E-ISSN:2456-3110

Review Article

Vataja Bhadirya

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

Conceptual study on Vataja Bhadirya w.s.r. to Presbycusis

Bhat BV1*, Moharana PK2
DOI:10.21760/jaims.10.3.43

1* Bhavana Vinayak Bhat, Assistant Professor, Dept of Shalakya Tantra, Sanjeevini Ayurveda Medical College and Hospital, Hubli, Karnataka, India.

2 Pradeep Kumar Moharana, Professor and HOD, Dept of Kayachikitsa, Shri Jayendra Saraswati Ayurveda Medical College and Hospital, Nazarathpet, Chennai, Tamil Nadu, India.

Shalakya Tantra is also known as Jatrurdhva Tantra a branch of Ayurveda which deals with the diseases manifesting above clavicular region. Aacharya Susrutha is the only person who explained Ophthalmology and ENT in a systematic manner in Uttara Tantra portion of his Sushruta Samhita. According to Ayurveda, Shrotrendriya originates from Akasha Mahabhoota. Shabda (sound) travelling through Vata in the presence of Aakasha (space) comes in contact with Shrotrendriya Adhishthana (Karna) and transmitted through Shrotrendriya to the Shravana Buddhi which is responsible for perception of sound. So, Vata plays important role in normal hearing procedure. The detailed description about the disease Badhirya is available in Brihatrayees and Laghutrayees of Ayurvedic classics. Badhirya is caused due to the vitiated Vata Dosha or Vatakapha Doshas by deranging or obstructing the Shabdavahasrotas (pathway of hearing) or Shabdavaha Sira (auditory nerve) gives rise to diminished hearing or incapability of hearing. Vataja Bhadirya can be nearly corelated to the concept of Sensorineural Hearing loss of alternative science where the age group of 60 years plus will be named with the deafness condition called Presbycusis. As the Vardhyakya stage in Ayurveda will be dominated with Vatadosha the Vata Vikriti Lakshanas are more in that age group with this reference we can consider Vataja Bhadirya Lakshanas are similar to the sign and symptoms of Presbycusis.

Keywords: Bhadirya, Vata Dosha, Presbycusis

Corresponding Author How to Cite this Article To Browse
Bhavana Vinayak Bhat, Assistant Professor, Dept of Shalakya Tantra, Sanjeevini Ayurveda Medical College and Hospital, Hubli, Karnataka, India.
Email: 		Bhat BV, Moharana PK, Conceptual study on Vataja Bhadirya w.s.r. to Presbycusis. J Ayu Int Med Sci. 2025;10(3):281-288.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-18 2025-02-27 2025-03-07 2025-03-17 2025-03-27
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© 2025 by Bhat BV, Moharana PK and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(3)281
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Bhavana VB et al. Conceptual study on Vataja Bhadirya

Introduction

Acharya Charak has subdivided the Karna rogas into four groups based on the predominance of Dosha - Vataja, Pittaja, Kaphaja and sannipatajakarnarogas. On the basis of Doshas, Badhirya is one of the symptoms of Vataja Karna Rogas. This condition is mainly characterized by Srotorodha due to predominance of Vata or Vata Kapha Dosha.

इन्द्रियाणि समाश्रित्य प्रकुप्यन्ति यदा मलाः|
उपघातोपतापाभ्यां योजयन्तीन्द्रियाणि ते||२०||
उपघातेत्यादौ उपघातो विनाशः, उपतापस्तु किञ्चिद्वैकल्यम्||२०||

Badhirya refers to the Ayurvedic term for hearing impairment, characterized as an obstruction ('Badha').

In Ayurveda, it is associated with the imbalance of Doshas, particularly Vata and Kapha. This term highlights the traditional understanding of hearing loss and its relevant treatment methods in the Ayurvedic framework.

Acharya Charaka has mentioned Badhirya under Vatajananatmaja Vyadhi. In Charaka Samhita where Acharya Charaka, Vataroga does not linger in Kostha that has been softened by Snehana.

Sabdavahasrotas (auditory canal) or Sabdavahasira (vessels) and nerves of the ear get obstructed or deranged by Prakupita Vatadosa or Vata Kapha Dosas and neglecting the disease Karnanada leads to difficulty in hearing or incapability of hearing, known as Badhirya.

Aim and Objectives

1. Conceptual study of Vataja Bhadirya
2. Conceptual study of Presbycusis
3. Conceptual study of both Vataja Bhadiryas.r. to Presbycusis

Understanding of Vataja Bhadirya

The detailed description about the disease Badhirya is available in Brihatrayees and Laghutrayees of Ayurvedic classics. Badhirya is caused due to the vitiated Vata Dosha or Vatakapha Doshas by deranging or obstructing the Shabdavahasrotas (pathway of hearing) or Shabdavaha Sira (auditory nerve) gives rise to diminished hearing or incapability of hearing.[1,2] Aacharya Sushruta has mentioned 28 types of Karna-Roga in Uttar Tantra and Badhirya is one among them.

