Our bodies want to stay alive.  We have many amazing ways to self-regulate bodily processes to remain stable and continue to live.  Much of this goes on without our awareness; tiny adjustments occurring on a minute-by-minute basis.  But what happens when things start to go awry? The body goes through 6 stages of disease, exhibiting different symptoms at each stage. 

The first 4 stages prodromal symptoms; early symptoms that appear before the main symptoms of a disease fully manifest.  This gives us lots of time to intervene if we’re attuned with our minds and bodies.

Achieving a high level of awareness of our minds and bodies allows us to pick up on the small signs that things aren’t quite right and allows us to fix them before disease takes root.  If we know the very early signs of imbalance, we can quickly nip the imbalance in the bud, self-correcting back to a balanced state.  Prevention is even better; understanding your constitution and thus the things that help and hinder you can stop disease before stage 1 even kicks in.

These are the 6 stages of disease as described by Sushruta (Sutra Sthana Chapter 21).

6 stages of disease
The 6 stages of disease. My rudimentary drawings are inspired by Vasant Lad’s (much better) ones. 
6 stages of disease
6 stages of disease according to Sushruta

Take action early

As the stages of disease progress, they get more difficult to treat.  Ayurveda says that we should always be correcting imbalances in the first (accumulation) stage.

The deranged doshas checked and subdued in the sanchaya [first] stage fail to exhibit any further or subsequent development but, if left unremedied, they gain in strength and intensity in the course of their further development.

Sushruta Samhita Sutra Sthana 21/36-37

How do we take action?

Do you remember the rule: Like increases like, opposites decrease? This is a fundamental principle in Ayurveda.  Substances with similar qualities will increase doshas with those qualities.  If you want to calm a dosha down, use opposite qualities to those of the dosha.  For example, to counter vata’s cold, dry, light qualities use hot, oily, heavy qualities.  To counter pitta’s heat, slightly oiliness and lightness use cold, slightly dry, heavy qualities.  Reduce kapha’s cold, oily, solid and heavy qualities with hot, dry, subtle, light qualities.

Stage 1 and 2 – DIY rebalancing

The beauty of the way the body works is that in the initial stages of imbalance (stage 1 and to an extent 2), it will automatically lean towards qualities that calm the imbalance and away from those of the causative factors.  This is when the doshas, still in their seats in the digestive tract, behave well and create opposite cravings to pacify the imbalance. If you are experiencing vague, mild symptoms and have a hunch you know what you need to do, do it.  Grab the opportunity as after this it gets more complex.

An example in your daily life

You went out on a warm summer Saturday night, had a spicy curry and some wine.  The next day, you feel a little overheated, hot and bothered. Your instinct is to keep cool today, stay out of the sun, drink plenty of water, eat some cooling fresh fruit and generally take it easy.  But it is sunny (so rare in the UK at least) and everyone else wants to go and have a picnic at lunch time.  You find yourself sitting in the mid-day sun, a beer in hand eating some garlicky tomatoey dips.  Your pitta, for that is what is on the increase, gets further aggravated and you begin to feel some acid indigestion and increased thirst.  Your instincts tell you what to do again, and you have a choice to listen and calm the pitta down or continue down the pitta-path possibly ending in an ulcer or prolonged reflux.

Please note, before you throw your device away in disgust at the hectoring ‘have-no-fun’ theme here, that the slightly boozy curry night out is fine now and again, it just needs some awareness afterwards to counteract it.  We can still have fun, I promise!

Stage 3 and beyond – seek some help

After moving through from stage 2 to 3, the doshas move out of their ‘home’ digestive tracts seats and start to misbehave.  The messages you get become very mixed and unhelpful.  This is a time to seek objective practitioner help so that you know what to have or avoid.

An example of a disease progressing

Diabetes type II is in the news a lot at the moment, let’s take that as an example.  This disease starts with kapha increasing factors, such as a heavy diet rich in sweet, salty and sour tastes and not enough physical movement. 

Imagine the very start of a kapha imbalance.  You go out to dinner with some friends, you eat a (lovely) heavy kapha-increasing meal and go home for a very long sleep into mid-morning.  You awake feeling a bit heavy and languorous (stage 1), and you realise you need to eat very lightly today, maybe have a little run to wake up the body.  Then your partner presents you with a wonderful spread at lunchtime, to which it would be rude to say no, and the kapha gets further aggravated.  You start to develop some nausea and lose your appetite (stage 2).  

The next day you go to work, sit at your desk all day and eat lots of cake that your colleague has brought in for her birthday.  This continues day after day; kapha starts to spread, your digestion weakens, your limbs feel heavier (stage 3), it gets a bit harder to get up and exercise and you seem to crave more and more sugar. 

At some point, you find you have much more thirst than you ever did, and your tongue and teeth feel coated (stage 4, prodromal signs of diabetes II – prameha).  You may get a blood test at this point, and it shows you have raised blood sugar levels and you get put in the ‘high risk’ category for diabetes. The medical establishment are now very aware that this is a good time to intervene before you move into established diabetes (stage 5).  A change in diet and lifestyle has been shown to be very effective at this stage to get you back out of ‘high risk’.  This has even been proven to be the case in established diabetes, fully reversing the disease. If we haven’t intervened in stage 1, 2, 3 or 4, we definitely want to now in stage 5 so that we prevent the collateral damage that diabetes can do to our tissues and organs (e.g. nerve damage). 

A beautiful system of second chances

This is not meant to be a fearful tale but rather the opposite; an exploration of the beautiful system of chances we have to keep our minds and bodies healthy.  Be as aware as you can, learn your normal, increase your ability to listen to your body, notice the small signs and act on them straightaway.

It’s as easy as 1, 2, 3 (4, 5, 6!).

1 Comment

Jeevaya · February 9, 2023 at 12:16

Great post! It’s so important to have an early warning system in place so you can get ahead of any potential problems. Using the right tools and keeping an eye out for potential warning signs can make all the difference in keeping your business running smoothly. Thanks for the insight!

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