PANDU

 INTRODUCTION :-
 In Ayurveda , Pandu roga (Anemia) and kamala (Jaundice) are described
together.
 In such conditions or even without Pandu Roga when one indulges in
“Ateeva pitta vardhaka Ahara” kamala ensures .
 Definition of Pandu:-
 Severe deplation of ‘ojah gunah’ in body (like Bala, Varna, Sneha etc )
leads to ‘AlpaRakta ‘ and ‘AlpaMeda’ and ‘Nissara’ which in turn
‘SithilaIndriya’. Such child attains ‘Vivarnata’ of skin like Pandu, Haridra,
and Harita varnah.because of dominance of Panduvarna in all of them the
disease goes by the name of PanduRoga.
 Synonyms Of Pandu :-
स कामलपानाकिपाण्डुरोगः कुम्भाह्यो लाधर(व )कोड् लसाख्य : ।
विभाष्यते लक्षणमस्य कृत्सनं निबोधः वक्ष्याम्यानु पर्वू शस्तत ॥
 Kamala ,Panaki, PanduRoga, Kumbhahya , ladharak, Alasa etc.
 NIDANA :-
 According to Sushruta :-
व्यायाममम्लं लवणानि मध :मृ दं दिवास्वप्नमतीव तीक्ष्णम् ।
नीषवमाणस्य प्रदष्ू य रक्तं कुर्वन्ति दोषास्त्वचि पाण्डुभावम् ॥
 According to Charak :-
1. Aharaja Nidana
क्षाराम्ललवणात्यष्ु णविरुद्धासात्म्यभोजनात ् ।
निष्पावमाषपिण्याकतिलतैलनिषेवणात ्॥ ( C.Chi.16/7)
- Excessive intake of Kshara, Amla, Lavana, ushna ahara
- ViruddhaAhara (Mutually cotra-indicated food) , Ahitaahara
(Unwholesome foods)
- Nispava (a type of simbi, Masa ,Pinyaka (oil cake) and Tila
taila etc.

2. Viharaja Nidana
विदग्धेऽन्ने दिवास्वप्नाद् व्यायामान्मैथन
ु ात्तथा ।
-when the food is not properly digested
-sleeping during day time
-doing excessive exercise
-more sexual intercourse before digestion
-supression of natural urges.
 3. Manasika Nidana

कामचिन्ताभयक्रोधशोकोपहतचेतसः ।

- Affliction of mind with kaam, chinta, bhaya, shoka etc.

4. Others

प्रतिकर्मर्तुवैषम्याद्वगानां च विधारणात ् ॥ (C.Chi.16/8)

-Improper administration of panchakarma therapies and

transgression of prescribed seasonal regimen
 According to HaritaSamhita :-
पथि शिथिलशरीरे रोगसम्पिडिते वा लवणकटु कषायासे वना मृ दभि ् :।
अतिसु रसमजस्त्रं से वनातिक् रमे ण नयति रुधिरशोषं ते न वे पाण्डुरोगं ॥
- Consuming saline/salt ,Pungent, sour and sour eatables
- Indulge in sexual coitus excessively.
 Poorva Rupa:-
 According to Charak :-

--- तस्य लिङ्गं भविष्यतः।हृदयस्पन्दनं रौक्ष्यं स्वेदाभावःश्रमस्तथा ॥ (C.Chi 16/12)

 The premonitory symptoms of pandu are,

-Palpitation
-Un-unctuousness
-Absence of sweating
-Fatigue
 According to Kashyapa :-
-Eyes Nails & Face become Pale.
-Losss of Appetite.
 According to Sushruta :-
त्वक्स्फोटनम् ष्ठीवनगात्रसादौ मृ दभ्् क्षणं प्रेक्षणकू टशोथाः ।
विणमूतर् पितत्वमथाविपाको भविष्यतस्तस्य पूरःसराणि ।।
-Cracks in the skin
-Excessive Spitting
- Malaise
-Persistant inclination for eating earth cakes
-Oedema of the Orbital region
-Yellowish discoloration of Faeces& Urine
-Improper digestion.
 Samprapti:-
 Ukta Nidana