Aacharya Sushruta has mentioned Badhirya is one of the Karna Roga which is vitiated by Vata Dosha along with Kapha resides in Shabdanuvaha Sira and in the absence of appropriate treatment the person will suffer from Badhirya without any doubts.[3,4] Acharya Dalhana comment on this Samprapti that not only Vata Dosha but also Rakta, Pitta and Kapha Doshas also reside in Shabdanuvaha Sira causing Badhirya.[5-7]

Sushrutha Samhita Uttara Tantra 20th chapter, 8th Shloka says[8]

स एव शब्दानुवहा यदा सिराः कफानुयातो व्यनुसृत्य तिष्ठति |
तदा नरस्याप्रतिकारसेविनो भवेत्तु बाधिर्यमसंशयं खलु ||८||
बाधिर्यमाह - स एव शब्दानुवहा इत्यादि| स एव शुद्धो वायुः कफानुयातः कफानुगतः| स एवेत्यत्रापिशब्दो लुप्तो द्रष्टव्यः, तेन न केवलं शुद्धो वायुः श्लेष्मान्वितोऽपि वेत्यर्थः| व्यनुसृत्य विविधमार्गमावृत्य| अप्रतिकारसेविनः चिकित्सामकुर्वतः||८||

In Nidanasthana, of Susruta Samhita it has mentioned that vitiated Kevala Vata or Kapha Anubandhavata initiates the pathology of Badhirya by obstructing the Sabdavaha Srotas.[9] Whereas, in Uttartantra, Acaryasusruta has mentioned that Kapha accompanies Vata throughout the Samprapti of Badhirya.[4] The Suddha or Kevala Vata accompanied by Kapha initiates the pathology of Badhirya which can be understood in the following way. Due to various etiological factors, vitiation of Vata and Kapha occur, Vata is being covered, hindered, or obstructed by Kapha. Because of the obstruction in the movement of Vata, its activities hamper or decreases, which results into improper conduction of sound (Sabda Grahana). According to Aacharya Vagbhatta, Vata associated with Kapha and getting increased or by neglect of Karnanada, gives rise to hearing of loud sounds only, hearing with difficulty and gradually leads to deafness.[10]

उच्चैर्वृच्छात् श्रुतिं कुर्यात् बधिरत्वं च ।।" (अ.हृ.उ.१७)

An individual who can’t listen the loud sound eventually suffers from Badhirya.

Astanga Hrudaya Uttara sthana 17th chapter 10th Shloka[11]

श्लेष्मणाऽनुगतो वायुर्नादो वा समुपेक्षितः|
उच्चैः कृच्छ्राच्छ्रुतिं कुर्याद्बधिरत्वं क्रमेण च||१०||
स०-वायुः श्लेष्मणाऽनुगतः कर्णनादो वा समुपेक्षितः-अचिकित्सितः, कर्णे-श्रोत्रे, उच्चैः कृच्छ्राच्छ्रुतिं-श्रवणं, कुI

Acarya Vagbhata also explains the same Samprapti for Badhirya.


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He mentions that if Karnanada is left untreated it may leads to excess Dusti of Sthanikavatadosa and results in complete loss of its function i.e., Sabda-Grahana, which leads to Badhirya.

र्यात्| क्रमेण बधिरत्वं-बाधिर्यं च, कुर्यात्|[12]

In the other reference of Puranas and Maha Kavyas like in Mahabharata the word meaning of Bhadirya is mentioned like this.

Badhirya (बाधिर्य).> - Deafness; बाधिर्यंप्राणमन्दत्वंयःपश्यतिसमुच्यते Mahabharata in 12.288.4.[13]

Badhirya (बाधिर्य) in the Sanskrit language is related to the Prakrit word: Bahijja.[14]

Madhavakara while explaining the Samprapti of Badhirya says that Badhirya is caused when Sabdavahisrotas is vitiated by Vata or by both Vata and Kapha, hence it can be divided into two types - Vataja and Vata-Kaphaja.[15] Bhavamisra also mentions that Badhirya is caused either solely by Vata or by the association of Vata and Kapha.[16] Whereas in view of Yogratnakara it occurs due to vitiated Vata which results in the destruction of Shrotrendiyas thereby producing their functional loss.[17]

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Figure 1

Presbycusis

Presbycusis refers to bilateral age-related hearing loss. In literal terms, presbycusis means 'old hearing' or 'elder hearing. It is the most common cause of hearing loss worldwide and is estimated to affect approximately two-thirds of Americans aged 70 or older. The hallmark of presbycusis is the impaired ability to understand high-frequency components of speech (voiceless consonants, such as p, k, f, s, and ch). This activity reviews the evaluation and management of presbycusis and highlights the role of the interprofessional team in improving care for patients with this condition.

