BALA GRAHA

Introduction:

In Ayurveda’s classical texts, the various disorders of children is related to divine power ; like balagraha, jataharini( Kashyap Samhita), matrika ( Ravanakrit Kumartantra).
Bala graha is defined as a disease which captures and seizes a child.
ग्रह उपादाने धातु: गृह्णाती ग्रह:।
In Ashtang Sangraha, the daivik features of bala graha is described more specifically.
ग्रहैरपि हि जायन्ते प्रच्छन्नैर्व्याधय: शिशो: ।
कर्मशस्तमतस्तेषु दैवयुक्त्याश्रयं सदा ।।
-अ.सं.उ.२/९८
This means that the hidden grahas in child also causes diseases. This can be pacified and controlled only by daivvyapashraya and yuktivyapashraya chikitsa. Acharya Sushruta has said that this grahas are of different forms and are under control of god . Thus generally can’t enter any body. Hence considering the ‘apta vakyas ‘ the features of graha roga are described by him.
ऐश्वर्यस्थास्ते न शक्या विशन्तो देहं मानुषैर्विश्वारूपा:।
आप्तं वाक्यं तत्समीक्ष्याभिधास्ये लिंगान्येषां यानि देहे भवन्ति।।
-सु. उ.२७/७

Microscopic nature of grahas:

The balagrahas are invisible and can also be viewed by keen observation of clinical features or shastra chaksu. This was illustrated by Acharya Vagbhatta.
आविशन्तश्च लक्ष्यन्ते केवलं शास्त्रचक्षुषा।
-अ. सं. उ. ३/३५

Definition:


The grahas are unknown factors (during ancient period) which suddenly and negatively affect the health and well being of children leading to several spectrum of diseases.
The definition of graha projects a general impression of both ‘psychiatric’ and ‘acute physical disease manifestations’. But in the context of Kaumarbhritya most of the grahas are physical diseases.

Mythological concept of grahas:

The grahas were created by Lord Shiva and Parvati for the protection of their son.
पुरा गुहस्य रक्षार्थ निर्मिता: शूलपाणिना।
-अ. हृ. उ. ३/१

When the dhatri (wet nurse) and matri (mother) indulge in improper conduct i.e. ahara and vihara , neglect cleanliness and performance of auspicious rites , then the grahas desiring worship, cause harm to children when they are either agitated, overjoyed, frightened or being beaten. ( Su. U. 27/6)
These grahas are can be male or female in origin. Strivargiya grahas are predominant in rajas and tamas guna and these are created by Ganga, Uma and Krittika.

Other causes of origin of grahas:

• Fearful condition for child
• Disrespect to elderly persons and teachers
• Improper indulgence in eating, sex, exercise etc. of mother and dhatri
• Taking food in broken kasya patra
• Child carried to lonely and inauspicious places
• Psychologically unwell child

Etiopathology of graha rogas:

• No vitiation of dosha initially
• They are invisible by naked eyes
• Agantuja in nature
• They enter the body just like suryakirana enters the earth( acc. To Acharya Charaka)
• These are microorganism caused disease.

Fate of the disease:

Graha affects an individual with the help of super natural powers with three aims —

  1. Himsa- Death ( the disease which finally results in to death- fatal somatic disease). It could be understood as an acute viral disease, elucidated via running nose, watering from eyes etc. Jwara is a prodromal symptom and this aggravates the febrile seizure. It is elucidated by tongue bite, loud noise, foul smell and passing of urine and stool during episode.
  2. Rati- Coitus ( the disease in which the patient shows excessive interest in sexual act- psychiatric disorder).
  3. Archana- Worship ( by performing some religious activities like Homam etc, the patient will be relieved by daiva vyapashraya chikiysa).

