NIDANA
• Kshaara – excessive consumption of alkalis
• Amla – excessive consumption of sour things
• Lavana – excessive consumption of salt or salty stuff
• Ati ushna – excessive consumption of hot substances / foods
• Viruddha ahara – mutually incompatible foods
• Asaatmya aahara – incompatible foods
• Nishpaava – Flat bean
• Maasha – black grams
• Pinyaka – paste of sesame
• Tila taila – sesame oil
• Vidagdha anna – corrosive foods
• Diwa swapna – sleeping during day time
• Vyaayaam – excessive physical exercise
• Maithuna – excessive indulgence in sex
• Pratikarma – doing any activities out of proportions
• Rutu vaishamya – seasonal incompatibility
• Vega dhaaranam – forcible suppression of natural body urges / reflexes
• Kaama – keeping attached to things
• Chinta upahata cheatas – mind afflicted by worries
• Bhaya upahata cheatas – mind afflicted by fear, panic,
• Krodha upahata cheatas – mind afflicted by anger
• Shoka upahata cheatas – mind afflicted by grief
Due to the above said factors, the pitta located in the Hrudaya (Sadhaka) gets vitiated.
This pitt which has got aggravated is thrown into the circulation through the
10 dhamanis (main arteries) by the vitiated vata. This pitta being propelled by
vata reaches all the corners of the body. It finally gets lodged between skin and
muscles and further contaminates kapha, vata, rakta (blood), twacha (skin) and
mamsa (muscles). The pitta imparts turmeric, pale (earthen) and green colours
on the skin and causes pandu roga.
The above said aetiological factors are those which cause vitiation of pitta,
which leads to the manifestation of inflammation in all parts of the body
which come into contact with the vitiated pitta in circulation. The immunity
deteriorates henceforth and causes autoimmune response. Since these
causes afflicts the liver mainly and damage it, the inflammatory process
first begins in the liver causing autoimmune hepatitis. Thus it can be said
that the causes and pathogenesis of pandu roga and the symptoms
(mentioned ahead) point towards autoimmune hepatitis or an autoimmune
inflammatory process taking place in the liver, anaemia and jaundice being
the chief by-products and chief manifestations of this process.
LAKSHANA ACCORDING TYPES (5 TYPES)
1. Vatika Pandu Nidana, lakshana
Vata gets vitiated by the Vayu- aggravating diet and regimen which brings about
Krshnapanduanga – black and pale-yellow complexion,
Rukshaanga – dryness,
Arunaanga – reddish discolouration of the body,
Angamarda – malaise
Ruja – ache
Toda – pricking pain
Kampa – tremor
Parshavruja – pain in the sides of the chest,
Shiroruja – headache
VarchaShosha – dryness of feces
MukhaVairasya – distaste in the mouth,
Shopha – swelling,
Anaha – constipation and
Balakshaya – Weakness [17-18]
2. Pittaja pandu Nidana, Lakshana
If a person of Pitta body type indulges in Pitta increasing diet and regime, then increased Pitta vitiates blood and causes Pittala type of Pandu roga giving rise to below signs and symptoms:
1. PeetaHarita Varna – complexion becomes yellow or green
2. JwaraDahaSamanvitah – fever and burning sensation
3. TrushnaMurcchaPipasa – Faints, because of excessive thirst and suffers from morbid thirst
4. Pita mutra – His urine and stool becomes yellow in colour
5. SvedanahSheetakamita – Sweating and develops longing for cold things
6. Annam Abhinandati – He does not relish food
7. KatukaAasya – Feeling pungent taste in mouth and
8. UshnaUpasheteAmlameva cha – hot and sour things do not suit him
9. Amlaudgara – sour eructation and
10. VidahaVidagdhe Anne – burning sensation due to indigestion of food
11. MukhaDaurgandhya – bad breath and
12. Bhinnavarchas, Daurbalyam, tama eva cha – He gets loose motions, weakness and fainting. [19-22]
3. Kaphaja Pandu Nidana, Lakshana:
Kapha vitiated by its aggravating food and drinks gives rise to Kaphaja type as per the pathogenesis described before.