Aggravated Pitta predominant dosha vitiates the dhatu

Causes Shithilata(Stiffness) and Gaurava (heaviness) in the dhatu

Resulting in dimution of Varna, Bala, Sneha and the qualities of Ojas

Person develops diminished Rakta and Medas&Nissara , Shithilendriya&vivarnata

Causes Pandu

 Samanya Lakshana:-
 According to Kashyapa:-
नाभ्यां समन्ततः शोथः स्वे ताक्षिनखवक् रता।
पन्दुरोगे अग्निसादश्च् सवयथु स्चाक्षिकुतयो :।। (Ka.su.25/34)
- In anemia there is swelling around umbilicus
- Whitness of eyes
- Deformity of nails
- Loss of appetite
- Swelling in both eye-pits.
 According to Charak:-
- Tinitus (कर्णक्ष्वेड)
- Supression of the power of digestion (सदनोऽग्नि)
- Weakness (दर्ब
ु ल)
- Exhaution or tiredness (श्रम)
- Repugnance of food
- Fatigue
- Giddiness (भ्रम)
- Pain in the body (शूल)
- Fever (ज्वर)
- Dyspnoea (श्वास)
- Heaviness (गौरव)
- Anorexia (अरुचि)
- He feels as if all the limbs of his body are being kneaded, squeezed,
and chruned
- swelling of the orbital region.
 - His complexion becomes green, the small hairs falls out, he loses his
bodily lusture
- Becomes irritable
- Dislikes cold things
- Feels sleepy
- Spits in excess
- Avoid speaking
 Types of Pandu :-
Acc.to Charak Acc.to Sushrut Acc.to Harita
(1) Vataja (1) Vataja (1) Vataja
(2) Pittaja (2) Pittaja (2) Pittaja
(3) Kaphaja (3) Kaphaja (3) Kaphaja
(4) Sannipataja (4) Sannipataja (4) Sannipataja
(5)Mritbhakshanajanya (5)Mritbhakshanajanya

(1) VATAJA PANDU:-

• Vata gets vitiated by the vayu aggravating diet and regimen which brings about:-
-Black and pale yellow complexion (कृष्णपाण्डुत्वं)
-Ununctuousness (रूक्ष)
-Reddishness of the body (अरुणाङ्गताम ्)
-Malaise (अङ्गमर्द)
-Ache (रुज)
-Pricking pain (तोद)
-Tremor (कम्प)
-Pain in the sides of the chest and headache (पार्श्वशिरोरुजम ्)
-Dryness of faeces (वर्चःशोष)
-Distaste in the mouth (आस्यवैरस्य)
-Swelling(शोफ)
-Constipation(आनाह)
-Weakness (बलक्षय)

(2)PITTJA PANDU :-
 • If a pitta prakruti person takes pitta aggravating diet and regimen then this pitta vitiates
blood etc. and causes pittala type of pandu roga giving rise to signs and symptoms as
follows:-

- Yellow or green complexion

- Fever
- Burning sensation
- He faints because of execessive thirst and suffers from morbid thirst
- Urine and faeces becomes yellow in colour
- Sweating
- Longing for cold things
- Hot and sour food items do provide enough satisfaction or he does not
relish such food
- Pungent taste appears in the mouth
- Foul smell comes out of his mouth
- Diarrhoea
- Weakness
- Fainting

(3)KAPHAJA PANDU :-
• Kapha vitiated by kapha aggravating food and drinks gives rise to kaphaja type of pandu.
The signs and symptoms of this type of pandu are as follows :-

- Heaviness
- Drowsiness
- Vomiting
- Whitish complexion
- Salivation
- Horripilation
- Debility
- Fainting
- Giddiness
- Mental fatigue
- Dyspnoea
- Cough
- Laziness
- Anorexia
- Obstruction in speech and voice
- Whitishness of urine, eyes and faeces
 - Longing for pungent, ununctuous and hot things
- Oedema
- Sweet taste in the mouth

(4)SANNIPATAJA PANDU:-
• If a person involves in all types of food then all the three doshas get vitiated leading to
sannipataja panduroga. Thus all the symptoms of all three doshas are involved it is
difficult to cure

(5) MRUT-BHAKSHANA JANYA :-

 Nidana:-
-Habitual consumptionofmrittika (mud) aggravate one of three doshas.