Change in the taste of breast milk:

Feature of breast milk  Graha badha
Katu, tikta rasaShakuni
All dosha lakshanSkanda and Shasthi
Madhur, katu rasaPutana

Number of graha roga:

RefNumber
Sushruta9
Vagbhata12
Kashyapa9
Harita8
Balatantra12
Bhavaprakasha9
Yogaratnakara12

Classification of graha:

 KashyapaSushrutaVagbhatta
1.Skanda1.Skanda1.Skanda
2.Skanda apasmara2.Skanda apasmara2.Vishakha
3.Skanda pita3.Shakuni3.Sakuni
4.Pundarika4.Putana4.Putani
5.Revati5.Andha putana5.Adrishti putana
6.Shuska revati6.Sita putana6.Sita putana
7.Mukha mandita7.Mukha mandika7.Mukha mandita
8.Putana8.Naigamesha8.Mesha
9.Naigamesha9.Revati9.Revati
  10.Sushka revati
  11.Pitra graha
  12.Swagraha

Poorvarupa:

तेषां ग्रहीष्यतां रूपं प्रततं रोदनं ज्वर:। –(अ. हृ. उ. ३/३) Upon affliction with graha, acute fever manifests in an apparently healthy child promoting it to cry constantly. This has to be considered to be a grave condition.

Lakshan:

According to acharya Vagbhatta:
सामान्यं रूपमुत्त्रासजृंभाभ्रूक्षेपदीनता:।
फेनस्रावोर्ध्वदृष्ट्योष्ठदन्तदंशप्रजागरा:।।
रोदनं कूजनं स्तन्यविद्वेष: स्वरवैकृतम्।
नखैरकस्मात् परित: स्वधात्र्यङ्गविलेखनम्।।
-अ.हृ.३/४-५

• Yawning-tired ( O2 deficiency)
• No sleep, painful disease, discomfort
• Aversion to breast feeding- loss of appetite
• Twitches- convulsions- febrile convulsion from the mouth
• Rodanam, kujanam, swaravaikritim, grasping mother -due to pain
According to acharya Sushruta, the lakshanas are
नष्टसंज्ञो भवति – altered sensorium
दन्तान् खादति – scratching
दुर्बलो म्लानाङ्गो – lethargy
मत्स्य छुछुन्दरिमत्कुणपगन्धो – foul odor
(सु.शा.१०/५१)

Sadhya – Asadhyata of graha rogas:


प्रस्तब्धो य: स्तनद्वेषी मुह्यते चाविशन्मुहु:।
तं बालमचिराद्धन्ति ग्रह: संपूर्णलक्षण:।।
विपरीतमत: साध्यं चिकित्सेदचिरार्दितम्। (सु.सं.उ.२७/१७-१८)

Child which has rigidity of the body, aversion to the breast, becomes unconscious often and the graha exhibiting all its features kills the child soon; that with opposite features and seizure being recent, it is curable and so should be treated.

1.Skanda Graha-

शूनाक्ष: क्षतजसगन्धिक: स्तनद्विड् वक्रास्यो हतचलितैकपक्ष्मनेत्र:।
उद्विग्न: सुलुलितचक्षुरल्परोदी स्कन्दार्तो भवति च गाढमुष्टिवचर्चा:।।
-सु.उ.२७/८

Child seized by Skandagraha has swelling of the eyes, smell like blood, aversion to the breast, irregular (distorted) face, eyelids and eye of any one side having either loss of movement or more movements, child is agitated (irritated), eyes closed, cries very little, holds fist tight and has hard faeces.
तत्रैक्नयनस्रावी– watering of one eye
शिरो विक्षिपते मुहु– shaking of head frequently
हतैकपक्ष-one eye/side paralysed
स्तब्ध- stiffness
सस्वेद– perspiration
नतकन्धर– drooping of head
स्तनद्वेषी– aversion to milk
रोदिति विस्वरम्- cry in bad voice
त्रस्यन-fear
वक्रवक्त्र– facial palsy
भृशमूर्ध्वं निरीक्षते- rolling up of eyeballs
बद्ध मुष्टिशकृच्छिशु– clenching of palm (A.H.U.3/4)

Skanda can be correlated to polio and facial palsy in the following ways.
• Paralysis of extraocular, facial and masticatory muscle
• Absence of effective coughing
• Improper speech due to paralysis of vocal cords
• Can be considered as spinal type of paralytic poliomyelitis with weakness of muscles of neck, abdomen, trunk or extremities.


