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Samprāpti: The 6 Stages of Disease

by Sheyna Haisman-Holmes

In Ayurveda, there are six successive layers that lead to the manifestation of a disease. The accumulation of imbalances and toxins is what furthers the disease process, usually behind the scenes before signs and symptoms are very noticeable. The undercurrent of unnoticed imbalances can cause the movement and settling of doshas and toxins that eventually lead to degradation or damage at the tissue level. If we can tune in to our bodies with loving awareness, we may be able to catch the earlier stages of the disease process and meet it with counterbalance. Each stage of disease has characteristics that are traceable, and the help of an Ayurvedic practitioner may be necessary after the spreading stage has occurred.

1-Sañchaya~ Accumulation

This is where the doshas are in an accumulated imbalance in their own sites. The main site of Vata is in the colon, Pitta in the small intestine and Kapha in the stomach.

Symptoms that the doshas are increased in their sites:

Vata- constipation, gas

Pitta- cravings, heat in abdomen, yellow coloration in eyes and urine

Kapha- lethargy, heaviness, poor appetite

2-Prakopa~ Provocation

The doshas are still in their seats at this time, but are accumulating more and causing more symptoms. Decisions here are crucial, as the intelligence of the body wants to balance things. For example, having hot spicy food on a really hot day can further increase pitta or having lots of greasy and heavy foods on a cold rainy day can increase kapha.

Symptoms that the doshas are more increased in their sites:

Vata- pain in back, gurgling stomach, breathlessness, hyperperistalsis

Pitta- acid reflux, heartburn, nausea

Kapha- cold symptoms (cough, congestion)

3-Prasara~ Spread

This is where the doshas leave their main sites and enter into a weak place in the body or their secondary sites. The doshas enter the circulatory system and are looking for a place to settle. The doshic imbalances can be in multiple places of the body.

Symptoms that the doshas have moved from their main seat:

Vata- dry skin, cold extremities, goose bumps, ringing ears, tingling sensations, shaking legs. Cravings for rough and dry foods and activities that aggravate vata.

Pitta- heartburn, rashes, burning eyes, burning sensations. Craves hot & spicy foods & foods that aggravate pitta.

Kapha- sinus congestion, water retention, lymphatic congestion, heaviness, cold and clammy skin. Cravings for heavy, cold and sweet food & drinks.

4-Sthāna Samshraya~ Deposition/Localization

This is where the aggravated dosha settles or deposits into a weak spot in the body. This could be a place of old trauma, injuries, stored emotions, stress and genetic memories. Whichever dosha is increased, mobile in the body and lands in one of these places will bring those qualities to the area. For example, if there is a weak spot in the knee from an old injury and there is excess vata dosha, the qualities of vata (dry, light, cold, mobile, rough) will increase in this weak spot. Having strong dhatu agni (digestive fire in the tissues) helps the excess dosha to not land there and protects tissue degradation. These weak spaces are called “Khāvaigunya” which means a defective space, like a pothole.

*The symptoms and signs per doshic imbalance in this stage are all dependent on the individual, where the dosha has landed, where the weak spot is and the current imbalance.

5-Vyakti~ Manifestation

This is where the qualities of the mobile dosha really moves into the places of deposition and cause changes at the tissue level. This may be vata dosha reversing the moisture held in the joints that are a vital element to the movement and flexibility of the body. With increasing weakness here, there may be pain, cracking joints and the potential for an injury to occur. The tissues, organs and channels are vulnerable to destruction here.

Symptoms of manifestation in the tissues:

Vata- pain and stiffness in joints, cracking and deformity

Pitta- inflammation, burning sensations, obvious irritation of skin

Kapha- congestion, swelling

6- Bheda~ Complication/Destruction

In vyakti, the function of the tissues get impaired, and in bheda the structure of the tissue is compromised and being destructed.

Symptoms of damage to tissue structure:

Vata- emaciation, osteoporosis, degeneration, muscle wasting, severe dehydration

Pitta- ulceration, hemorrhage, tumor, bleeding disorders

Kapha- tumor, hardening of tissues & cells, cysts


It is important to keep doshas in their main seats to prevent imbalances from spreading throughout the body, damaging tissue structure and causing disease. Habits that cause the doshas to leave their seats may include poor diet choices, unbalancing seasonal habits, stress, over activity and lack of daily nourishing habits.

A main psycho-emotional factor in disease manifestation is prajñāpārādha, which is the misuse and disrespect of the senses by choosing to ignore the intelligence of the body. The withholding of emotions and self-expression can also disturb the tissue agni, causing tisses to weaken and be a place of vulnerability to wandering doshas.

The first two stages are the easiest to reverse by counter balancing the present qualities and doing simple & effective home remedies. After spread begins to happen in stage three, the signs and symptoms are called purva rupa. They are warning signs, but not yet cardinal symptoms of a disease. In this third prasara stage, the body craves things that worsen the imbalances. This weakens the digestive fire, causing the doshas to wander about the body, which confuses agni from craving the proper foods.

So what can we do to prevent the disease process from continuing?

~Balance our cravings with what we know about the seasons (balance hot and dry with cool and moist, etc.)

~Check in on whether we are adding to an imbalance with our cravings (cravings for grounding foods or for sweets and sugar)

~Make sure our agni is strong, which will further support the strength of the tissues (avoid iced drinks and drinking lots of liquid before of after a meal)

~Notice the symptoms to catch imbalance at the early stages (dry skin, gas, heartburn, etc.)

~Daily habits to flush out toxins that confuse the intelligence of the body (sipping warm water, taking triphala, eating ginger and black pepper, etc.)

~Emotionally processing/digesting the thoughts, feelings and emotions to eradicate stuck emotions that confuse the intelligence of the body (meditation, crying, writing, laughing, physical movement)

May we all have strong dhatu agni and awareness to balance our systems for optimal health! 🙂


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