Introduction

Pandu as mixture of white and yellow colour which resembles like  Ketaki Flower.[1] Acharya Charaka who has mentioned that in Pandu there is Kshaya or loss of Varna or general complexion. It has also mentioned the word "VaiVarnaya" in this disease.[2]2 It indicates that in Pandu , colour of the body become changed i. e. discoloration. Acharya Charaka has classified the Pandu Roga of 5 types.[3] i.e Vataja Pandu Roga, Pittaja Pandu Roga, Kaphaja Pandu Roga , Tridoshaja Pandu Roga and Mridbhakshanaja Pandu Roga while according to Acharya Sushruta has not included Mridbhakshanja Pandu. Because according to him the variety of Pandu caused by Mrid-bhakshana is included in the Sannipatika variety of Pandu.[4] So, the  Pandu Roga is divided into  four types. Acharya Charaka has clearly described the Samprapti of Pandu.[5]

Chikitsa of Pandu Roga:

Line of treatment in General:[6] The patient suffering from Pandu Roga should be given emetic and purgative drugs for the shodhana of the body by the elimination of DoshasOld shali type of Rice, Godhuma and Yusha of mudga, Adhaki and Masura.

1. Mamsa Rasa of Jangala Animals.
2. After that, specific medicines on the basis of the aggravated Doshas should be administered.

Ghrita for Shehana: For the purpose of oleation, the patient suffering from Pandu should be given Panchagavya Ghrita, MahaTiktaGhrita and Kalyanaka Ghrita.[7]

Most suitable Drugs for Vamana Karma: Acharya Charaka has mentioned “Krutavedhana” for Vamana Karma in case of Pandu.[8]

Most suitable Drugs for Virechana Karma: [9]

After the patient is properly oleated, he should be given purgation therapy frequently with the Milk added with cow’s urine or Milk alone.

a. Virechana Yoga for Paitika type of Pandu:[10]

The patient suffering from paittika type of Pandu Roga should take half pala of the powder of Trivrita mixed with one pala of sugar.

b. Virechana Yoga for Kaphaja type of Pandu:[11]

The patient suffering from Kaphaja type of Pandu Roga should take Haritaki impregnated with cow’s urine. Snuhi Kshira is also good.[12] As per Acharya Vagbhatta, patient should keep on a medicament consisting of only milk and cow’s urine together for a period of 15 days.[13]

 Treatment in specific types of Pandu:[14]

For Vatika Type of Pandu , the  Sneha Dravya, for Paittika Pandu, bitter and sheet drugs, for Kaphaja type of Pandu, the by Katu, Ruksha and Ushna drugs and for Sannipatika Type of Pandu , all the above-mentioned ingredients should be combined.

Treatment for Mrid-Bhakshanja Pandu:

Means, depending upon the Doshas, different types of treatment given to the patient suffering from Mrid-Bhakshanaja Pandu. However, because of the specific nature of the causative factor Pandu needs specific treatment. After the body is cleansed, the patient should be given different types of medicated ghee for the promotion of strength.[15]

Important Yogas used in Pandu Roga:

•  Dhatri Phala Rasa + Kshaudra
•  Ikshu Rasa + Kshaudra
•  Mantha + Kshaudra
•  Yashtimadhu Kashya + Madhu
•  Yashtimadhu Churna + Madhu
•  Balamula + Chitraka with sukhambu
•  Shigrubija + Lavana with sukhambu
•  Nyagrodhadi + Sharkara + Madhu Shitakashya
•  Salasradi Sara churna + Madhu
•  Sauvarchaladi yoga
•  Pandu sudana Rasa
•  Pandu nigraha Rasa
•  Lauha garbho Rasa

Yogas which contain minerals :

• Pravala + Mukta + Anjana + Shankha + Swarna Gairika Churna with Gomutra
• Akshakashta Dagdha Mandura Prayoga
• Saindhava Mandura Prayoga

Vati

• Mandura Vataka
• Punarnava Mandura
• Shilajatu Vataka
• Kautajadi Gutika
• Bibhitakadi Vataka

Ghrita

• Katukadhya Ghrita
• Pathya Ghrita
• Danti Ghrita
• Draksha Ghrita
• Haridradi Ghrita
• Dadimadhya Ghrita
• Brihatyadi Ghrita  

Asava Arista

• Dhatrayarista
• Bijakarista
• Gaudarista

Pathya – Apathya:

 

A) Pathya- (Measures which are beneficial to the patients of Pandu): When the alimentary system has been cleaned by the preliminary procedures (Snehana and Shodhana) the patient should be given wholesome food namely Old rice, Barley or Wheat either with soup peppered with Green Gram, Pigeon Pea, or Lentils or wholesome meat juice of 'Jangala' creatures. Sushruta has mentioned the use of drink containing juice of Amalaki, Ikshurasa, Salt and Honey including  Patola, Guduci, and Punarnava, Pakva Amala, Karjura, Rasona, Palandu etc. are beneficial in Pandu Roga.[16]

B)Apathya - (Measures that aggravate the disease) According to Bhaiishajya Ratnavali the followings should be avoided in Pandu Roga- Raktavisravan, Dhumrapan, Vegadharana, Svedana, Maithuna, Shimbi patrashaka, Mashambupana, Pinyaka, Tambula, Sarshapa, Sura, Mridbhakshana, Divasvapna, Tikshna, Lavana etc.[17]

Discussion

According to charaka When the Doshas with Pitta as the most predominant one are aggravated in the Dhatus, then the Dhatus get afflicted with the result they become Shithila and Guru. Thereafter, the Varna (Complexion),Bala (Strength), Sneha (unctousness) and properties of Ojas get exceedingly reduced on account of the vitiation of Doshas and Dushyas. So, the patient becomes poor in Rakta (Alpa Rakta) and poor in Meda (Alpa Meda) and Nihsara and Shithilendriya and he suffers from Vaivarnya (Discolouration).[18]

Langhana is coined as the best treatment for Rasa as well as Rakta pradoshaja vikara prescribed by Acharya Charaka is of ten types including 4 types of Samshuddhi (Vamana, Virechana, Niruha, Nasya.) Apart from this, while describing the management of Pandu, Acharya Charaka gives due emphasis on Urdhava and Adhoshodhana.[19] In Pandu Roga there is mainly vitiation of Pitta Dosha and Virechana is considered as the best therapy for it. Virechana is more acceptable, easily tolerable and equally effective to all categories of patients.

Conclusion

Thus, Shodhana specifically Virechana help in breaking the Samprapti of disease Pandu by clearing the morbid Doshas, which creates Khavaigunya and thereby relieving sign and symptom of the disease. It has direct affect on Agnisthana and thus also helpful in increasing Agni. Mostly shaman drugs contain contains deepan pachana & Srotoshodhaka Proerty which leads to proper metabolism & formation of proper Dhatus. Madhur, tikta, katu rasa has pittashamaka properties. Veerya property of drugs leads to increased Gastric secretions which is helpful in the increase absorption of iron. Ayurveda cumulative effect leads to correction of Metabolism, Iron absorption, improved blood formation & correction of disease.