The signs and symptoms of this type of Pandu are as follows:
1. Gauravam – Heaviness,
2. Tandra – Drowsiness,
3. Chardim – Vomiting,
4. Shvetavabhasa – whitish complexion,
5. Prasekam – Salivation,
6. Loma harsha – Horripilation,
7. Murchha- fainting,
8. Bhrama – Giddiness,
9. Klama – mental fatigue,
10. Shvasa – dyspnoea,
11. Kasa – cough,
12. Aalasya – laziness,
13. Aruchi – anorexia,
14. Vakshasavara graham – obstruction in speech and voice,
15. Shukla akshivarchas – whitish discolouration of urine, eyes and faces
16. Katurukshaushnakamata – Longing for pungent, unctuous and things and
17. Shwathu – Oedema and
18. Madhuraaasya – sweet taste in the mouth. [23-25]
4. Tridoshaja Pandu
Etiology, Signs and Symptoms of Tridoshaja Pandu Roga:
If a person indulges in all types of unwholesome food, then all the 3 Doshas get vitiated to cause Tridoshaja Pandu. This type of Sannipatika Pandu is extremely intolerable (difficult of cure). [26]
5. Mrudbhakshanajanya Pandu
Mrud-bhakshanaja Pandu Nidana, Lakshana:
Habitual indulgence in eating clay (Mrttika) aggravates one of the 3 Doshas.
If the mud is of astringent taste, then it aggravates Vayu: if it is saline with alkaline as subsidiary taste, then Pitta gets aggravated: and if it is sweet in taste, then Kapha gets aggravated.
Because of its dryness, the clay (Mrut) causes dryness in the Rasa Dhatu (Chyle) and the ingredients of food. Thus, the undigested clay, i.e in its crude form, fills up the channels of circulation and blocks them. It afflicts the sharpness of senses, lustre, energy and Ojas which results in the loss of strength, complexion and Agni (power of digestion and metabolism).
In this type of Pandu, the signs and symptoms manifested are as follows:
1. Shunagandaakshikuta – Oedema in the cheek, eye sockets and eye bones
2. Oedema in feet, umbilical region and the pudendum
3. Krimikoshta – Appearance of worms in Kostha (intestine) and
4. Atisara – Loose motions, the stool being associated with blood and mucus (Kapha).[27-30]
PURVA ROOPA
Hrudayaspandana – palpitation
Raukshyam – dryness
Swedaabhava – absence of sweating and
Shrama –fatigue
SYMPTOMS
Any of the varieties of Pandu Roga leads to below listed general symptoms.
Karna Kshveda – tinnitus
Hataanala – suppression of the power of digestion
Durbala – weakness
Sadana – prostration
Anna divshta – repugnance against food
Shrama – fatigue
Bhrama – giddiness
Gatrashoola – pain in the body
Jwara – fever
Shwasa – dyspnoea
Gaurava – heaviness and
Aruchi – anorexia
Mruditagatra – He feels as if all the limbs of his body are being kneaded,
squeezed and churned.
Shunakshikoota – He suffers from swelling of the orbital region
Haritasheerna – His complexion becomes green.
Loma hataprabha – The small hair of his body fall out: he loses his bodily lustre:
Kopana – he becomes irritable: he avoids speaking:
Pindikodveshtana – he suffers from cramps in the calf region: and while making
efforts for climbing,
Kati urapadaruksadana – he suffers from pain and weakness in the lumber region, tights and feet.
Sadhyaa sadhyata-
Signs of bad prognosis in Pandu –
After some time if not treated properly, the Kamala [Jaundice] try it now!
becomes deep-seated (Kharibhuta – roughened, hardened) and thus, becomes difficult of cure. This condition is called Kumbha-Kamala (a type of Jaundice). try it now!
