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Introduction

The derivation of the word ‘Time’ by the Proto-Indo-European root ‘di-mon’ [1] means to divide. The Oxford dictionary defines time as the ‘continued progress of existence as affecting people and things.[2] because time is that external entity which never ceases to exist. An imaginary line separates the endless flow of time and divides it into past, present and future. This acceptance is understood and used to define almost all events in the Universe. Time or Kaala (time) according to Ayurveda means transformation.[3] Acharya Charaka considered Kaala (time) as one of the nine fundamental elements (Nava Karana Dravyas). [4] By Knowledge of Kaala (time), one can have Roga Jnana and Roga Nivarana.

Methodology

A literary review of Charaka Samhita, Susruta Samhita and Ashtangahridaya was done. Also referred to various articles published in international journals.

Kaala (time): It is divinity, it has neither a beginning nor an end, it follows the accumulated effect of actions (of the past), ordained by it, the Aditya, Kha and other Mahabhuta transform, it is the cause for the birth and death of all living beings, for the disorders and excellence of the seasons, of the tastes and potency (of all the substances) of disorder or excellence of the strength of the Dosas and body.[5] Kaala (time) is considered Nimitta Karana for every activity.

Kaala (time) is divided into two :1. Eternal (Nityaga): It is the eternal moving time that is concerned with day/ season/year. And 2. Temporary (Avastika / AturaKaala (time)). A patient’s condition changes with moving time due to various stages of disease management. These are called Shad Kriya Kaala. [6]

Role of Kaala (time) in the classification of vyadhi: Vyadhi can be classified into two based on Kaala (time) as Kaalaja vyadhi (Disease due to old age eg: Parkinsonism, Alzheimer’s disease) and AKaalaja Vyadhi. (Disease due to an unnatural cause. eg: premature greying of hair, blindness, deafness, etc.) [7]

Table1 Kaala (time) & relation with dosha [8] [9] [10]

As our treatment principle is to bring back the vitiated Dosas to equilibrium. Knowing which dosa has been vitiated makes it easy for physicians to treat it. In childhood, the person will be suffering from diseases like cough, cold asthma produced by Kapha vitiation. In middle age, the person will suffer from Pitta vitiation diseases like acne, ulcers etc. In Old age diseases of Vata vitiation, the person will be suffering from diseases of Vata like joint pain, and parkinsonism. Similarly in the morning, noon and evening there is vitiation of Kapha, Pitta, and Vata dosha seen respectively.

Kaala (time) and Vyadhi relation: In the succession of time, natural disorders caused by old age and approaching death occur.[11]

Role of Kaala (time) as Hetu of disease and health: The Hinayoga, Mithya yoga, and Ati yoga of Kaala (time) is the cause of diseases and the Samyak yoga of Kaala (time) is the cause of health. Atiyoga of Kaala means experiencing excess heat in Greeshma Ritu or excess rain in Varsha Ritu or excess cold in Sishira Ritu etc. Hina yoga of kala means experiencing negligible heat in Greeshma Ritu or Varsha Ritu or negligible cold in Sishira Ritu etc. Mithya yoga means experiencing cold in Greeshma Ritu, heat in Sishira Ritu, rain in Greeshma Ritu, etc. [12]

Role of Kaala (time) in producing diseases: According to Bikshu Atreya, Human beings and their diseases are caused by time (Kaala (time)) because the whole universe is under the control of Kaala (time). Kaala (time) is the cause of everything [13]

