THE CONCEPT OF BALA, BALA PAREEKSHA AND ITS CLINICAL IMPLICATION

Shahul Hameed et. al: The Concept of Bala, Bala Pareeksha and its Clinical Implication

2 www.iamj.in IAMJ: Volume 1; Issue 5; Sept – Oct 2013

THE CONCEPT OF BALA, BALA PAREEKSHA AND ITS

CLINICAL IMPLICATION

Shahul Hameed Puli Anilkumar Jadhav Lakshmi Prasad Chiplunkar Shivprasad1

Dept. of Kayachikitsa, 1Dept. of Kriya Shareera, SDM Ayurveda College, Hassan, India

ABSTRACT

Bala is considered as the physical and mental strength of the individual. It can be assessed

in healthy individuals as well as diseased. It is helpful in assessing the severity of the disease.

The knowledge of bala of a patient is needed to know about the prognosis and to fix the

dosage, to adopt proper treatment modality and to advice proper regimens for a healthy life style. Information on bala is available in Ayurvedic texts, but at different contexts. Among the explanation given are, bala is one which prevents the roga, one which is adhistana of arogya and

treatment is given for protecting it. Thus examination of bala of an individual is important. It

cannot be assessed solely on basis of parameters alone like body built, as it has explanation in

different contexts like, role of ojus in bala, assessment of prakrutha Kapha as bala, assessment

of shareerika , manasika and vyadhikshamatva bala. There are different methods available for

assessing bala, so in this study an attempt is being made to collect informations available on

concepts of bala and suggest an appropriate method for assessment of bala.

Keywords: Ojus, Vyadhikshamatva, Ardha vyayama shakti, bala

NEED FOR STUDY

There are different concepts on bala and it is of wide use in health and treatment of an individual. There is a necessity to understand the concept of bala pareeksha in patients and healthy individuals. Charaka, Vaghbata and Sushruta have explained about concepts of bala. The present review was done in order to collect the concept of bala, its pareeksha and its implication.

MATERIALS & METHODS

A thorough search was done in Astanga Hrudaya, Charaka smhitha, Sushrutha Samhita and the available commentary on it and the contents and references were analyzed and used for the study.

Various concepts of bala in Ayurveda Ojus as bala

Acharya Sushrutha mentions that the final and excellent essence of dhatus beginning with Rasa to Shukra is Ojus and that Ojus is said to be bala.1 Dalhana has commented on this as Ojus is the cause for predominance of bala to sampurna shareera.2 Vagbhata supports this by mentioning that Ojo vrudhi leads to thushti, pushti and bala.3 Acharya Charaka says that normalcy of Kapha is said to be bala and it is considered to be ojus. Vitiated kapha is mala and it causes disease.4 Sushruta also mentions Prakruta karma of ojus as , stability, growth of muscles, ability to perform all the activities without any hindrance or obstruction, clarity of voice, brightness or complexion.5

Shareerika bala

Charaka explains regarding dasha vidha bala pareeksha, which is a combination of rogi pareeksha and roga pareeksha.

Prakrutyadi nine fold examinations except vikrititah are for athura bala pramana. Vikrititah

pareeksha is for vyadhi bala pramana.6 Sushrutha mentions about sthaulya, karshya and Madhya shareera, among them madhya shareera is considered balavan.

One who consumes food which is not excessive unctuous and dry, digested annarasa circulates all over the body and nourishes all dhatus equally. Due to this the person is said to be madhya  shareera. He is having good ability to perform the physical activities, he can tolerate hunger, thirst, cold, heat, pain, sunlight. He is said to be balavan.7 Charaka explains about sama samhatha purusha, that one whose shareera mamsa and shareera samhanana are even in measurement, whose indriyas are stable, devoid of vikara due to good bala, who can tolerate hunger, thirst, heat, cold, increased body activities, whose jataragni and digestion are good.8 This can be considered as strength attained by proper food intake, the physical abilities and proper sensory perception.