• Chirotpanna Pandu – chronic pandu
• Kharibhuta – deep rooted disease which has caused extreme dryness of all the tissues of the body
• Shuna, peetani pashyati – swelling all over the body due to chronicity and the patient sees everything around him or her yellow
• Baddha vit – constipation
• Alpa vit – less faeces
• Sakapha vit – stools with phlegm
• Harita atisara – diarrhoea with green coloured stools
• Shwetatwa – whiteness of the body due to excessive blood loss
• Signs and symptoms indicating incurability of Panduroga are as follows
1. The disease becomes chronic
2. Excessive dryness has appeared in the patient
3. When the patient has oedema owing to chronicness of this diseases
4. When the patient gets yellow vision
5. When the patient is fully or partially constipated
6. When the patient passes loose stool which is green in colour and which is mixed with mucus
7. When the patient feels exceeding prostrated
8. When the body is exceedingly white as if besmeared ( with whiteness)
9. When the patient is exceedingly afflicted with vomiting fainting and morbid thirst and
10. When the body of the patient becomes pale on account of loss of blood. Such a patient never survives
Thus, the signs and symptoms of all 5 types of Pandu Roga (Vatika, Pittaja, Kaphaja, Sannipatika and Mrd-Bhaksanaja) are discussed. [31-33]
SAMPRAPTI GHATAKA
DOSHA- pitta pradhan tridosha prakopa
DUSHYA- rasa, rakta tvaka & mamsa
ADHISTHANA- sarva sariragata tvak
SHROTAS- rasavaha & raktavaha
SVABHAVA- chirkari
AGNIDUSTI- dhatvagni mandhya
SADHYAASADHYATA- sadhya/ kricchasadhya
SAMPRAPTI
NIDANA SEVANA -> PITTAPRADHAN TRIDOSHA PRAKOPA -> TVAK & MAMASA MADHYE STHAN SANCHAYA -> KAPHA, VATA, RAKTA, MAMSA DUSHITA( RAKTAALPATA) -> TVAK PANDU VARNATA -> PANDU ROGA
TREATMENT
General treatment as indicated in Sannipata jvara. to bring down the temperature should be adopted.
The patient should be kept in perfect rest in bed with least movement and exertion. 'Shadanga paniya' is recommended to releive thirst, burning sensation. Suitable antibiotics should be used in consultation with modern doctor.
Ayurvedic drugs Godanti mishran is good antipyretic, and makharadwaja 125 mg daily with honey or juice of betel leaf, found to be useful as a rejunative. The main treatment is to maintain the strength and vitality of the patient.
Paratyphoid The signs and symptoms in para typhoid are milder than that of Typhoid. The condition are not so acute. Treatment is also the same as that of typhoid.
PRICIPAL OF CHIKITSA
Line of Treatment:
Now the treatment for curable patients of Pandu Roga and Kamala (Jaundice) are being described.
The patient suffering from Pandu Roga is given –
Vamana – emetic therapy and
Virechana – Purgation therapies with Snigdha – unctuous and Teekshna – sharp drugs for the cleansing of his body.
The patient suffering from Kamala (jaundice) is given Virechana – purgation therapy with mild and bitter medicines.
After the gastro-intestinal tract is cleansed by the above mentioned elimination therapies, patient is given wholesome food containing old rice, barley and wheat mixed with the Yusha (vegetable soup) of Mudga (green gram), Adhaki (pigeon pea) and Masura (lentil) and the JangalaMamsarasa (meat soup) of animals inhabiting arid zone.
On the basis of Doshas aggravated to cause these diseases, specific medicines are to be administered to these 2 categories of patients (which will be described later in this chapter)
For the purpose oleation, the patient suffering from Pandu Roga (Anemia) and Kamala (Jaundice) is given
PanchagavyaGrutha,
Maha-TiktaGhruta and
Kalyanaka- Ghruta. [39 ½ -43]
Classical medicines and home remedies for Pandu
• Loha Bhasma (ash of iron) – with honey and ghee
• Shunti churna (ginger powder) with Loha Bhasma
• Loha bhasma with Gomutra (urine of cow)
