Changes

== Six pathological stages of a disease ==

== Six pathological stages of a disease ==

=== Stage of accumulation (Sanchaya) ===

=== I. Stage of accumulation (sanchaya) ===

This is the inceptive phase of a disease when dosha accumulates and stagnate within their natural site of predominance. Vague and non-specific features are diagnosable with minute observations.  

This is the inceptive phase of a disease when dosha accumulates and stagnate within their natural site of predominance. Vague and non-specific features are diagnosable with minute observations.  

'''Identifying features''':

====Identifying features ====

* Dullness or fullness of the abdomen due to sluggish digestion is observed due to the accumulation of vata [[dosha]]  

* Dullness or fullness of the abdomen due to sluggish digestion is observed due to the accumulation of vata [[dosha]]  

* Lower energy and subnormal temperature due to the accumulation of kapha [[dosha]] iv. An aversion of similar qualities of [[dosha]] and attraction towards opposites

* Lower energy and subnormal temperature due to the accumulation of kapha [[dosha]] iv. An aversion of similar qualities of [[dosha]] and attraction towards opposites

'''Principle of management in this stage''':

====Principle of management in this stage====

Avoid “similar” diet and lifestyle, Using “opposites” diet and lifestyle  

Avoid “similar” diet and lifestyle, Using “opposites” diet and lifestyle  

'''Example''':

====Example====

Fatigue, distended abdomen, loss of appetite occurs at the very early stage of most of the viral fevers even during the incubation period of infections. Primary features are often ignored by the patients and physicians both. Hence the first opportunity of the treatment is lost. If this stage is observed and proper interventions are done, then the disease progression can be prevented or disease with mild symptoms will occur.

Fatigue, distended abdomen, loss of appetite occurs at the very early stage of most of the viral fevers even during the incubation period of infections. Primary features are often ignored by the patients and physicians both. Hence the first opportunity of the treatment is lost. If this stage is observed and proper interventions are done, then the disease progression can be prevented or disease with mild symptoms will occur.

=== Stage of vitiation (Prakopa)===

=== II.Stage of vitiation (prakopa)===

Previously accumulated and stagnated [[dosha]] within their own site are further aggravated and get ready to spread all over the body with the following symptoms:   

Previously accumulated and stagnated [[dosha]] within their own site are further aggravated and get ready to spread all over the body with the following symptoms:   

This is the second opportunity of management if diagnosed at this level.  These signs may appear due to the micro inflammatory process in the tissues, which forms the backbone for the disease process.   

This is the second opportunity of management if diagnosed at this level.  These signs may appear due to the micro inflammatory process in the tissues, which forms the backbone for the disease process.   

=== Stage of spread or transmission (prasara)===

=== III. Stage of spread or transmission (prasara)===

At this stage there are two possibilities:

At this stage there are two possibilities:

==== 3 (a) Remission or prashama ====  

==== III.(a) Remission or prashama ====  

The [[dosha] may return back to normalcy and to their normal sites, and stop further progression, if they are vitiated in the first two stages.  [[Dosha]] may return to normalcy either naturally (swabhavik) or due to the employment of appropriate therapeutic measures. Thus, leading to the absence of disturbances (vikaras). [A. Hr. Sutra Sthana 12/24]<ref>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>  

The [[dosha] may return back to normalcy and to their normal sites, and stop further progression, if they are vitiated in the first two stages.  [[Dosha]] may return to normalcy either naturally (swabhavik) or due to the employment of appropriate therapeutic measures. Thus, leading to the absence of disturbances (vikaras). [A. Hr. Sutra Sthana 12/24]<ref>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>  

* Charity & truthfulness (data & satyaparata) etc.

* Charity & truthfulness (data & satyaparata) etc.

==== 3 (b) Spread or prasara ====

==== III.(b) Spread or prasara ====

* If above said precautions are neglected, following factors lead to spread of vitiated [[dosha]] through the blood circulation.