Role of Kaala (time) in diagnosis: The increase in heart rate is called tachycardia, and the decrease in heart rate is bradycardia. Tachycardia could be an indication of fever, Anemia, Hyperthyroidism, Cardiomyopathy, Valvular heart disease, or Hemorrhagic shock. [14] Bradycardia could be an indication of disease of SA Node, Hypothermia, Hypothyroidism, Heart attack, congenital heart disease, Degenerative process of ageing, obstructive jaundice, increased intracranial pressure, use of certain drugs like beta blockers, digitalis, Atherosclerosis etc. [15] The increased respiratory rate (Tachypnea) is indicative of sepsis or acidosis. Also seen in patients with Pneumonia, Pleural effusion, Pulmonary embolism, COPD, asthma, or allergic reaction.[16] Decreased respiratory rate (Bradypnea) indicative of high blood pressure, electrolyte imbalance, inflammatory disease like lupus, hepatic failure etc. [17] Clotting time is 10 to 13 seconds if the abnormality is detected it indicates hemophilic disorders.[18] Bleeding time is 2 to 9 seconds, it is prolonged in liver cirrhosis[19] . So here Kaala (time) is playing an inevitable role in diagnosing the disease.

Some diseases have a specific duration of pathogenesis. Five types of intermittent fevers (Vishama Jvara) are described based on frequency and time of manifestation.  [20]

1. Continuous fever (Santata)
2. Two times a day (Satata)
3. Alternate day (Anyedyushka)
4. Third day (Tritiyaka)
5. Fourth day (Chaturthaka)

Kaala (time) in the examination:

Dasha Vidha pareekshya bhava It is one of the 10 factors in the examination of a patient. [21] Here the season is taken into consideration. In the Dasha Vidha pareekshya of the patient, we see the Vaya or age of the person. Age is the most important and inevitable factor that should be considered while treating a patient.

History of the past illness is taken into consideration while taking patient history

Role of Kaala (time) in the prognosis of the disease: The disease which is of a long time is difficult to be cured. The disease of recent onset is easily cured. If the person is young disease is easily curable. The disease of long duration becomes incurable. Shleepada (elephantiasis becomes incurable after 1 year. [22] Ardita (facial palsy) becomes incurable after 3 years.[23] Unmada(insanity) becomes incurable after 13 years. Rakta gulma should be treated after 10 months. [24]

Importance of starting treatment at the proper time: Acharya Charaka says that physicians should start the treatment at the proper time after distinguishing whether the disease is curable or incurable. Treatment will be successful if he starts at the right time. [25]

Kaala (time) is a factor in producing Janapadodvamsa (epidemic): The common factors that produce epidemics are air, water, land, and Kaala (time) (season). A time is said to be unwholesome if it shows characteristics opposite to normal or exhibits excess or deficient characteristics (e.g., early rain, too little rain, excessively hot, summers or cold winters, etc. Among the four factors, the Kaala (time) or season is the most potent factor. [26]

Role of Kaala (time) in producing Bala(strength): At young age and in winter the person will be having maximum strength.

KRIYA KAALA (TIME): Kriya Kaala (time) means time or opportunity to prevent the development of disease. It is of 2 kinds

Table 2 Ritu Kriya Kaala (time) [ 27]

2. Vyadhi Kriya Kaala (time): It is the appropriate time to adopt the proper treatment line. [28]

1. Chaya (Stage of Accumulation)

2. Prakopa (Provocation)

3. Prasara (Propagation)

4.Sthanasamsraya (Localisation)

5. Vyakthi (Manifestation)

6. Bheda (Complication).

These are the different stages of disease manifestations. Each successive stage denotes the progressive nature of the disease and with the successive stage, the disease becomes progressively difficult from the management point of view. If we identify a disease before it reaches the stage of complication, it can be cured.

Table 3 Role of Kaala (time) in collecting, preparing, storing, and preserving drugs [29]

