This refers to the stage of mixing of dosh with the those factors which helps to generate a disease called dosh dushya sammurchhana. The sign & symptoms developed on the body according to the involvement of dosha (vata, pitta, and kapha) and dushya (rasha, rakta, mans, meda, asthi, majja, shukra)
if dosh dushya sammurchhana takes place between pitta (dosh) and rakta (dushya) then the sign & symptoms developed over the body are small furuncles over the skin which have burning sensation. The sign & symptoms developed at this stage is called purvaroopa of the disease.

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

Vyakta (Stage of symptom manifestation) – It is the fifth stage of Shat kriya kal in Ayurveda and it literally means something which can be seen. This stage is the one in which clearly differentiated symptoms first appear. It is the stage of symptom manifestation. The disease process overwhelms the ability of the body to maintain immunity and healthy functioning. At this stage, structural dysfunctions or damages have progressed to the point where the illness actually activates. The disease proces manifests the symptoms that are used by the Western system for classification and diagnosis.