2.Skanda apasmar graha-


नि:संज्ञो भवति पुनर्भवेत्ससंज्ञ: संरब्ध: करचरणैश्च नृत्यतीव
विण्मूत्रे सृजति विनद्य जृम्भमाण: फेनंच प्रसृजति तत्सखाभिपन्न:।।
-सु.उ.२७/९


Child loses consciousness and regains it again, is irritable, makes dancing like movements of the arms and legs, eliminates faeces and passes urine accompanied with sound (crying), yawns more and emits froth from the mouth. These are the features of the child seized by the friend of skanda graha, that is skanda apasmar.
केशलुञ्चनम्- pulling of hair
कन्धरानति– drooping of head
विनम्य- opisthotonas
हस्तभ्रूपादनर्त्तनम्- convulsion of hand, eyebrows and legs
स्तनस्वजिह्वासंदंश:– biting of breast and tongue
संरम्भज्वरजागरा:– recurrent loss of consciousness, fever, sleeplessness
पूयशोणितगन्ध- smell of pus and blood
Features of skandapasmar are much similar to that of febrile convulsions. The convulsions in a baby occuring when the child has fever of 38⁰ C or above and without the evidence of documented CNS infections. It lasts for less than 15 minutes and immediate recovery of sensorium and more than one episode may occur on the same day.

3.Shakuni graha-


स्त्रस्ताङ्गो भयचकितो विहङ्गन्धि: संस्राविव्रणपरिपीडित: समन्तात्।
स्फोटैश्च प्रचिततनु: सदाहपाकैर्विज्ञेयो भवति शिशु: क्षत: शकुन्या।।
-सु.उ.२७/१०

Child has debilitated parts ( arms,legs,etc), is fear stricken, has smell of bird, troubled by many ulcers exuding pus, blood etc all over the body, studded with eruptions ( blebs, vescicles), having burning sensation and pus formation are the features when seized by Shakunigraha.
अतिसार– diarrhoea
जिह्वातालुगले व्रणा:– ulcers on tongue,palate,throat
स्फोटा: सदाहरुक्पाका: सन्धिषु– papules on joint
निश्यह्नि प्रविलीयन्ते पाको वक्त्रे गुदेऽपि वा– excoriations on anal region
शकुनिगन्धत्वम्- smell of birds
Shakuni graha can be correlated to stomatitis,bacillary dysentery,pellagra which are having following symptoms.
• Red patches
• Mouth ulcers, blisters
• Peeling, swelling
• Oral dysaesthesia
• Watery diarrhea contains mucous & blood
• Loss of appetite
• Adominal pain, body ache
• Nausea & Vomiting
• Fever & chills
• Rapid dehydration & wt loss
• Sensitivity to sunlight
• Aggression
• Smooth red glottis

4.Naigamesh graha-


य: फेनं वमति विनम्यते च मध्ये सोद्वेगं विलपति चोर्ध्वमीक्षमाण: ।
ज्वर्येत प्रततमथो वसासगन्धिर्नि:संज्ञो भवति हि नैगमेषजुष्ट:।।
-सु.उ.२७/१६

Child has frothy vomiting, stretches its body often, cries with restlessness, has upward gaze, continuous fever, emits smell like muscle fat and even becomes unconscious such a child is to be understood as seized by Naigamesha graha.
आध्मानं– abdominal distention
पाणिपादास्य स्पन्दं फेननिर्वम:- focal convulsion at face, limb, hand
तृण्मुष्टिबन्ध– excessive thirst, clenching of hands
स्वरदैन्यविवर्णता– feeble sound, cyanosis
कूजनं- excessive cry
ओष्ठदंशाङ्गसं- biting of lips
ऊर्ध्वं निरीक्ष्य हसनं– rolling up of eyes
मध्ये विनमनं- opisthotonas
मूर्च्छैकनेत्रशोफ– monocular inflammatory signs
This can be correlated with the meningitis having the following features.
 Fever with neck rigidity
 Vomiting, wt loss, headache
 Photophobia
 Irritability
 Low BP, irregular pulse
 Papilledema
In infants- Cold extremities, refuse feeds, high pitched cry dislike handling, neck retraction, difficulty in walking & a pale complesion.