The Sara collection is mentioned in Vasant Ritu by Sushruta whereas others have mentioned it in Hemant. The Moola in Greeshma and Shishira Ritu, Kanda in Sharad (after the rainy) season shows the storage of nutrients and chemical constituents in those parts, indicating the self-protecting phenomenon of plants also. Sushruta and Vagbhata opine that Ushna(hot) and Sheeta(cold) Virya (potency)drugs should be collected in Agneya Ritu and Saumya Ritu respectively Each part is collected in different seasons because the potency of the part of the plant will be high in that season. Madana Phala should be collected during the period of transition between spring and summer in the Pusya, Aswini, or Margashirsha constellation and Maitra Muhurta. [30] The day Pushya Nakshatra falls is considered an auspicious day for administering swarnaprashana. Administering drugs on this Pushya Nakshatra day is very effective even though there is no reference to this day in any classical texts. As the Pushya is considered the auspicious star among all the stars – ‘the star of nourishment’. It means it provides nourishment like a mother to her kids. The cow’s udder is a symbol of Pushya. Just as how the cow nourishes us by giving us milk the Pushya nakshatra day is best for activities like taking medicine, preparing herbs, etc. [31] For preparing Pushyanuga churna the drugs are collected on the day of Pushya nakshatra as the potency of the ingredients collected on that day is high.

The shelf-life of medicines also varies. For Churna (powder)shelf life is 2 months, for Swarasa(juice) and Kwatha (decoction)shelf life is 24 hours, for Taila(oil) its 3 years. Some preparations like Asavas and Arishtas its10 years. Their potency is increasing daily, and there is no expiry for these. Purana Ghrita that’s 100 years old ghee is having a lot of benefits. It’s indicated for Vataprakopaka vyadhi, Balya, Chakshusaya, and Medhya. [32]

Role of Kaala (time) in Panchakarma treatment: Panchakarma is a unique form of treatment in Ayurveda. It aims to achieve a balanced state of mind, body and consciousness by detoxifying all systems in a seasonal and disease-specific manner. In panchakarma, a specific order should be followed. This protects against diseases and cures diseases uniquely. After Snehapana (administering unctuous substance internally), Svedana(fomentation) should be done for a specific duration then only panchakarma can be administrated. [33] Vamana (emesis )is done in Purvahna (early morning) as Kapha will be in the vitiated state at this time. (Should wait for 1muhurta Kaala (time) for vega). [34] Anuvasana Basti (oil enema) is done in Sayam Kaala (time) (evening) as Vata is vitiated at this time. [35] Uttara Basti is done in the morning. The concept of time is essential in every phase of panchakarma.  Panchakarma, if done on time, destroys the disease and gives effective results and if done at an improper time it can lead to serious complications. [ 36] So, Kaala (time) plays an important role in the success of treatment.

Table 4. Age and Dose of Basti medicine [37]

 Table 5. Age and Basti Netra length [38]

Role of Kaala (time) and Arishta: Arishta means the signs of upcoming death. We can determine how long the patient will live from certain signs and symptoms. The appearance of a network of blood vessels on the forehead is an indication that the patient won’t be living for six months. The patient who is having tremors in the body, a stupor, movement, and speechlike an insane indicates death within a month. [39]

Discussion

From birth that’s the day of conception, then delivery after 40 weeks, each stage of growth, intake of food daily routine, seasonal routine, the occurrence of disease, and stages of the disease, all depends on Kaala (time) or time.

Then occurrence of the disease, its diagnosis, treatment, prognosis, medicine preparation, storage shelf life, and administration of medicine depends on Kaala (time) or Time. So, we can say that Kaala (time) or time is an inevitable factor in the life of every being.

Conclusion

Each stage of Roga right from Nidana is governed by Kaala (time). Diagnosis and prognosis of many diseases enabled by Kaala (time). Each step of treatment, from collecting raw drugs to preparation, administration and storage is under the control of Kaala (time). The effectiveness of treatment is also governed by Kaala (time). Nothing is left behind that the Kaala (time) cannot influence.

So, if we follow the Daily and seasonal regimens, and lead our life-giving due respect to time we can get a happy long life.

Acknowledgement

The author would like to thank the principal sir of the Sumandeep Ayurveda college and hospital (Sumandeep Vidyapeeth deemed to be the university Pipaliya, Waghodia, Vadodara, Gujarata-391760) for providing me with the materials and books required for the writing of this article.

Conflict of interest: No conflict.