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The word 'Bala' refers to the strength of the body. It also indicates ability of the body or part of the body, to protect oneself against various harmful factors. In Ayurveda, some of the body constituents have been called as Balam owing to their key role in protecting body against multiple stressors. Imbalance of these is supposed to play the key role in making body susceptible to harmful agents and vulnerable to diseases of body as well as mind. Thus, one can find that, term 'Bala' which literally means strength is also used interchangeably with Vyadhikshamatwa which refers to the immunity of the individual.  

The word 'Bala' refers to the strength of the body. It also indicates ability of the body or part of the body, to protect oneself against various harmful factors. In Ayurveda, some of the body constituents have been called as Bala owing to their key role in protecting body against multiple stressors. Imbalance of these is supposed to play the key role in making body susceptible to harmful agents and vulnerable to diseases of body as well as mind. Thus, one can find that, term 'Bala' which literally means strength is also used interchangeably with Vyadhikshamatwa which refers to the immunity of the individual.  

== Introduction ==

== Introduction ==

Ayurveda describes process of disease development in the unique way. Weakness of the body building tissues i.e. dhatus along-with vitiation of doshas is considered to be the primary step in development of any disease. Thus, Ayurveda lays great emphasis on maintaining high strength of all the Dhatus. Balam is the entity which represents this strength constituted by all 7 dhatus. This strength encompasses both aspects, physical as well as mental. Naturally, when this kind of strength (physical as well as mental) is present in body, it can fight against various diseases by its own. Appraising this role of Balam in protecting body from harmful factors, it is also correlated with immunity and immune system of the body. Ayurveda acharyas have advised to assess this Balam of the individual before planning treatment for anyone. While offering knowledge about measures to prevent and treat multiple diseases, Ayurveda acharyas have given great importance to maintenance of this Balam at each and every stage of clinical management as well as conducting surgical procedures.  

Ayurveda describes process of disease development in the unique way. Weakness of the body building tissues i.e. dhatus along-with vitiation of doshas is considered to be the primary step in development of any disease. Thus, Ayurveda lays great emphasis on maintaining high strength of all the Dhatus. Bala is the entity which represents this strength constituted by all 7 dhatus. This strength encompasses both aspects, physical as well as mental. Naturally, when this kind of strength (physical as well as mental) is present in body, it can fight against various diseases by its own. Appraising this role of Bala in protecting body from harmful factors, it is also correlated with immunity and immune system of the body. Ayurveda acharyas have advised to assess this Bala of the individual before planning treatment for anyone. While offering knowledge about measures to prevent and treat multiple diseases, Ayurveda acharyas have given great importance to maintenance of this Bala at each and every stage of clinical management as well as conducting surgical procedures.  

== Definition ==

== Definition ==

The word Balam has been used invariably for strength of mind, body and its components. It also stands for immunity and immune system in normal state.<ref name=":0">Mahesh TS, Shreevidya M. A review on balya action mentioned in Ayurveda. J Ayurveda Integr Med. 2014;5(2):80–84. doi:10.4103/0975-9476.133796</ref> From the clinical perspective, Balam has been correlated with 2 entities viz. normal Kapha dosha and Ojus present in the body.     

The word Bala has been used invariably for strength of mind, body and its components. It also stands for immunity and immune system in normal state.<ref name=":0">Mahesh TS, Shreevidya M. A review on balya action mentioned in Ayurveda. J Ayurveda Integr Med. 2014;5(2):80–84. doi:10.4103/0975-9476.133796</ref> From the clinical perspective, Bala has been correlated with 2 entities viz. normal Kapha dosha and Ojus present in the body.     

=== Ojus as Balam ===

=== Ojus as Bala ===

According to Acharya Sushruta, 'Balam' is the synonym of 'Ojus'. Ojus is the quintessence of all 7 dhatus. It is also known as bioenergy or body component that helps in sustaining life. It is formed at the end of dhatu level pachana (metabolism) and it is believed to be teja (quintessence or cream) of all these dhatus.<blockquote>तत्र रसादीनां शुक्रान्तानां धातूनां यत् परं तेजस्तत् खल्वोजस्तदेव बलमित्युच्यते, स्वशास्त्रसिद्धान्तात् || (Sush. Samh. 15.19)<ref>Sushrut Samhita (Sutrastanam Adhyaya 15 Sutra 19)</ref></blockquote><blockquote>''tatra rasādīnāṁ śukrāntānāṁ dhātūnāṁ yat paraṁ tejastat khalvojastadeva balamityucyate, svaśāstrasiddhāntāt ||''</blockquote>