MRITTIKA AGGRAVATION OF DOSHA

Kashaya Vata
lavana&kshara Pitta
Madhura Kapha

 SAMPRAPTI :-
Due to Ukta Nidana

Due to Ruksha in Nature causes Rukshata in RasadiDhatu

Due to Undigestable in Nature causes Srotoavarodha

Leads to MRUTTIKA-BHAKSHANA JANYA PANDU

 LAKSHANA :-
- Loss of Bala, Varna, Jatharagni, Virya, Oja.
- Oedema of the Cheeks, Peri orbital , Eye brows, Feet, Umbilical
region and the Pudendum.
- Infestation of worms in the Kostha and Loose motion
- The Stool associated with the Blood and mucus.
 CHIKITSA OF MRUT-BHAKSHANA JANYA PANDU:-
-First the eated mud should be removed through Tikshna Samshodhana.
- Take Aushadha Siddha Ghrita for Acquiring Bala
(1) NagakesaradiGhrita
(2) VyoshadiGhrita
-DoshaAnusaraChikitsa
 - If the person is unable to leave the habit of taking mud then he
should be given mud along with the Rasa in which mud is
predominant that produce Aruchi for mud in that person.
 SADHYA-ASADHYATA (Prognosis) :-
-When the disease become chronic
-Excessive dryness, oedema , weakness in the patient.
-When the patient gets yellow vision
-Patient is fully or partially constipated,vomiting,fainting and morbid thirst.
-Body is exceedingly white.
-Green coloured stool along with mucous.
-Body of the patient becomes Pale in colour.
-In such cases the disease is ASADHYA(INCURABLE).
 CHIKITSA OF PANDU:-
 GENERAL TREATMENT
 The Physician should make appropriate changes depending upon
the strenghth of the dosha in the patient.
- FOR VATIKA PANDU, it should be dominated by Snigdha
dravyas (Oil, ghee etc.)
- FOR PAITIKA PANDU, it should be dominated by Tikta and
Sheeta dravya
- FOR KAPHAJA PANDU, it should be dominated by Katu,
Tikta and Ushana dravyas
- FOR SANNIPATAJA PANDU, all the above mentioned
ingredients should be combined.
- FOR MRUTTIKA-BHAKSHANAJANYA PANDU, the
treatment should be given according to the doshas, however
because of the specific nature of the causative factors , this type
of pandu needs special type of treatment.
 PANCHA KARAMA THERAPY:-
- The patient suffering from Panduroga which can be cured
should be given VAMANA & VIRECHANA therapies
with SNIGDHA & TIKSHNA drugs respectively for
cleansing of the body.
- After the cleansing of the GIT, the patient should be given
food containing old Sali type of rice, Barley and wheat
mixed with Yusa or Soup of Mudga, Adhaki and Masura&
the mamsa rasa of animals inhabitating arid zone.
- Then on the basis of dosha aggravate to cause the disease,
specific medicine are to be administered to the patient.
 FORMULATIONS:-
 (1) KatukadiGhrita
(2) Punarnava Mandura
(3) PathyaGhrita
- 100 Haritaki Phala svarasa + 50 Haritaki Phala
Kalka + Goghrita siddha ghrita
(4) DrakshaGhrita
- Draksha kalka(1/2 prastha) + Purana ghrita
(1 prastha) siddha ghrita sevana
(5) Gomutra Haritaki
- Haritaki along with Gomutra Daily.
(6) Navayasa Churna
- Triphala,Trikatu,Vidanga,Musta,Chitrakchurn(all
are 1-1 part) + Lauha Bhashma (1 part) along with
Madhu and Ghrita.
(7) Suvarnamakshika Yoga
(8) Mandura vataka
 PATHYA-APATHYA :-
 Pathya:-
 Godhuma, Salidhanya, Yava, Sastika dhanya, Mudga,
Syamaka, Adhaki etc cereals
 Apathya:-
 Tikta, Ruksha, Katuka, Tivradahakara, Kanjika, Sura,
Amla drava, Sauviraka, Bijapuraka, Taila etc

