Bala Samprapti: Understanding pathogenesis Based On Causes And Symptoms

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Bala refers to strength of all factors contributing towards formation of disease
Samprapti refers to ‘ process of formation of disease’ from exposure to etiological factors (nidana) to vitiation of doshas and subsequent invasion and damage of dhatus (tissues) by vitiated doshas and eventual formation of disease.

Related Reading – Samprapti

Table of Contents

Bala Samprapti

Bala Samprapti is one of 5 types of Samprapti or pathogenesis as explained in Ayurveda.

Bala Samprapti helps in understanding overall strength of a disease based on
strength of factors causing disease and
strength of symptoms manifested in a given disease.

Strength of a disease depends upon wher nidana (causative factors), purvarupa (premonitory symptoms) and rupa (symptoms) of a given disease are partially or completely manifested. When these are completely manifested, strength of a disease is greater. When these are partially manifested, strength of a disease is weak.

Thus Bala Samprapti depends on strength and weakness of, and complete and incomplete manifestation of –

Nidanas – causative factors leading to formation of that disease
Purvarupas – Premonitory symptoms which indicate formation of that disease in future
Rupas – signs and symptoms of manifested disease

Disease strength based on Nidana

Strength of disease based on nature of causative factors (Nidanas)
They vary from disease to disease. causative factors may be in the form of unwholesome foods and food combinations, erratic lifestyle practices, stress, geographical and climatic changes, and lot more. They cause disturbance of doshas in body which triggers onset of pathogenesis.

More number, more severe is strength of disease, stronger samprapti and difficult cure.

Thus, when disease is manifested due to exposure to less causative factors, it will be easy to cure. When more number of causative factors and stronger factors, then the disease is difficult to cure disease. When person tries to keep away causative factors, it becomes easy for her to recover from a disease.

As said in Ayurveda – ‘Sankshepatah Kriya Yogah Nidana Parivarjanam…’
This means – ‘The best way to cure a disease is to keep away its causative factors’. This statement reveals how important is role of causative factors in disease process and how important it is to keep them away. Nidana Parivarjana or avoiding causative factor becomes most important strategy in the protocol of comprehensive healing. If person continuous to consume etiological factors even after diagnosis of disease, the disease turns incurable or yapya (manageable with difficult) or disease gets worsened.

Example – smoking even after being diagnosed with bronchitis or tuberculosis, consuming alcohol even after being diagnosed with liver cirrhosis, leading a sedentary life being a diabetic etc.

Consuming nidanas in spite of knowing that they are harmful is ‘a mistake done in consciousness’ i.e. prajgnaparadha.

Disease strength based on Purvaroopa

Strength of disease based on premonitory symptoms of a disease (Purvarupas)
Purvarupas tell that a disease is getting manifested in you in short time. This condition, according to Ayurveda is onset of invasion of tissues by morbid doshas and also onset of damage of those invaded tissues. This stage occurs in sthana-samshraya stage (stage of lodgment of doshas in weak and susceptible tissues) of kriyakala (stages of pathogenesis or samprapti of a disease). Here vitiated doshas get lodged in weak tissues and damage m.

Related Reading – Kriya Kala

If disease is treated in this condition, disease will not get manifested and will get aborted in its initial stage itself. When disease gets manifested, most of these purvarupas will get converted into rupas or signs and symptoms of a manifested disease, some purvarupas will disintegrate and will not progress into disease and some new symptoms may be formed in due course.

Related reading – Purvarupas

More the number of premonitory symptoms, more difficult is the disease. More the strength of premonitory symptoms, more difficult is the disease. There is a chance that many of these purvarupas progress to stage of rupavastha – full blown signs and symptoms and create a strong symptom complex or syndrome.

Thus, strength and quantity of purvarupas of a disease would be an indicator of strength of samprapti of that disease.

Disease strength based on Rupa

Strength of disease based on symptoms of a disease (Rupas)

Rupas are signs and symptoms of a disease which has manifested. symptoms help in identification and diagnosis of disease. They are manifested when dosha-dushya sammurchana or amalgamation of morbid doshas and tissues which had commenced in sthana-samshraya (stage of lodgment of doshas) or purvarupavastha (stage of manifestation of premonitory symptoms) gets completed i.e. in Vyakta stage of samprapti (pathogenesis).

When dosha dushya sammurchana gets completed, symptoms are formed completely. manifestation of signs and symptoms marks manifestation of disease.
This stage of samprapti or pathogenesis (kriya kala) is called Vyakta Avastha or Vyakti Bhava or Rupa Avasta (stage of manifestation of disease or symptoms). If treatment is done in this stage, disease will not progress ahead to stage of complications i.e. bheda avastha.

Quality and quantity of symptoms reflects strength of disease. If there is more number of symptoms in a disease, disease becomes difficult to treat. strength of disease will also be very strong. Particular diseases will have ir hallmark signs and symptoms but it is not mandatory that all symptoms are present in a textual way. But if all symptoms are present disease becomes complicated or incurable. If disease is not treated properly in this stage, strength of symptoms and also samprapti (pathogenesis) becomes stronger and disease will progress to stage of complications. This will make disease incurable.

Thus, strength and quantity of rupas or symptoms of a disease would be an indicator of strength of samprapti of that disease.

Or factors contributing to and suggesting strength of pathogenesis

Apart from above mentioned factors, bala samprapti or strength of pathogenesis is also dependent on many or indirect factors which can be taken into consideration, they are –

Atura Bala – strength and immunity of an individual also determines strength of pathogenesis. If person is physically and mentally strong even a strong disease looks weak and vice versa.

Agni and Jarana Bala – If digestive fire is good, digestion is also good. Ayurveda tells that all diseases are caused due to disturbance of fire or metabolic strength (increased or decreased). Sama Agni or normalcy (balance) of different agnis in body is one of factors which determine perfect health (swasthya). refore stronger and balanced agni, weaker is disease. In fact if agni is balanced, disease never manifests. On contrary if agni is stabilized (this is initial and key strategy in treatment of any systemic disease according to ayurveda), many diseases will be destroyed.

Dhatu Bala – If tissues are strong, they fight against invading vitiated doshas and keep mselves guarded. Stronger tissues, weaker are disease.

Importance of Bala Samprapti

Importance of knowledge of Bala Samprapti

knowledge of Bala Samprapti helps us to understand nature of a disease. It helps us to understand which disease is stronger and which is weak. This forms foundation for planning a reasonably comprehensive treatment protocol.

Bala Samprapti helps us to know nature and strength of doshas and tissues participating in pathogenesis of a disease. This will enable a physician to plan suitable measures to break samprapti or dosha-dushya sammurchana (pathological combination of morbid doshas and weak tissues).

Bala Samprapti helps us to evaluate and estimate number and strength of nidanas, lakshanas and purvarupas of a disease and thus help in evaluating strength of pathogenesis of a given disease.

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