The imbalance of doshas and the course they follow to cause disease is termed samprapti or pathogenesis. Since diseases develop in distinct stages, a good knowledge of those helps in early recognition of disease. Ayurveda thus elaborates a six stage process for diagnosis called kriya (action) kal (time). The first 4 stages being unique to Ayurveda in that they permit recognition and elimination of the disease before it ventures into differentiated clinical symptoms.

One who knows the various stages of pathogenesis accumulation (sanchaya), provocation (prakopa) spread or migration (prasara), deposition or augmentation (sthana samshaya), manifestation (vyakti) and the differentiation (bheda) is entitled to be a physician.

Stage One: Accumulation (Sanchaya)

• Weak digestive power and excess of dosha is responsible for such a condition.
• Here toxins (ama) produced by improper digestion collects in the gastro-intestinal (GI) tract.
• Toxins resulting from a Kapha imbalance accumulates in the stomach, those associated with a Pitta imbalance collects in the small intestine, and that related to Vata malfunction amasses in the colon.
• Due to the presence of one of these toxins, mild and ill-defined symptoms may show.
• We should recognize and eliminate the cause instead of ignoring or suppressing it.
• Causes aversion to similar things and attraction for contraries.

Stage Two : Aggravation (Prokapa)

• The accumulated, stagnant doshas are now `excited? by factors as ahara, vihara & seasons.
• The toxins amass in such degree to get provoked in the site of production in the GI tract.

Stage Three : Spread (Prasara)

• In this stage, the toxins accumulated in the GI tract start overflowing.
• Generally, up to this stage the damage is entirely reversible and restoration of doshic balance can be achieved with proper measures. Or there may be spontaneous prashama (remission) influenced by seasonal changes. Thus there is sanchaya of Pitta in rainy season, prakopa in fall and prasara in early winter. Based on degree of excitation, it might even passed the stages of prashama or prasara.

Stage Four : Agumentation (Sthana Samshraya)

• Overflowing toxins migrate, entering and taking refuge in localized, weak or defective dhatus thereby leading to malfunction and structural damage.
• It is from here that specific degenerating disease and susceptibilities to serious infections begin.

Stage Five : Symptom Manifestation (Vyakti)

• Differentiated symptoms first begin to appear from the location.
• Manifested symptoms being used by modem medicine for classification & diagnosis of disease.

Stage Six: Complications/Differentiation (Bheda)

• The disease having taken years or even decades to reach this final stage, becomes chronic.
• Offers detailed understanding of the group of symptoms thereby making clear nature of disease.
• Might act as predisposing factors for the spread of other diseases.