• Powders of Ela (cardamom), Jeeraka (cumin seeds), Bhumyamalaki (Phyllanthus niruri) and Sita (sugar) – taken in equal quantities and mixed with ghee should be taken early in the morning
• Haridra churnam (turmeric powder) with curds early in the morning
1. YOG
A. Gomutra 50ml + Triphala kvatha 50ml (2 times )
B. Purana guda -10gm + Mandur bhasma -10gm + Kala tila-10gm +
Pippali- 20gm (curna 1gm 2 times 21 days) ******
2. RASA AUSHADHI
A. Navayas loha-250mg + Sothari loha-250mg + Giloy stva-250mg +
Muktapraval panchmrut-60mg ( 2 times with madhu )
B. Svarnmakshik bhsma-250mg + Tapyadi loha-250mg + Ghatri loha-250mg +
Giloy satva-250mg ( 2-3 times with madhu )
3. KVATHA
A. Phalatrikadi kvatha
B. Punarnavadi kvatha
4. ASHAV
A. Lohasava
B. Kumaryasava
C. Drakshasava
D. Drakshavaleha
E. Chayavanprasha
5. Amalki rasayana ( 5gm 2 times with milk )
6. Arogyavardhani vati ( 2 vati 2 times )
1. Punarnava mandur-250mg + Navayas loha-125mg + Sankh bhasma-250mg +
Praval pisti-250mg (2 times with madhu )
2. Amlaki curna-2gm + Triphala curna-2gm ( 2 times with ushnodaka )
3. Arogyavardhani vati- 2vati ( 3 times )
4. Lohasava -20ml + Raktmitrark -20ml ( 2 times with 40ml water )
5. Drakshavaleha-20ml ( 2 times with milk )
6. Haritaki curna-3gm (before sleep with ushnodaka)
PATHYA-
- Purana Sali, Mudga, Masoor, Parval, yava, jangal mamsa, gomutra, haridra, mahu, ghrita, takra, harad, sunthi, amlaki, palak, maithi, karela, gajar,lehsuna
APATHYA-
- Atapsevan, maithuna karma, dhumrapana, divasvapna, vyayam, vega dharana, chinta, krodha
- Masa-sem-tila, hingu,tambula, sarsapa, sura, lavana, amla, matasya, ati jalapana
A. AAM PACHAK AUSHADHI-(5-7DAYS)
B. ABHYANTER SNEHAPANA-
Kalyanak ghrita or panchtikta ghrita (krur kosti-80-90ml/madhya kosti-50-60ml/hina kosti-20-30ml)
Samyak sneha lakshan then
C. 1 din svedana
D. VAMANA
VAMANA KALP-
amlaki-20gm + patol-20gm + mulethi-20gm -> 100ml kadha -> add 15gm madanphala pippali yavkut with madhu pilaye
E. SANSAMAN KARMA
F. 9TH-10TH-11TH DAY abhyanter snehapana increase dose
G. 12th-14th day rest
H. 15th day VIRECHANA
VIRECHAN KALP-
a. Danti phala 30gm + sveta nisoth 30gm + munakka 20gm-> 100ml kadha
Add 30ml erand taila + 1-2 ratti icchbhedi rasa(if krur kosti)
b. Nisotha 30gm + suger 60gm -> curna empty stomach with ushnodaka
whole day fasting then eating laghu ahar at night
c. Gomutra 50ml + godugdha 50ml + nisotha 2gm -> curna empty stomach with ushnodaka
whole day fasting then eating laghu ahar at night
(IN CASE OF THALESIMIA)
A. AJARAKTA BASTI
B. RAKT PARPATI
• Guluchyadi Kashayam
• Drakshadi Kashayam
• Ardhavilwam Kashayam
• Patolakaturohinyadi Kashayam
• Punarnavadi Kashayam
• Mahatiktakam Kashayam
• Vasaguluchyadi Kashayam
• Lohasavam
• Lodhrasavam
• Drakshasavam
• Draksharishtam
• Rohitakarishtam
• Mridwikasavam
• Punarnavasavam
• Pippalyasavam
• Parthadyarishtam
• Dantyarishtam
• Chavikasavam
• Kumaryasavam
• Ayaskrity
• Loha bhasma
• Mandura Bhasma
• Punarnava Mandura
• Loha Mandura
• Shotari Mandura
• Madhu mandura
• Yakritpleehari Lauha
• Navayasa Lauham
• Svarnamakshika bhasma
• Rasasindhoora
• Mandura Vataka
• Arogyavardhini Vati
• Trailokyanatha Rasa
• Chandraprabha Vati
• Giloy Satwa
• Chinchadi leham
• Danti haritaki leham
• Drakshadi leham etc
Herbs beneficial for Pandu and Shotha:
• Bhumyamalaki – Phyllanthus niruri
• Amalaki – Emblica officinalis
• Sharapunka – Tephrosia purpurea
• Katuki – Picrorrhiza kurroa
• Punarnava – Boerhavia diffusa
• Kakamachi – Solanum nigrum
• Kalamegha – Andrographis paniculata
• Loha – Iron
• Kumari – Aloe vera
• Guduchi – Tinospora cordifolia
• Yashtimadhu – Glycyrrhiza glabra
• Haridra – Curcuma longa
• Bhringaraja – Eclipta alba
• Vasa – Adhatoda vasica
• Kiratatikta – Swertia chirayata
• Daruharidra – Berberis aristata etc
Anti-anemia decoctions
Effective anti-anemia decoctions from Sahasrayogam
1. Pandu Parvikardrakadi Kashayam
2. Vyoshadi Kashayam
3. Panduhara Kshaya
a. Punarnavadi Kashayam
b. Vasaguluchyadi Kashayam
c. Tintrinyadi Kashayam