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|title=Pandu Chikitsa

|title=Pandu Chikitsa

|type=article

|type=article

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<big>'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)</big>'''

<big>'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)</big>'''

{{Infobox

{{Infobox

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|label6 = Translator and commentator

|label6 = Translator and commentator

|data6 = Kar A.C.,Rai S., Aladoriya N., Deole Y. S.

|data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]

|label7 = Reviewer  

|label7 = Reviewer  

|data7  = Ojha S.N.

|data7  = Ojha S.N.

|label8 = Editors

|label8 = Editors

|data8  = Singh G., Goyal M., Deole Y.S., Basisht G.

|data8  = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication  

|label9 = Year of publication  

|data9 =  2020

|data9 =  2020

|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]

|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]

}}

}}

<big>'''Abstract </big>'''

<big>'''Abstract </big>'''

<div style="text-align:justify;">

<p style="text-align:justify;">''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given.  

''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given.  

 

'''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice

'''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice

</div>

</p>

==== Types of ''kamala'' ====

==== Types of ''kamala'' ====

==== 1. ''Shakhashrita Kamala/Alpa [[pitta]] (''Dhatu ashrita'') ====

==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====

The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools.  

The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools.  

This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.

This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.

==== 2. ''Kostha Shakhashrita Kamala/bahu [[pitta]] (''Maha Srotasashrita'') ====

==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====

''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.

''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.