Presbycusis refers to bilateral age-related hearing loss. In literal terms, presbycusis means "old hearing" or "elder hearing."[18] It becomes noticeable around age 60 and progresses slowly; however, there is evidence that certain stressors can speed the rate of deterioration. The diagnosis can be confirmed with audiometry.[19]

The hallmark of presbycusis is the impaired ability to understand high-frequency components of speech (voiceless consonants, such as p, k, f, s, and ch).[19] There is no cure; however, hearing aids that amplify sounds can be used to mitigate symptoms. Anatomically, presbycusis involves multiple components of the auditory system. It is primarily due to age-related changes in hair cells, the stria vascularis, and afferent spiral ganglion neurons.[20]

jaims_4162_03.jpg
Figure 2

During the normal hearing, sound, in the form of air vibration, is captured by the funnel-shaped external ear and is directed to the tympanic membrane. This causes the tympanic membrane to vibrate at a specific frequency and amplitude. This movement is amplified by three small bones in the middle ear: the malleus, incus, and stapes. From there, the signal proceeds as vibrations that are transmitted through the fluid within the inner ear to the cochlea.


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In the cochlea, receptors known as hair cells transform the information encoded in the vibrations into a neurologic signal which travels to the auditory cortex via the cochlear nerve.[20]

Age-related hearing impairment (ARHI), also referred to as presbycusis, is the most common sensory impairment seen in the elderly. As our cochlea, the peripheral organ of hearing, ages, we tend to experience a decline in hearing and are at greater risk of cochlear sensory-neural cell degeneration and exacerbated age-related hearing impairments, e.g., gradual hearing loss, deterioration in speech comprehension (especially in noisy environments), difficulty in the localization sound sources, and ringing sensations in the ears. However, the aging process does not affect people uniformly; nor, in fact, does the aging process appear to be uniform even within an individual. Here, we outline recent research into chronological cochlear age in healthy people, and exacerbated hearing impairments during aging due to both extrinsic factors including noise and ototoxic medication, and intrinsic factors such as genetic predisposition, epigenetic factors, and aging. We review our current understanding of molecular pathways mediating ARHL and discuss recent discoveries in experimental hearing restoration and future prospects.

jaims_4162_04.jpg
Figure 3

Aging is a progressive decline or loss of tissue and organ function over time due to the gradual accumulation of deleterious biological changes. The aging process has three distinct components: biological degeneration, extrinsic damage, and intrinsic damage. These factors are superimposed on a genetic substrate and can be overshadowed by the general age-related susceptibility to diseases. Age-related diseases are those that are observed with increasing frequency with increasing age, such as atherosclerosis, cardiovascular disease, cancer,

arthritis, cataracts, Alzheimer’s disease, presbyopia, and presbycusis. Whereas all adult humans or animals become old, not all suffer from age-related diseases. Age-related diseases can be conceptualized as accelerated aging resulting from the genetic background interacting throughout life with environmental and lifestyle factors.

Presbycusis, or age-related hearing loss (ARHL), is the loss of hearing that gradually occurs in most people as they grow older. According to the World Health Organization,[20] approximately one third of people over 65 years of age are affected by disabling hearing loss. In 2025, there will be 1.2 billion people over 60 years of age worldwide, with more than 500 million individuals who will suffer significant impairment from presbycusis.[20] ARHL is a progressive, irreversible, and symmetrical bilateral neuro-sensory hearing loss resulting either from degeneration of the cochlea, where sound-induced vibrations are encoded by sensory hair cells into electrical signals in cochlear neurons that relay the information to the brain (Figure 1), or loss of auditory nerve fibers during cochlear aging. Hearing loss begins in the high-frequency region of the auditory spectrum and spreads towards the low-frequency regions with age (Figure 2). The age-dependent deterioration in threshold sensitivity is generally associated with difficulty in speech discrimination, as well as in sound detection and localization, particularly in noise. Males are generally more severely affected than females (Figure 2). Untreated presbycusis can contribute to social isolation, depression, and dementia.[20]

jaims_4162_05.jpg
Figure 4

Epidemiologic studies in large populations of unscreened elderly adults show that the decline in hearing sensitivity accelerates above the age of 20 to 30 in men, and above age 50 in women.[21]


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The average hearing thresholds of men exhibited a sharply rise of hearing loss in the high frequency range, whereas women’s audiograms display a more gradual sloping.[22] Interestingly, a high proportion of participants reported exposure to noise, otologic disease, and ototoxicity,[23] suggesting that the source of the hearing impairment among unscreened populations is not exclusively associated with aging.

