Treatment of Pandu Roga in Ayurveda

Pandu Roga (पाण्डुरोग) in Ayurveda is a condition that closely resembles anemia in modern medicine. It is caused due to the imbalance of Pitta and can be associated with improper digestion, weak metabolism, and malnutrition. The treatment involves Shodhana (purification), Shamana (palliative therapy), and Rasayana (rejuvenation).

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1. Shodhana Chikitsa (Purification Therapy)

Before starting internal medications, detoxification through Panchakarma is recommended in specific conditions.

• Vamana (Emesis Therapy) – Indicated if Kapha is dominant in Pandu.
• Virechana (Purgation Therapy) – The best therapy for Pandu caused by Pitta vitiation. Trivrit Leha (Haritaki, Trivrit, Draksha, etc.) is used. (Charaka Samhita Chikitsa 16/21-22)
• Basti (Medicated Enema) – In chronic cases with Vata involvement.

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2. Shamana Chikitsa (Palliative Therapy)

After detoxification, medicines that enhance digestion, correct metabolism, and improve blood formation are administered.

a) Herbal Medicines

1. Lauha Bhasma – Increases hemoglobin levels and treats anemia. (Charaka Samhita Chikitsa 16/33)
2. Punarnava Mandoora – Corrects iron deficiency and acts as a liver stimulant. (Sarangadhara Samhita Madhyama Khanda 2/22)
3. Navayasa Lauha – A combination of Lauha Bhasma and herbal drugs to treat Pandu. (Bhaishajya Ratnavali, Pandu Rogadhikara)
4. Draksharishta – Useful in weakness, improves digestion, and enhances blood production. (Ashtanga Hridaya Chikitsa 15/34)
5. Kumaryasava – Beneficial for liver disorders and anemia. (Bhaishajya Ratnavali, Pandu Roga Chikitsa)
6. Ashwagandha Churna + Shatavari Churna – Acts as a general tonic and Rasayana.

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3. Pathya-Apathya (Diet & Lifestyle Management)

Pathya (Recommended)

• Iron-rich food – Black sesame seeds, dates, pomegranate, and jaggery.
• Easily digestible food – Green gram, rice gruel, ghee, and buttermilk.
• Herbal decoctions – Triphala Kwatha, Draksha Kwatha.

Apathya (To Avoid)

• Excessive intake of sour, salty, and spicy foods.
• Heavy, difficult-to-digest foods like red meat and deep-fried items.
• Suppression of natural urges and excessive physical exertion.

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4. Rasayana Chikitsa (Rejuvenation Therapy)

• Chyawanprash – Strengthens immunity and nourishes Dhatus.
• Guduchi Satva – Acts as a blood purifier and immunity booster.
• Amalaki Rasayana – A powerful antioxidant that enhances iron absorption.

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5. Ayurvedic References for Pandu Roga

• Charaka Samhita Chikitsa Sthana 16 – Detailed description of Pandu, its causes, and treatment.
• Sushruta Samhita Uttara Tantra 44 – Explains the pathology and management of Pandu Roga.
• Ashtanga Hridaya Chikitsa Sthana 15 – Line of treatment for Pandu with diet and lifestyle modifications.

Pandu Roga is a condition extensively discussed in Ayurvedic classical texts, characterized by pallor and often correlated with anemia in modern medicine. The term "Pandu" signifies a pale or whitish-yellow hue, reflecting the primary symptom of the disorder. citeturn0search10

Classical References and Explanations:

1. Charaka Samhita:

   • Nidana (Etiology): Charaka emphasizes that Pandu Roga arises from the consumption of incompatible foods, excessive intake of sour and salty substances, and the suppression of natural urges. These factors lead to the vitiation of Pitta dosha, which subsequently impairs Rakta dhatu (blood tissue).
   • Chikitsa (Treatment): The treatment protocol includes both Shodhana (purification) and Shamana (palliative) therapies. Specific formulations like Lauha Bhasma (incinerated iron) are recommended to enhance the quality of blood. citeturn0search1

2. Sushruta Samhita:

   • Pathogenesis: Sushruta describes that the vitiated Pitta dosha affects the Rakta dhatu, leading to symptoms such as pallor, weakness, and fatigue.
   • Treatment: Emphasis is placed on blood-purifying therapies and the administration of iron-rich formulations to restore the balance of doshas and improve blood quality. citeturn0search2

3. Ashtanga Hridaya:

   • Clinical Features: Vagbhata notes that individuals with Pandu Roga exhibit a pale complexion, lethargy, and diminished strength.
   • Management: The text advocates for the use of rejuvenating therapies (Rasayana) and dietary modifications to bolster the body's vitality and correct the underlying imbalances. citeturn0search10

4. Madhava Nidana:

   • Diagnostic Insights: Madhava provides a detailed account of the diagnostic criteria for Pandu Roga, highlighting the importance of observing the patient's complexion, energy levels, and digestive health.
   • Therapeutic Approach: The text recommends a combination of detoxification procedures and the use of herbal formulations to address both the symptoms and root causes of the disorder. citeturn0search0

Key Ayurvedic Formulations for Pandu Roga:

• Lauha Bhasma: An incinerated iron preparation that enhances hemoglobin levels and improves overall blood quality.
• Punarnava Mandura: A classical formulation combining iron with herbs like Punarnava (Boerhavia diffusa), which acts as a diuretic and supports liver function.
• Navayasa Lauha: A compound formulation containing iron and nine other herbs, traditionally used to treat anemia and related conditions.

Dietary and Lifestyle Recommendations:

• Pathya (Recommended): Inclusion of iron-rich foods such as black sesame seeds, dates, pomegranates, and green leafy vegetables.
• Apathya (To Avoid): Avoidance of heavy, oily, and hard-to-digest foods, as well as activities that can lead to excessive physical strain.

These classical references underscore the comprehensive approach Ayurveda adopts in understanding and managing Pandu Roga, focusing on individualized treatment strategies