 MORDEN CO-RELATION
ANEMIA
 DEFINATION:-
- Anemia defined as a haemoglobin concentration in blood below
the lower limit of the normal range for the age and sex of the
individual.
- In Adults the lower extreme of the normal Hb is taken as….
o 13.0 gm /dl (For Males)
o 11.5 gm/dl (For Females)
- In New born infants have higher Hb level:-
o 15 gm/dl taken as lower at nirth
o 9.5 gm/dl (at 3 months)
 CAUSES:-
- Anemia from Active Bleeding
- Due to Iron Deficeincy
- Anemia of Chronic Diseases
- Anemia related to Kidney Disease
- Anemia related to Pregnancy.
- Anemia related to Poor Nutrition.
- Pericious Anemia
- Sickle cell Anemia
- Alcoholism
- Disease invading the Bone marrow
 SYMPTOMS:-
 Anemia signs and symptoms vary depending on the cause of your anemia.
They may include:
- Fatigue
- Weakness
-Pale or yellowish skin
- Irregular heartbeats
- Shortness of breath
- Dizziness or lightheadedness
- Chest pain
- Cold hands and feet
- Headache

 CLASSIFICATION:-
 The anemia can be classified in to following headings…..
1. Nutritional Anaemia :-
- These are iron deficiency anaemia.
- Clinical features include - Progressive pallor, Irritability,
Anorexia, Tiredness, Failure to thrive, Pica, Koilonyechia.
2. Anaemia from Blood Loss:-
- Trauma, esophageal varices, hook worm infestations,
ulceratie colitis, haemorrhagic diseases of new born,
cow’s milk allergy, haematuria, etc are the common
causes.
3. Haemolytic Anaemia :-
 These are characterized by sustained reticulocytosis above
-
2%.
4. Anaemia from inadequate red cell production:-
- This means bone marrow is unable to produce sufficient
number of new red cells to replace those removed from
circulation.

CAUSES FINDINGS
Iron deficiency Transferrin saturation <15% and ferritin <30%
B12 and folate deficiency Low B12 folate level
Bleeding Fecal occultblood or bleeding that can be
found with endoscopy
Hemolysis Positive coombs
test,positiveDictest,lowhaptoglobin level and
indirect billirubin level
Kidney disease GFR<60 mL/min/1.73m2, low EPO level
Hereditary anemia With a family history
Sideroblastic anemia A large number of ringed sideroblasts in the
bone marrow

 COMPLICATION:-
 Severe fatigue
 Pregnancy complications
  Heart problems
 Death
 INVESTIGATION:-
 Complete blood count (CBC)
 A test to determine the size and shape of your red blood cells
 TREATMENT:-
 Anemia treatment depends on the causes. eg,
 Iron deficiency anemia:-
- Treatment for this form of anemia usually involves taking iron
supplements and making changes to yor diet.
 Vitamin deficiency anemia:-
- Treatment for folic acid and B-12 deficiency involves dietary
supplements and increasing this nutrient in diet.
- If digestive system has trouble absourbing vitamin b-12 from the food
may need vitamin B-12 shots.
 Aplastic anemia:-
- Treatment for this anemia may include blood transfusions to boost
levels of red blood cells.
 Anemia associated with bone marrow disease:-
- Treatment of these various disease can include medication,
chemotherapy or bone marrow transplantation.
 Hemolytic anemia:-
- Managing hemolytic anemias includes avoiding suspect
medication, trating related infections and taking drugs that
suppress immune system, which may be attacking red blood cells.
 Sickle cell anemia:-
- Treatment for this anemia may include the administration of
oxygen, pain-relieving drugs and oral & intravenous fluids to
reduce pain and prevent complications.
- Recommended for blood transfusions, folic acid supplements and
antibiotics.