According to Acharya Sushruta, 'Bala' is the synonym of 'Ojus'. Ojus is the quintessence of all 7 dhatus. It is also known as bioenergy or body component that helps in sustaining life. It is formed at the end of dhatu level pachana (metabolism) and it is believed to be teja (quintessence or cream) of all these dhatus.<blockquote>तत्र रसादीनां शुक्रान्तानां धातूनां यत् परं तेजस्तत् खल्वोजस्तदेव बलमित्युच्यते, स्वशास्त्रसिद्धान्तात् || (Sush. Samh. 15.19)<ref>Sushrut Samhita (Sutrastanam Adhyaya 15 Sutra 19)</ref></blockquote><blockquote>''tatra rasādīnāṁ śukrāntānāṁ dhātūnāṁ yat paraṁ tejastat khalvojastadeva balamityucyate, svaśāstrasiddhāntāt ||''</blockquote>

=== Kapha as Balam ===

=== Kapha as Bala ===

Among 3 doshas controlling bodily functions, Kapha is the one that performs the function of strengthening and lubricating the body. Thus, 'Balam' also denotes the Kapha dosha in Prakrt awastha (normal state). Acharya Charaka has stated that role of Kapha dosha in balanced state or role of Ojus is same as Balam. Thus, Balam has also been defined as the kapha dosha which is in unaltered, non-vitiated or natural state.<ref name=":0" /> <blockquote>प्राकृतस्तु बलं श्लेष्मा विकृतो मल उच्यते| स चैवौजः स्मृतः काये स च पाप्मोपदिश्यते||- (Char. Samh. 17.117)<ref>Charaka Samhita (Sutrasthanam Adhyaya 17 Sutra 117)</ref></blockquote><blockquote>''prākr̥tastu balaṁ śleṣmā vikr̥to mala ucyate| sa caivaujaḥ smr̥taḥ kāye sa ca pāpmopadiśyate||''</blockquote>

Among 3 doshas controlling bodily functions, Kapha is the one that performs the function of strengthening and lubricating the body. Thus, 'Bala' also denotes the Kapha dosha in Prakrt awastha (normal state). Acharya Charaka has stated that role of Kapha dosha in balanced state or role of Ojus is same as Bala. Thus, Bala has also been defined as the kapha dosha which is in unaltered, non-vitiated or natural state.<ref name=":0" /> <blockquote>प्राकृतस्तु बलं श्लेष्मा विकृतो मल उच्यते| स चैवौजः स्मृतः काये स च पाप्मोपदिश्यते||- (Char. Samh. 17.117)<ref>Charaka Samhita (Sutrasthanam Adhyaya 17 Sutra 117)</ref></blockquote><blockquote>''prākr̥tastu balaṁ śleṣmā vikr̥to mala ucyate| sa caivaujaḥ smr̥taḥ kāye sa ca pāpmopadiśyate||''</blockquote>

== Role of Balam ==

== Role of Bala ==

Acharya Sushruta has clearly described various functions or advantages of having balam. <blockquote>तत्र बलेन स्थिरोपचितमांसता सर्वचेष्टास्वप्रतिघातः स्वरवर्णप्रसादो बाह्यानामाभ्यन्तराणां च करणानामात्मकार्यप्रतिपत्तिर्भवति ||२०|| (Sush. Samh. 15.20)<ref>Sushrut Samhita (Sutrastanam Adhyaya 15 Sutra 20)</ref></blockquote><blockquote>''tatra balena sthiropacitamāṁsatā sarvaceṣṭāsvapratighātaḥ svaravarṇaprasādo bāhyānāmābhyantarāṇāṁ ca karaṇānāmātmakāryapratipattirbhavati ||20||''</blockquote>He states that, if an individual has enough strength then he can benefit in various ways<ref name=":0" /> as below,

Acharya Sushruta has clearly described various functions or advantages of having Bala. <blockquote>तत्र बलेन स्थिरोपचितमांसता सर्वचेष्टास्वप्रतिघातः स्वरवर्णप्रसादो बाह्यानामाभ्यन्तराणां च करणानामात्मकार्यप्रतिपत्तिर्भवति ||२०|| (Sush. Samh. 15.20)<ref>Sushrut Samhita (Sutrastanam Adhyaya 15 Sutra 20)</ref></blockquote><blockquote>''tatra balena sthiropacitamāṁsatā sarvaceṣṭāsvapratighātaḥ svaravarṇaprasādo bāhyānāmābhyantarāṇāṁ ca karaṇānāmātmakāryapratipattirbhavati ||20||''</blockquote>He states that, if an individual has enough strength then he can benefit in various ways<ref name=":0" /> as below,

* Nourishment and stability of Mamsa [[Dhatus (धातवः)|dhatu]] ( the muscular tissues of the body) can be obtained.  

* Nourishment and stability of Mamsa [[Dhatus (धातवः)|dhatu]] ( the muscular tissues of the body) can be obtained.  