* If above said precautions are neglected, following factors lead to spread of vitiated [[dosha]] through the blood circulation.

* Nausea and excess salivation - By kapha

* Nausea and excess salivation - By kapha

'''Treatment and precautions at this stage:'''

====Treatment and precautions at this stage====

# Avoid antagonistic Diet (viruddhahar)  

# Avoid antagonistic Diet (viruddhahar)  

# Practice daily and seasonal purification

# Practice daily and seasonal purification

=== Localization stage at other site (sthansamshraya) ===

=== IV. Localization stage at other site (sthansamshraya) ===

* This is a prodromal stage and symptoms of the disease start to appear but these may be specific or non-specific.

* This is a prodromal stage and symptoms of the disease start to appear but these may be specific or non-specific.

# Four features of defects of channels viz. increased flow, obstruction, the formation of nodules, and improper direction of movement

# Four features of defects of channels viz. increased flow, obstruction, the formation of nodules, and improper direction of movement

'''Treatment at this stage:'''

====Treatment at this stage====

* Practice for the avoidance of impairing factors listed specifically for all the 13 major involved channels   

* Practice for the avoidance of impairing factors listed specifically for all the 13 major involved channels   

* Rejuvenation and protection of the vital organs  

* Rejuvenation and protection of the vital organs  

=== Stage of manifestation (vyakti) ===

=== V. Stage of manifestation (vyakti) ===

This is the stage of full manifested disease as a result of invasive interaction of morbid factors into defensive healthy tissues ([[dosha]]-[[dushya]] sammurcchana) with its characteristic symptomatology. At this stage, the disease can be named properly. This stage is comprised of:

This is the stage of full manifested disease as a result of invasive interaction of morbid factors into defensive healthy tissues ([[dosha]]-[[dushya]] sammurcchana) with its characteristic symptomatology. At this stage, the disease can be named properly. This stage is comprised of:

* Resulting pathologies in organs – [[avayava]]

* Resulting pathologies in organs – [[avayava]]

'''Treatment suggested at this stage:'''

====Treatment suggested at this stage====

Restoration of normalcy or  vikriti vighata:  

Restoration of normalcy or  vikriti vighata:  

* Non recurrence of disease

* Non recurrence of disease

=== Stage of differentiation/ termination (bheda)===

=== VI. Stage of differentiation/ termination (bheda)===

This is the stage of differentiation/ termination/ rehabilitation of symptomatology. In this stage, disease becomes sub-acute, chronic, or incurable. When disease further progresses, it may produce complications becoming incurable or severe complications leading to death or may cause temporary/ permanent disability. Otherwise in self-limiting disorders, the disease may get cured itself by body and rehabilitation will be required. This is the last opportunity of the management, where all the possible management is to be applied.

This is the stage of differentiation/ termination/ rehabilitation of symptomatology. In this stage, disease becomes sub-acute, chronic, or incurable. When disease further progresses, it may produce complications becoming incurable or severe complications leading to death or may cause temporary/ permanent disability. Otherwise in self-limiting disorders, the disease may get cured itself by body and rehabilitation will be required. This is the last opportunity of the management, where all the possible management is to be applied.

* Recognition of this stage is also important to know the predisposition for further new disease (Nidanarthkaratva)

* Recognition of this stage is also important to know the predisposition for further new disease (Nidanarthkaratva)

* In this last stage, disease may lead to temporary/ permanent disability.  

* In this last stage, disease may lead to temporary/ permanent disability.  

* It may advance to incurability/ complications / death  on account of neglect of treatment suggested in earlier stages.

* It may advance to in-curability/ complications / death  on account of neglect of treatment suggested in earlier stages.

* With strong therapeutic interventions, the health might be restored without disability.

* With strong therapeutic interventions, the health might be restored without disability.

'''Suggested as Rehabilitative therapies or prakriti Sthapana:'''

====Suggested as rehabilitative therapies or prakriti Sthapana====

* Prevent/limit the complications

* Prevent/limit the complications