Changes

Indulgence in the above factors aggravates pitta seated in the cardiac region and then this pitta is forcefully propelled by the vāta into the ten dhamanies (attached to the heart) and further into the whole body. There, it gets located in between the tvachā (skin) and the mānsa (flesh) and additionally vitiates the kapha, vāta, rakta, tvachā and mānsa resulting in the development of various discolorations in the body like pāndu (pale), hāridra (yellow), harita (green). This is called as pāndu roga (7-11½ ).  

Indulgence in the above factors aggravates pitta seated in the cardiac region and then this pitta is forcefully propelled by the vāta into the ten dhamanies (attached to the heart) and further into the whole body. There, it gets located in between the tvachā (skin) and the mānsa (flesh) and additionally vitiates the kapha, vāta, rakta, tvachā and mānsa resulting in the development of various discolorations in the body like pāndu (pale), hāridra (yellow), harita (green). This is called as pāndu roga (7-11½ ).  

Premonitory symptoms:

==== Premonitory symptoms ====

 

.. तस्य लिङ्गं भविष्यतः|  

.. तस्य लिङ्गं भविष्यतः|  

हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||

हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||

hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||

hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||

The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue (12).

The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue (12).

General symptoms of pāndu:

 

==== General symptoms of pāndu ====

 

सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः|  

सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः|  

दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३||  

दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३||  

On developing pāndu roga the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnoea, heaviness and anorexia. The patient feels as if the limbs are being kneeded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body lusture, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing (13-16).

On developing pāndu roga the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnoea, heaviness and anorexia. The patient feels as if the limbs are being kneeded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body lusture, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing (13-16).

The signs and symptoms specific to each variety of pāndu will be described henceforth.  

The signs and symptoms specific to each variety of pāndu will be described henceforth.  

Vātika pāndu:

 

==== Vātika pāndu ====

 

आहारैरुपचारैश्च वातलैः कुपितोऽनिलः|  

आहारैरुपचारैश्च वातलैः कुपितोऽनिलः|  

जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७||  

जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७||  

varcaHshoShAsyavairasyashophAnAhabalakShayAn||18||  

varcaHshoShAsyavairasyashophAnAhabalakShayAn||18||  

Indulging in vāta increasing diet and regimens aggravates vāta leading to vatika pāndu roga. The skin of the patient becomes blackish dawn coloured and un-unctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried faeces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness (17-18).

Indulging in vāta increasing diet and regimens aggravates vāta leading to vatika pāndu roga. The skin of the patient becomes blackish dawn coloured and un-unctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried faeces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness (17-18).

Paittika pāndu:

 

==== Paittika pāndu ====

 

पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः|  

पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः|  

दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९||  

दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९||  

daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||

daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||

Pitta gets aggravated by indulging in pitta vitiating nidānās (diet and regimens) which by involving the blood etc. causes pittaja pāndu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in colour, has loose motions and develops weakness and fainting (19-22).

Pitta gets aggravated by indulging in pitta vitiating nidānās (diet and regimens) which by involving the blood etc. causes pittaja pāndu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in colour, has loose motions and develops weakness and fainting (19-22).

Kaphaja pāndu:

 

==== Kaphaja pāndu ====

 

विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्|  

विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्|  

करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३||  

करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३||  

shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25||  

shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25||  

Aggravated kapha by indulging in kapha increasing diet and regimen gives rise to kaphaja pāndu roga through the pathogenesis described earlier. The sign and symptom of kaphaja pāndu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnoea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and faeces; longing for pungent, ununctuous and hot things; and develops oedema and sweet taste in the mouth (23-25).  

Aggravated kapha by indulging in kapha increasing diet and regimen gives rise to kaphaja pāndu roga through the pathogenesis described earlier. The sign and symptom of kaphaja pāndu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnoea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and faeces; longing for pungent, ununctuous and hot things; and develops oedema and sweet taste in the mouth (23-25).  

Tridoshaja pāndu:

 

==== Tridoshaja pāndu ====

 

सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्|  

सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्|  

त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६||  

त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६||  

tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26||  

tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26||  

Indulging in the etiological factors of all the three types of pāndu leads to aggravation of the three dosha resulting in tridoshaja pāndu with the features of all the three types of pāndu roga. This type of pāndu causes much distress to the patient (26).   

Indulging in the etiological factors of all the three types of pāndu leads to aggravation of the three dosha resulting in tridoshaja pāndu with the features of all the three types of pāndu roga. This type of pāndu causes much distress to the patient (26).   

Mr̥ttikā bhakshana pāndu:

 

==== Mr̥ttikā bhakshana pāndu ====

 

मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः|  

मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः|  

कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७||  

कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७||  

krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30||  

krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30||  

Person indulging in the habitual consumption of clay (mṛttikā) gets dośhā aggravated according to the taste of mud viz. astringent mud aggravates vāta, saline and alkaline mud aggravates pitta and sweet mud aggravates kapha dośha.  The clay further because of its ununctuousness causes dryness in the rasa (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, lusture, energy and ojas (vital essence of the tissues). This quickly manifesting pāndu results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the kośtha (gastrointestinal tract) and loose motions, the stool associated with blood and mucus (27-30).

Person indulging in the habitual consumption of clay (mṛttikā) gets dośhā aggravated according to the taste of mud viz. astringent mud aggravates vāta, saline and alkaline mud aggravates pitta and sweet mud aggravates kapha dośha.  The clay further because of its ununctuousness causes dryness in the rasa (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, lusture, energy and ojas (vital essence of the tissues). This quickly manifesting pāndu results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the kośtha (gastrointestinal tract) and loose motions, the stool associated with blood and mucus (27-30).

Prognosis of pāndu:

 

==== Prognosis of pāndu ====

 

पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति|  

पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति|  

कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१||  

कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१||  

Chronic pāndu roga is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in colour; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.

Chronic pāndu roga is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in colour; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.

Thus, the signs and symptoms of all the five type of pāndu roga have been described (31-33).  

Thus, the signs and symptoms of all the five type of pāndu roga have been described (31-33).  

Kōṣṭhaśākhāśraya kāmala:

 

==== Kōṣṭhaśākhāśraya kamala ====

 

पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते|  

पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते|  

तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४||  

तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४||  

If a patient of pāndu roga excessively follows pitta vitiating diet and regimen, the pitta so aggravated by involving the rakta  and the mānsa causes kāmalā. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become redish-yellow in colour; complexion develops a colour similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This kāmalā is caused by excess of pitta is known as kośthāśākhāśṛta (34-36).

If a patient of pāndu roga excessively follows pitta vitiating diet and regimen, the pitta so aggravated by involving the rakta  and the mānsa causes kāmalā. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become redish-yellow in colour; complexion develops a colour similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This kāmalā is caused by excess of pitta is known as kośthāśākhāśṛta (34-36).

Kumbha kāmalā:

 

==== Kumbha kāmalā ====

 

कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½  

कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½  

kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½

kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½