* An individual becomes capable of performing various tasks efficiently and uninhibitedly  

* An individual becomes capable of performing various tasks efficiently and uninhibitedly  

* One achieves good complexion as well as clearness and pleasantness of voice   

* One achieves good complexion as well as clearness and pleasantness of voice   

* Excellent balam also facilitates clear, efficient working of all the organs either external like [[Indriyas (इन्द्रियाणि)|Indriyas]] [Jnyaanendriya (sense organs) or Karmendriya (organs with motor functions)] and internal like [[Manas (मनः)|Manas]] (mind), Buddhi (Intellect) etc

* Excellent Bala also facilitates clear, efficient working of all the organs either external like [[Indriyas (इन्द्रियाणि)|Indriyas]] [Jnyaanendriya (sense organs) or Karmendriya (organs with motor functions)] and internal like [[Manas (मनः)|Manas]] (mind), Buddhi (Intellect) etc

== Classification of Balam ==

== Classification of Bala ==

The balam of the individual could have various aspects. Some individuals possess strength naturally while some may lack this strength even after following rigorous diet, exercise and use of medicines. Similarly role of Kala is also considered significant by Ayurveda in maintaining this strength of the individuals. Considering all these factors, Ayurveda acharyas have classified the Balam of an individual in 3 components. Acharya Charaka has mentioned 3 types of Balam <ref>Charaka Samhita (Sutrasthanam Adhyaya 11 Sutram 36)</ref>  as below,   

The Bala of the individual could have various aspects. Some individuals possess strength naturally while some may lack this strength even after following rigorous diet, exercise and use of medicines. Similarly role of Kala is also considered significant by Ayurveda in maintaining this strength of the individuals. Considering all these factors, Ayurveda acharyas have classified the Bala of an individual in 3 components. Acharya Charaka has mentioned 3 types of Bala <ref>Charaka Samhita (Sutrasthanam Adhyaya 11 Sutram 36)</ref>  as below,   

# Sahaja (Natural, Present right from the birth)   

# Sahaja (Natural, Present right from the birth)   

# Kalaja (Present due to particular season and age) and   

# Kalaja (Present due to particular season and age) and   

# Yuktikrita (Obtained by deliberate efforts to acquire strength like use of diet, exercise, medicines).   

# Yuktikrita (Obtained by deliberate efforts to acquire strength like use of diet, exercise, medicines).   

Ayurveda offers ways to improve Yuktikruta balam of an individuals. Also, under topics like [[Rutucharya (ऋतुचर्या)|Rtucharya]] and Swasthavrtta, level of Kalaja balam has been explained. The methods to preserve balam which is lowered due to seasonal variations, have been mentioned. Multiple herbs, dietary components, activities and medicines that can enhance Balam of [[Purusha (पुरुषः)|purusha]] have been described at places in classical Ayurveda treatises. At each and every point of describing any medical intervention, Ayurveda acharyas have given undisputed attention to balam of the patient and further management has been recommended on that basis. Such an approach in planning medicinal treatment while keeping an eye on strength of individual ensures safe and holistic healing with Ayurveda treatments. Various branches of Ayurveda like [[Rasayana (रसायनम्)|Rasayana]] (Tonic that nourishes all the tissues of the body) and Vajikarana (Invigorating and aphrodisiac medicine) primarily focus on enhancing this Yuktikrita balam. In this context, Balam is considered as effect of the food, medicine or activities which are having the action of nourishment.   

Ayurveda offers ways to improve Yuktikruta Bala of an individuals. Also, under topics like [[Rutucharya (ऋतुचर्या)|Rtucharya]] and Swasthavrtta, level of Kalaja Bala has been explained. The methods to preserve Bala which is lowered due to seasonal variations, have been mentioned. Multiple herbs, dietary components, activities and medicines that can enhance Bala of [[Purusha (पुरुषः)|purusha]] have been described at places in classical Ayurveda treatises. At each and every point of describing any medical intervention, Ayurveda acharyas have given undisputed attention to bala of the patient and further management has been recommended on that basis. Such an approach in planning medicinal treatment while keeping an eye on strength of individual ensures safe and holistic healing with Ayurveda treatments. Various branches of Ayurveda like [[Rasayana (रसायनम्)|Rasayana]] (Tonic that nourishes all the tissues of the body) and Vajikarana (Invigorating and aphrodisiac medicine) primarily focus on enhancing this Yuktikrita bala. In this context, Bala is considered as effect of the food, medicine or activities which are having the action of nourishment.   

== Balya as karmas in Ayurveda ==

== Balya as karmas in Ayurveda ==

The pharmacodynamic activities of herbs have been described under Dravya karmas (actions of medicinal substances) in Ayurveda. One of these actions is named as  Balya. Balya is defined as 'that which is beneficial and tend to increase Balam of an individual'.<ref name=":0" /> Balya herbs, medicinal substances, foods and activities improve the strength by nourishing all dhatus which form all organs and systems of the body.  