5.Swagraha-

कम्प– convulsion
हृषितरोमत्व– horripilation
• स्वेद– excessive sweating
चक्षुर्निमीलनम्- drooping of eyelid
बहिरायामनं- opisthotonas
जिह्वादंशोऽन्त:– biting of tongue
कण्ठकूजनं- hoarseness of voice and laryngeal spasm
धावनं- hyperactivity
विट्सगन्धत्वम्– smell of faeces
क्रोशनं श्ववच्छुनि- barking voice
This graha is correlated with the whooping cough and tetanus which are having the following features.
 Mild cough
 Sneezing
 Runny nose
 Low fever
 Spasm of jaw muscles
 Difficult to swallow
 Stiffness of abdominal muscle
 Sweating seizures

6.Pitrigraham-


रोमहर्ष– horripilation
मुहुस्त्रास:- tics
सहसा रोदनं- frequent cry
ज्वर- fever
कास– cough
अतिसार– diarrhoea
वमथु– vomiting
जृम्भा- excessive yawning
तृट्– excessive thirst
शवगन्धता– smell of cadaver
अंङ्गेष्वाक्षेपविक्षेप– convulsion
शोष– emaciation
स्तम्भ– stiffness or hypertonicity of muscles
विवर्णता– cyanosis or pallor
मुष्टिबन्ध: स्रुतिश्चाक्ष्णोर्बालस्य– pain or severe discomfort
This graha is correlated with cholera. Cholera is having the symptoms given below:
• Rapid heart rate
• Loss of skin elasticity
• Dry mucous membrane
• Low BP
• Thirst

7.Putana graha-

स्रस्ताङ्गः स्वपिति सुखं दिवा न रात्रौ विड् भिन्नं सृजति च काकतुल्यगन्धि:।।
छर्द्याऽऽर्तो हृषिततनूरूह: कुमारस्तृष्णालुर्भवति च पूतनागृहीत: ।।
-सु. उ. २७/१२

Child has weak body, does not sleep well either during day or night, eliminates loose faeces, body emits smell similar to a crow, suffers from vomiting, has horripilations (often) and profound thirst always are the features of seizure by putana graha.
कम्प– convulsion
तन्द्रा– drowsiness
हिध्म– hiccup
आध्मान– abdominal distention
शकृद्भेद– diarrhoea
पिपासा– excessive thirst
मूत्रनिग्रह– anurea
स्रस्तह्रष्टाङ्गरोमत्वम्– loss of muscle tone
Putana graha is correlated with the epidemic diarrhoea. The features are:
• Hyponatremic dehydration due to plain water intake
• CNS irritability causing sleeplessness
• Seizures
• Dizziness and cerebral edema

8.Shita putana-


उद्विग्रो भृशमतिवेपते प्ररुद्यात् संलीन: स्वपिति च यस्य चान्त्रकूज:।।
विस्त्राङ्गो भृशमतिसार्यते च यस्तं जानीयाद्भिषगिह शीतपूतनार्तम् ।।
-सु.उ.२७/१४

Child is highly irritable ( emotional, restless), shivers much , cries greatly, huddles inside of the bed while sleeping, has gurgling noise in the intestine, body emits foul smell and has severe diarrhoea ; with these features, the physician is to understood that the child as seized by Shita putana.
कम्प– convulsion
रोदनं– excessive cry
तिर्यगीक्षणम्– deviation of eyeball/ anxious look
तृष्णा– excessive thirst
अन्त्रकूजन– increased bowel sound
अतिसार– diarrhoea
वसावद्विस्रगन्धता– smell of fat
पार्श्वस्यैकस्य शीतत्वमुष्णत्वमपरस्य– rise/loss of temperature on one side
Shita putana is a graha roga which can be correlated with the choleric diarrhoea. Choleric diarrhoea has the following symptoms-
• Loose watery stools
• Abdominal cramps
• Fever
• Bloody stool
• Bloating
• Occurs in usually summer season


9.Andhaputana graha-

यो द्वेष्टि स्तनमतिसारकासहिक्काच्छर्दीभिर्ज्वरसहिताभिरर्द्यमान: ।।
दुर्वर्ण: सततमध:शयोऽम्लगन्धिस्तं ब्रूयुर्भिषज: इहान्धपूतनार्तम् ।।
-सु. उ.२७/१३

Child has aversion to breast milk, suffers from diarrhoea, hiccup, vomiting and fever, bad(abnormal) colour in the body, lies with its face down and emits sour smell; the physician say that such a child is seized by Andha putana graha.
कास- cough
अल्पनिद्रता- reduced sleep
दृष्टेसादातिरुक्- dimness of vision, pain in eye
कण्डूपोथकीजन्मशूनता- boils and inflammation over eyes
स्वरतीक्ष्णता– severe shrilled cry
The above features may be seen in multiple infectious diseases involving respiratory system, gastro intestinal tract and eye. These are also seen in bacillary dysentery.
• Watery diarrhea contains mucous & blood
• Loss of appetite
• Adominal pain, body ache
• Nausea & Vomiting
• Fever & rapid dehydration and weight loss


