A History of Indian Medical Literature v1.c23.103

v1.c23.103

The second part of the chapter is devoted to the six stages of development of a disease, which are called kriyākāla because they necessitate treatment. 228 The symptoms of accumulation (saṃcaya) of the doṣas, the first stage, are described (21.18); 229 the second stage, excitement (prakopa) of the doṣas, is elaborately discussed; the factors leading to excitement of each of the doṣas and blood are separately enumerated, followed each time by the seasons, parts of day and night, and stages of the digestive process during which this excitation is likely to occur (21.19–26); the symptoms of excitement are listed (21.27); the third stage, spread (prasara) of the doṣas, 230 impelled by vāta, throughout the body, shows fifteen varieties, dependent on the number of doṣas involved 231 and all their combinations (21.28); the way morbid changes (vikāra) are produced during this stage, their management, and the signs indicating prasara are dealt with (21.29–32); the fourth stage is called sthānasaṃśraya because localized disorders, or even generalized ones, begin to appear; these disorders may affect a particular part of the body or one of the seven elements; the characteristic sign of this stage is the prodrome (pūrvarūpa) (21.33); the fifth stage (vyakti) 232 is characterized by the appearance of the fully manifest signs (pravyaktalakṣaṇa) 233 of particular diseases (21.34); the sixth stage (bheda) 234 is that in which sores appear and generalized diseases become chronic (21.35); a good physician is he who has acquired an accurate knowledge of these six stages (21.36).