Manasika bala

One among the dasha vidha bala pareeksha is satwa pareeksha which can be considered as mental strength. It is of pravara, madhyama and avara respectively.9

Vyadhikshamatva bala

Charaka explains regarding Vyadhikshamatva as, all shareera will not have similar vyadhikshamatva. This is considered as ones immune power. It varies from person to person. Chakrapani comments that it is the one which protects the body from disease and prevents from reoccurrence of disease. Charaka explains about Vyadhi asaha purusha as, one who is athisthula,

athikrusha, whose mamsa, shonitha and asthi dhatus are not well formed, who is durbala, who consume asatmya ahara, who consume less quantity of ahara and who is alpa satwa, these persons will not have vyadhikshamatha. The persons opposite to these features possess vyadhikshamatha.10

Types of bala: It is of 3 types sahaja, kalaja and yuktikrutaja bala.

Sahaja bala The shareerika and manasika bala which is attained due to matruja and pitruja bhavas like rasa rakta virya ojus is sahaja bala,which can be considered as strength attained from hereditary.

Kalaja bala which is attained from impact of rutus and other which is attained in different vayas. In adana kala the bala of individual will be less and in visarga kala it will be more. The bala will be alpa, uttama and alpa in child, young and old age respectively.

Yuktikrutaja bala Bala which is attained from food and nutrition and physical activities.11

Method of bala pareeksha

Charaka while explaining the pareeksha by anumana pramana mentions that Bala should be assessed by vyayama shakti.12 Vyayama means performing different bodily movement i.e. chesta.13 Through ones vyayama shakti, karma shakti can be assessed and it can be classified under three types i.e. pravara, madhyama and avara bala. If the person can perform more physical work then he is of pravara bala, if moderately then madhyama bala and if less then

avara bala.14

Sushruta explains that bala is one among dwadasha pareeksha. The physician before commencing treatment, should first examine ayu, vyadhi, rutu, agni, vaya, deha, bala, satva, satmya, prakruti, bhesaja, and desha should be examined.15 Vagbata explains that physician should examine ten factors such as dushya, desha, bala, kala, anala, prakruti, vaya, satva, satmya and ahara.16

The bala can be assessed by dasha vidha athura bala pareeksha as follows:

Prakruti – If the person is of Vata prakruti then he is having alpabala, of Pitta prukruti then madhyama bala and of Kapha prakruti then balavan.

Vikruti - Here the roga is assessed through dosha, dushya, kala, bala.

Sara: To know the bala of purusha, ashta saras are explained. If the person is of Rakta

sara then he is having anatibala, if the person is of Mamsa, Majja and Shukra sara then he is balavanta and if the person is of Sarva sara then he is atibala.

Samhanana: The compactness is explained as well demarcated bones, well bound joints and well formed muscles and blood. If a person’s compactness is good then he is balavan, if not, alpabala and if his compactness is moderate then he is of madhyama bala.

Pramaanatah: It’s measured by one’s own anguli pramana. The person with proper measurement of the body are endowed with longevity, strength, immunity, happiness, supremacy, wealth and other desired qualities. The body with less or more measurement has qualities contrary to this.

Satmyatah: If the person is Sarvarasa satmya then he is balavan, if the person is Eka rasa satmya then he is of alpabala and if madhyama then madhyama bala.

Sattwatah: Here satwa means mano bala. It is of three types. The person with pravara satwa possesses pravara dhee, dhruthi and smruti, he will be able to bear stronger therapies, can tolerate severe nija and agantuja roga , adopts same sort of feelings towards happiness or sorrow, will be under control by themselves and predominant of satwa guna. The person with madhyama satwa will be of madhyama dhee, dhruthi and smruti , he will be able to bear stronger therapies,

predominant of rajo guna, tolerates when controlled by others, with much difficulties tolerates severe nija and agantuja roga, he tolerates and adjust to pain or odd situations. Persons with avara satwa will have avara dhee, dhruthi and smriti. They cannot sustain mental stress, in spite of having good physic they are susceptible to fear, grief, greed and delusion. If they hear frightening narratives or on the look of animal or human flesh or blood, get afflicted with anxiety, fainting or even succumb to death. These people are contra indicated for samshodhana therapy, they cannot tolerate pain, and they are predominent in tamoguna.

Ahara shakti: This is examined by the power of ingestion as well as digestion. Strength and life depend on ahara shakti.

