates into the lymph system. The attribute of oily manifests itself and oily fried, greasy foods will cause kapha to increase. Remember kapha in excess creates stagnation and engorgement.

4. Sthana samsraya: The kapha dosha will now find a place to lodge itself. The attributes of dull and stagnant are manifesting. In the Rasa dhatu, kapha may appear as lymph swellings and congestion, sinusitis, and plaque accumulations. Ayurvedically speaking, we can see kapha lodged in the rakta dhatu as purulent discharges such as boils, in the mamsa dhatu as flabby muscles and so forth through the dhatus.

5. Vyakti: All attributes of kapha are in full swing. At this stage the disease can be labeled and we can now identify the disease entity. We may call it pneumonia, polyps, obesity, diabetes, and hypertension due to water retention.

6. Bheda: Now the disease entity begins to cause organ changes and disruption of physiological functions. For example, there may be a tumor in the liver, ascites (an abnormal accumulation of serous fluid in the abdominal cavity indicating a very serious condition), or congestive heart failure.

To see more articles on the Basics of Ayurveda, search journal contents by clicking here. There is a series on Advanced Basics: The Five Elements by Dr. Marc Halpern starting with the Winter 2005 issue. Advanced Basics: The Doshas started in Summer, 2007, and Advanced Basics: The Seven Dhatus begins Spring 2008.