The pharmacodynamic activities of herbs have been described under Dravya karmas (actions of medicinal substances) in Ayurveda. One of these actions is named as  Balya. Balya is defined as 'that which is beneficial and tend to increase Bala of an individual'.<ref name=":0" /> Balya herbs, medicinal substances, foods and activities improve the strength by nourishing all dhatus which form all organs and systems of the body.  

[[Vaidya (वैद्यः)|Vaidyas]] make use of Balya medicines and advice Balya activities and diet during and after the treatment in order to regain the lost strength of shariram (body) after combating an illness. This helps to keep individual healthy, fit, devoid of harmful side effects caused by strong medicines and also helps to make one immune in order to prevent recurrence of similar diseases. Emergence of concepts of nutritional supplements in the contemporary science share similar ground however the approach of Ayurveda is more holistic and tailored to the needs of an individual.  

[[Vaidya (वैद्यः)|Vaidyas]] make use of Balya medicines and advice Balya activities and diet during and after the treatment in order to regain the lost strength of shariram (body) after combating an illness. This helps to keep individual healthy, fit, devoid of harmful side effects caused by strong medicines and also helps to make one immune in order to prevent recurrence of similar diseases. Emergence of concepts of nutritional supplements in the contemporary science share similar ground however the approach of Ayurveda is more holistic and tailored to the needs of an individual.  

Herbs like Bala (Sida cordifolia), Atibala (Abutilon indicum), Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Guduchi (Tinospora cordifolia), Payasya, Katuki, Ripened fruit of mango, Vidarikanda (Pueraria tuberose), Haritaki (Terminalia chebula), Amalaki (Emblica ofcinalis), Bibhitaki <ref name=":0" /> are known to display Balya action when consumed in authentic way under the supervision of a learned Vaidya. Many of these herbs are well-known rejuvenator herbs and thus provide strength by nourishing all dhatus. However, these miraculous herbs may not show desired effects when used in an irrational way. One should take these at appropriate time, stage, in proper dosage followed by specific Anupana (Adjuvant) which are decided after thorough assessment of an individual by Vaidya.  

Herbs like Bala (Sida cordifolia), Atibala (Abutilon indicum), Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Guduchi (Tinospora cordifolia), Payasya, Katuki, Ripened fruit of mango, Vidarikanda (Pueraria tuberose), Haritaki (Terminalia chebula), Amalaki (Emblica ofcinalis), Bibhitaki <ref name=":0" /> are known to display Balya action when consumed in authentic way under the supervision of a learned Vaidya. Many of these herbs are well-known rejuvenator herbs and thus provide strength by nourishing all dhatus. However, these miraculous herbs may not show desired effects when used in an irrational way. One should take these at appropriate time, stage, in proper dosage followed by specific Anupana (Adjuvant) which are decided after thorough assessment of an individual by Vaidya.  

== Assessment of Balam ==

== Assessment of Bala ==

Since balam of the individual should be assessed before planning any Ayurveda treatment, one needs to know the method to assess this balam. Methods of examination of bala is mentioned in classical Ayurvedic texts and it is mostly based on anumana pramana ( inference). Vyayamashakti (The capacity of exercising) is considered to be the parameter for assessment of balam. Details on Vyayama, its benefits, the symptoms observed after completing exercise equivalent with level of balam have been described in classical treatises. Similarly a guideline to asses Manasika balam (strength of mind) can also be found in Ayurveda literature. It is said that Manasika bala is can be understood by knowing the level of Utsaha (Enthusiasm) in individual.<ref name=":1">Nath et al. CLINICAL EXAMINATION OF BALA (STRENGTH). UJAHM 2015, 03 (04): Page 103-108</ref>  

Since bala of the individual should be assessed before planning any Ayurveda treatment, one needs to know the method to assess this bala. Methods of examination of bala is mentioned in classical Ayurvedic texts and it is mostly based on anumana pramana ( inference). Vyayamashakti (The capacity of exercising) is considered to be the parameter for assessment of bala. Details on Vyayama, its benefits, the symptoms observed after completing exercise equivalent with level of bala have been described in classical treatises. Similarly a guideline to asses Manasika bala (strength of mind) can also be found in Ayurveda literature. It is said that Manasika bala is can be understood by knowing the level of Utsaha (Enthusiasm) in individual.<ref name=":1">Nath et al. CLINICAL EXAMINATION OF BALA (STRENGTH). UJAHM 2015, 03 (04): Page 103-108</ref>  

=== The normal state of bala constitutes the following sign in an individual ===

=== The normal state of bala constitutes the following sign in an individual ===