Bull.Ind.lnst.Hist.Med. Vol. XXX - 2000 pp 1 to 14 PANDUROGA: A MEDICO - HISTORICAL STUDY P.V.V. PRASAD" ABSTRACT According to Ayurveda the word 'Pandu' denotes Pale or yellowish white colour. Panduroga (anaemia) is a disease in which man becomes Pallor due to deficiency of Rakta dhatu (blood) in the body. Rakta dhatu is mentioned among the Saptadhatus of the body. Historical importance ofPanduroga and a comparative study regarding its Nidana-Samprapti, Lakshanas, Upadravas and Chikitsa etc. as found in Atharvaveda, Mahabharata, Charaka Samhita, Sushruta Samhita, Chakradatta and Basava Rajeeyam etc. are being presented in this paper. Introduction: Regarding the aetiology, types, There are seven important constituents symptoms, complications and treatment of viz. Rasa, Rakta, Mamsa, Medo, Asthi, Panduroga a comparative study has been Majja and Shukra in the human body. They done based on Atharvaveda, Mahabharata, are known as "Sapthadhatu" in Ayurveda. Charaka Samhita, Sushruta Samhita, Amongst them Rakta (blood) is a very Astanga Hridaya, Astanga Sangraha, important dhatu. Acharya Sushruta has Madhava Nidana, Chakradatta, Bhava mentioned Rakta dhatu as fourth dosha of Prakasa Samhita and Basava Rajeeyam. In the body i.e. in addition to three doshas viz., addition to this, references were also Vata, Pitta and Kapha (Su.Sutra21/3). He collected regarding the usage ofLauha (iron) mentions that, Rakta is the life in living body. and Mandura and their preparations for Therefore it should be protected from all treating this important disease. types of vitiations and Pathogenic factors Atharvaveda : (Su.Sutra 14/44). Panduroga develops due This fourth and last veda of Indian to deficiency of blood in one's body. Ifit is literature gives information about Kamala not tackled in appropriate time can lead to (Jaundice) in the name of Harima or Kamala (Jaundice) and turns to be incurable. Panduroga (Kamala is the sequelae of The word 'Pandu' denotes pale-white or Panduroga) with literal meaning of yellowish - white colour. Panduroga is a "Yellowishness", At two places Harima has disease in which man becomes Pale. The been referred. Atharvaveda at XIX 44.2 word Pandu become more familiar ever since discusses about the Anjana and its efficacy :his was found in Mahabharata, one of the in treating Harima (Jaundice), Angabheda .two great epics of India. (aching of body), Visalpaka (Eczema), • Research Officer (Ayurveda) Indian Institute of Ilistory of Medicine (CCRAS) Osmania Medical College Buildings, Putlibowli, I/yderabad. 2 Bull.Lncl lnst.l l ist, Med. Vol XXX - ]O(j() Kshaya (Consumption) etc. At Hymn IX. Due to foresaid Nidana (aetiology) the 8.9 it is mentioned that the Harima and some aggrevated Pitta dosha will be propelled by other diseases like, abdominal colic, kshaya rakta in ten arteries which carry it to the (Phthisis) will be drived out by exertion. At whole body. This Pitta located in the space Hymn 1.22.1, it is mentioned that, Hridyota between tvak (Skin) and Mamsa (flesh) (heart disease) and Harima depart when sun affects Kapha, Vata, Rakta, tvak and Mamsa rises. It indicates, that sunrays will help to etc. and thereby produces various shades of treat Harima (It may be correlated with colours like pale yellow, deep yellow, and 'Phototherapy' which is used nowadays for green in skin. This condition is known as neonatal Jaundice). Seeds ofShuka trees and 'Panduroga' strong medicines also were used for the Premonitory symptoms of Panduroga treatment ofHarima (1.22.4.) It is interpreted include Hridaya Spandana (awareness of that Shuka trees are, Sirisha, Dadima, Shigru, heart beat), Rukshata (roughness), Kshiri, Jambu etc. and strong medicines are, Svedabhava (absence of sweat) and Gandhak, Sthauneyak, Talisha. (This Sramastha. (exhaustion). Symptoms offully interpretation is based on Astanga Sangraha). established Panduroga includes, Kama Mahabharata : Kshvedi (tinnitus), Ajeema (loss of digestive As narrated in Mahabharata the father power), Daurbalya (Debility), Sadana, of Pandavas was born Pale because, his (malaise) Annaddita (aversion to food), mother Ambalika became quite Pale with fear Shrama (exhaustion), Bhrarna (giddiness), when in private with the sage Vyasa and Nipeeda (Pain in body), Jwara (fever), Svasa named as Pandu (Panduraja) because of his (dyspnoea), Gauravam (heavyness) and Pale complexion. Aruchi (anorexia). Feeling of kneaded, Charaka Samhita : pressed or churned limbs. Moreover swelling In its Panduroga Chikitsadhikara (XVI on Akshikuta (orbit), Harital (green Chapter) of Chikitsa Sthana Panduroga has complexion), Sheerna lorna (falling of hairs), been described. Excessive intake of Kshara Hata Prabha (loss of lustre), Kopanah (alkaline), Amla (sour), Lavana (salty), (irritability), Sisiradveshi (aversion to cold) Ushna (hot), Viruddha (incompatible) and Nidralu (over sleepy) and Shteevana Asatmya (unsuitable) food, excessive use of (spitting). Alapavak (diminished speech), Nishpava (Dolichos lablab Linn.), Masha and Pindikodveshta (Pain in calves), Ruk (black gram), Tila(Sesamum) and its oil etc. (Pain) in whole body (waist thighs and legs) And in addition Divasvapna (day sleep), and Sadana (lassitude) are also seen exercises and sexual intercourse during the (Chikitsa Sthana 16112-16). digestion of food and lack of proper Acharya Charaka had mentioned five (5) management of evacuative measures, types of panduroga based on causative seasons and suppression of natural urges ( factors viz. 1) Vataja, 2) Pittaja, 3) Kaphaja, sexual desire. anxiety, fear, anger and grief), 4) Sannipataja (Tridoshaja) and have been mentioned as causative factors for Mritbhakshanajanyaja (Due to eating of soil! Panduroga. earth). 1) Vataja type presents with Krishna Panduroga : A Medico - Historical Study - Prasad 3 Pandutva (blackish paleness), troublesome. 5) Mritbhakshana Janyaja : It Ruksharunangata (roughness and is due to habit of eating earth. Kashayarasa reddishness of the body), Angamarda (body (astringent) of earth vitiates Vata, Kharaguna ache), Ruja (Pain), Toda (Piercing Pain), and Ksharaguna (rough and alkaline) viriates Kampa (trembling) Parshvasirorujah (Pain in Pitta, and Madhura rasa (sweet taste) vitiate sides of head), varchahsosha (dryness of Kapha In addition to this, earth obstructs the stools), Vairasya (distate in the month), srotas (channels) without undergoing any Sopha (oedema), Anaha (hardness in bowel) change and destroys bala (strength), ojas and Balakshaya (debility). 2) Pittaja Type (vigour) etc and produce Panduroga, which of Panduroga: Presents with Pita (yellow), further destroy the Bala (strength), Varna Harita (greenish tinge), Jvara (fever) Daha (complexion) and Agni (digestive fire) of (burning senation), Chardi (vomiting), the man. Patients may suffer from swelling Murcha (fating), Pipasa (thirst), Pita Mutra in cheeks, orbits, feet, navel, and genital (yellowish urine), and Pita Shakru (yellowish parts, as well as krimiroga and Atisara stools) and Patient with Pittaja Pandu (diarrhoea) with blood and mucus. (Chikitsa perspires profusely, may have desire for cold Sthana 16/1 7-30). and aversion to food. He may have pungency Charaka had clearly mentioned that in mouth, hot and sour things do not suit him Hridaya spandana (awareness of heart beat) "Arnla Udgara (acid eructations), Daurbalya is the symptom which is common to all (debility), Tama (feeling of darkness are also varieties of Panduroga (Chikitsa Sthana seen. 3) Kaphaja Type of Panduroga : 16/12). presents with Gauravam (heavyness), Tandra Regarding Kamala, Charaka says if a (drowsiness), Chardi (vomiting), patient of Panduroga, consumes Pitta Svetavabhasata (whitish complexion), aggrevating things excessively it may further Praseka (excessive Salivation), Lomaharsha vitiate Pitta and it bums blood, flesh and gives (horripilation), Sad a (malaise), Murcha rise to a disorder in which eyes, skin, nails (fainting), Bhrama (giddiness), Klama and face become deep yellow, feces and urine (exhaustion), Svasa (dyspnoea), Kasa as red and yellow. Patient looks like a frog. (cough), Alasya (lessitude), Aruchi His senses and organs loose their functions, (anorexia), Vaksvaragraha (obstruction in associated with burning sensation, Avipaka speech and voice), Shukla mutra (whitish (indigestion), Daurbalya (debility), Sada urine), Shukla Akshi (whitish eyes), Shukla (malaise) and Aruchi (anorexia). This is Varchasa (whitish stools) and desire for known as Kamala. It is due to aggrevation pungent, and hot things, Svayathu (swelling), of Pitta. and is of two types I) Kosthasrit Madhurasya (sweetness in mouth) etc. 4) (located in belly) and 2) Sakhasrit (spread Sanni Pataja (Tridoshaja) :In those who use into bodyly parts through blood). Chronic all sorts of things, all doshas get vitiated and condition of Kamala leads to Kumbhaka- cause Panduroga, which presents with all mala (Jaundice located in belly) which is the above mentioned symptoms (Vataja, curable but with difficulty. The patient of Pittaja and Kaphaja) and it is said to be very Kamala succumbs soon to the disease iffeces 4 Bull.Ind.Inst.Hist.Med. Vol.xAX - 20()() and urine become black yellow, if there is of ingested food by strong evacuatives, then excessive swelling, blood in eyes, in the strength promoting ghritas should be mouth, in the vomiting, feces, urine, and also administered. If the patient does not desist ifhe faints and presents with thirst hardness from earth eating habit due to greediness, in bowels, drowsiness, confusion, loss of the earth should be given to