10.Mukha mandika graha-

म्लानाङ्ग: सुरुचिरपाणिपादवक्त्रो बह्वाशी कलुषसिरावृतोदरो य:।। सोद्वेगो भवति च मूत्रतुल्यगन्धि: स‌ ज्ञेय: शिशुरिह वक्रमण्डिकार्त:।।
– सु. उ. २७/१५

Body parts debilitated, hands, feets and face appear brilliant, consumes more food, abdomen has ugly network of veins, is irritable, emits smell of urine, the child with these features should be understood as seized by Mukhamandika graha.
पाणिपादास्यरमणीयता– hands, feets and face with poor appearance
सिराभिरसिताभाभिराचितोदरता– prominent veins on the abdomen
ज्वर– fever
अरोचको– loss of appetite
अङ्गगग्लपनं– weakness/ debility
गोमूत्रसमगन्धता– smell of gomutra


11.Revati graha-


रक्तास्यो हरितमलोऽतिपाण्डुदेहः श्यावो वा ज्वरमुखपाकवेदनार्त: ।।
रेवत्या व्यथिततनुश्च कर्णनासं मृद्गाति ध्रुवमभिपीडित: कुमार: ।।
– सु.उ.२७/११
Child which has reddish face, green coloured faeces, body either yellowish- white or blue in colour, suffering from fever and ulcers of the mouth, suffers much, rubs its ears and nose often ; are the features when seized by Revati graha.
श्यावनीलत्वम्– cyanosis
कर्णनासाक्षिमर्दनम्– rubbing of eyes, ears and nose
कासहिध्म– cough, hiccup
अक्षिविक्षेप– blinking of eyes
वक्र वक्त्रत्वरक्तता– deviation of mouth to one side
बस्तगन्धो– smell of goat
ज्वर– fever
शोष– emaciation
पुरीषं हरितं द्रवम्– stool of greenish colour
This graha can be correlated with the pernicious anaemia which is having following features.
 Desire to eat non food things (pica)
 Diarrhea / constipation
 Fatigue
 Pale skin
 Swollen,
 Red tongue
 Loss of appetite

12.Sushka revati graha-


जायते शुष्करेवत्यां क्रमात् सर्वङ्गसंक्षय:।
-अ.हृ.उ.३/२९

Emaciation is the characteristic feature in this graha. The failure to thrive can also be correlated to this clinical condition.
This disease can be correlated to Marasmus.

GENERAL TREATMENT PRINCIPLES:


हन्तुकामं जयेद्धोमै: सिद्धमन्त्रप्रवर्तितै:।
इतरौ तु यथाकामं रतिबल्यादिदानत:।।
-अ.सं.उ.३/२८

Grahas aiming for seizing child for himsa can be treated by siddha mantra while performing hawan or yajna. Grahas which results in rati or archana, should be treated by rati or archana of their choice.
• Daivavyaparya was also done along with medical treatment. This include fumigation, prayers, worship, oblation, japa, (harsha charita262-263).
• Usage of bali, homa, Havana as a shanti karmafor graha (SU.SU 1/12)
• Karanja, dasanga sarshapa, vacha, ballataka, ajmoda & ghee – for Dhupana (AH, u 3/48)
• LEPA – guggulu, ela, Manashila, hartala, manjistha, rasna, devadaru, harenu, chandana
• SNANA – vatahara patra kwath
• ABHYANGA – oil processed with kantakari, punarnava, renuka, pippali, vacha, saral, sarpagandha, devadaru
• RAKSHASUTRA – somavalli, indravalli, shami, vilva
• BALI – red mala, red cloth, mani, tila, dadhi, ghuta, mamsa, fish

BIBLIOGRAPHY-


1.Kaumarbhritya, A comperative approach to child health care & treatment by Devendranath Mishra, published by Chaukhamba Sanskrit Pratisthan
2.Illustrated Sushruta Samhita, vol 3, translator Prof. K. R. Srikantha Murthy, published by Chaukhaba orientalia.
3.Kaumarbhritya, updated notes on kaumarbhritya based on BAMS syllabus,written by Dr. Dinesh K.S.


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