Based on temporal bone analyses correlating the patterns of hearing loss with defect location, Schuknecht[24] proposed three major forms of ARHL: (i) sensory presbycusis characterized by an abrupt pure-tone threshold elevation in the high frequencies and hair-cell loss at the basal end of the cochlea; (ii) strial presbycusis found in patients with a flat- or slightly descending pure-tone audiogram, correlated with atrophy of the stria vascularis; and (iii) neural presbycusis, characterized by a loss of cochlear neurons throughout the entire cochlea. The precise mechanisms underlying the age-related degeneration of the different cochlear structures remain unclear.[25] This is in part due to the complexity of each causal factor, but more importantly to the interaction of the different mechanistic pathways that can cause age-related hearing loss. Sensory hair cells are susceptible to an accumulation of injuries inflicted over time from a number of different sources, including direct mechanical, mitochondrial oxidative injury from noise, ototoxic drugs such as aminoglycosides, cisplatin, or other unknown factors.[26] The degeneration of spiral ganglion neurons (sgns) may be triggered by the accumulation of multitudinous noise-induced loss of afferent dendrites.[28,27] Interestingly, most vulnerable cochlear neurons, to both noise and aging, are those with high thresholds and low spontaneous rates. Although these low-spontaneous rate (SR) fibers do not contribute to threshold detection in quiet situations, they contribute to coding of transient stimuli in presence of continuous background noise,[29] leading to new concept called hidden hearing loss. Therefore, tone in noise detection may be a useful measure in detecting age-related hearing deficits for those patients who express difficulty, but have relatively normal thresholds in quiet.[30] This review recapitulates our current understanding of biological cochlear aging on hearing, extrinsic and intrinsic risk factors that exacerbate age-related hearing function decline in animal models and in humans,

the molecular pathways mediating cochlear cell senescence and degeneration as a consequence of aging, injury (noise, ototoxic drugs), and genetic predisposition. We discuss also the recent discoveries in experimental hearing restoration.

1. Major Causal Factors of Age-Related Hearing Loss

The clinical presentation of presbycusis, the rate of the progression, age at onset, and ultimate severity of hearing loss varies from patient to patient. Whereas the majority of elderly patients present clear hearing losses, a significant fraction of the geriatric population has almost normal hearing. This is due to intrinsic (genetic predisposition, epigenetic factors, and aging), and extrinsic factors (e.g., noise- or ototoxic drug-exposure, head trauma, cigarette smoking) that are either the sole etiology for hearing loss, or several work in synergy with the physiopathology of presbycusis.[31]

1.1. Biological Aging on Hearing
1.1.1. Aging and Hearing in Healthy People

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Figure 5

The clinical diagnosis of presbycusis is based on bilateral progressive loss of hearing starting from a high-frequency region of the hearing spectrum. Loss of hearing can begin in young adulthood, but is initially evident at 60 years for most people (Figure 2). Over time, the threshold elevation progresses to lower and lower frequency areas. However, presbycusis studies in humans are limited by the genetic heterogeneity and the difficulty in controlling deleterious auditory exposures over time. Despite these limitations, it has been reported that in a cohort unscreened for noise exposure, ototoxic drug exposure, and otologic disease history, presbycusis develops earlier and to a greater extent than in a highly screened cohort (without history of significant noise exposure or diseases that affect the ear).[32]


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It has been suggested that the onset of hearing loss induced by biological aging is very late. Indeed, the Mabaan tribe living in the Sudanese desert retains their hearing into old age.[33]. Because the hearing of the young Mabaans was the same as those of young people from other countries, the good preservation of hearing in the tribe has been attributed to their quiet living environment and generally healthy condition.[34]

However, it can be argued that this difference might be caused by genetic differences between the populations. To answer this question, Goycoolea et al.[35] compared the hearing of natives of Easter Island, people living in a pre-industrial society, with those who had emigrated to Chile and spent varying amounts of time in modern society. Results showed that hearing in males that had lived or were living in Chile was significantly worse than that of males who had lived their entire lives on Easter Island, and that the poorer hearing was related to the number of years lived in modern society. Contrary to these early investigations, more recent studies showed that hearing thresholds decline with age and the rate of decline accelerates with age in presbycusis patients without noise-exposure or diseases that may affect the ear.[36]

In addition, the differences of hearing thresholds between presbycusis patients with or without noise exposure are limited.[37] These results thus supported the belief that age is one of the major causal factors of ARHL.

Conclusion

Based on the above conceptual study the Lakshanas of Vataja Bhadirya and signs and symptoms of Presbycusis are similar with the interpretation. As the Vata predominant Vyadhis are more common in old age the hearing capacity disorders will be developed commonly in such age groups the proper understanding is required with these type of conceptual studies.

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