Vyayama shakti: If the person can perform more physical work then he is of pravara bala, if moderately then madhyama bala and if less then avara bala.

Vaya shakti : Baala- up to16 yrs are alpa bala, Madhyaavastha- 16 to 60 yrs are uttama bala and

Jeernaavastha- 60 to 100 yrs are alpa bala.17

Balaardha lakshanas:

It is told that bala should be examined through vyayama shakti. But up to what extent one should perform vyayama is not mentioned. So here the reference of samyak vyayama lakshana and bala ardha lakshana or ardha vyayama shakti can be adopted. After appearance of these symptomsmone should stop performing the vyayama. The lakshanas are appearance of sweat over  forehead, axillary region, nose, hands, foot, joints and mukhashosha, increased respiratory rate, lightness of the body, increased heart rate.18, 19

Methods available in modern science at present day are:

Harvard step test: The individual should step up and down off a gym bench for 5 minutes

at a rate 30 steps/minute. The pulse is measured every one minute after finishing the test. Pulse1, pulse 2 and pulse 3 are recorded and it is calculated in this formula.

Result = 30000 ÷ (pulse1 + pulse2 + pulse3)

Handgrip strength test: The individual holds the handgrip dynamometer in the hand, with the arm at right angles and the elbow by the side of the body. Squeeze the dynamometer with maximum isometric effort, which is maintained for about 5 seconds. Result is recorded in kilograms.

Push up Test: To do this, the individual should kneel on the floor, hands on either side of the chest and keep the back straight. Do as many pushups as possible until exhaustion. The total number of pushups performed is counted.

Bruce Protocol Stress Test: The individual is made to run on a tread mill. At three minute intervals the incline of the treadmill increases by 2% and the speed increases. The test score is the time taken on the test, in minutes.20

Clinical implication

For balavan rogi the treatment given yields better result and the prognosis is good. If rogi is durbala, the treatment may not yield better results and the prognosis may be bad.

To understand the prognosis of disease like in rajayakshma if patient’s bala and mamsa is kshina then the disease will turn into asaadhya and if the bala and mamsa is akshina, the disease is saadhya.To decide the nature and potency of the drug, assessing the bala is helpful.

Administration of thikshna veerya aushadhito a durbala person leads to shareera hani and heena veerya aushadhi to a sabala person leads to reduced action of drug.

The dosage of drug can be fixed on pravara, madhyama and avara bala respectively to avoid upadrava.

If samshodhana aushadhis administered to a dhurbala rogi, it may lead to athi dosha kshaya which intern leads to athi dhurbula. So assess the bala of patient before shodhana.

As mano and shareerika bala are uttama in guruvyadhita, physician may get confused as laghu vyadhita. Similarly, mano and shareerika bala are heena in laghu vyadhita, physician may get confused as guru vyadhita.

DISCUSSION

As bala is assessed by vyayamashakti, it can be considered as shareerika bala. Satwa is considered as manasika bala. The concept of ojus and its karma can be considered as vyadhikshamatva bala. So bala can be assessed in three ways i.e. physically, mentally and immunologically. For assessing the manasika bala, pravara, madhyama and avara satwa qualities are assessed. For assessing vyadhikshamatva bala, the lakshanas of vyadhi asaha purusha, sahaja bala, kalaja bala, yuktikrutaja bala and ojo bala should be evaluated.

For assessing the shareerika bala, different vyayama such as tulabramana, gunakarshana,

dhanurakarshana are explained in the texts. Similarly in modern aspect, different methods such as Harward step test, Bruce protocol stress test, Push up test, Hand grip test are explained. These methods can be adapted to assess the physical strength.

CONCLUSION

Bala pariksha is an important factor for ascertaining rogi bala, prognosis and proper treatment. It is an important factor for assessing the fitness levels of apparently healthy persons. It can be improved by adopting proper ahara and vihara. Physician should give importance to bala pareeksha before commencing the treatment. Different tests in modern science can be used to assess the physical strength.

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CORRESPONDING AUTHOR

Dr. Shahul Hameed

PG Scholar of Kayachikitsa

SDM College of Ayurveda & Hospital, Hassan,

Karnataka, India

Email: anilpuli16@gmail.com

Source of support: Nil

Conflict of interest: None Declared