Sushruta Samhita Uttaratantra Chapter 44 Panduroga Pratiṣedha (Therapy of Anaemia)


AIAPGET Factors

–    Twak Sphotana & Prekshanakuta Shotha are particular Purvarupas of Pandu Roga (Su.Ut.44/5).

–    Extreme consumption of Apathya Ahara, Madhya and Amla Anna by Pandu Rogi results in manifestation of Kamala Roga.

–    MAHAN SHOPHA and PARVABHEDA are signs of KUMBHASAHVA (Kumbha Kamala), quite a lot of Kamala. 

–    LAGHARAKA & ALASA are circumstances / variants of Kamala whereby Kamala is related to Jwara, Angamarda, Brahma, Sada, Tandra & Kshaya.

–    HALIMAKA is a variant of Kamala brought on by Vata and Pitta. It’s marked by the looks of HARITA, PITA & NILA Varna.

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The forty fourth chapter of Uttaratantra of Sushruta Samhita is known as as Panduroga Pratiṣedha Adhyaya. This chapter offers with the Therapy of Anaemia.   

अथातः पाण्डुरोगप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We’ll now expound Panduroga pratiṣedha – remedy of Anaemia; as

revealed by the venerable Dhañvañtari.

Nidāna- causes

व्यवायमम्लं लवणानि मद्यं मृदं दिवास्वप्नमतीव तीक्ष्णम् |
निषेवमाणस्य विदूष्य रक्तं कुर्वन्ति दोषास्त्वचि पाण्डुभावम् ||३||

Under talked about are the causes of Pandu Roga –

Indulgence in –

        an excessive amount of copulation,

        sours and salts,

        wine,

        behavior of consuming mud,

        day sleep and

        penetrating meals

As a result of above talked about causes, the doshas would get aggravated. These aggravated doshas vitiate the blood and produce about pandu bhava (change of regular physique color to pale or yellowish white color) of the pores and skin.

पाण्ड्वामयोऽष्टार्धविधः प्रदिष्टः पृथक्समस्तैर्युगपच्च दोषैः |
सर्वेषु चैतेष्विह पाण्डुभावो यतोऽधिकोऽतः खलु पाण्डुरोगः ||४||

Panduroga is claimed to be of 4 sorts –

        one from every dosha individually – vataja, pittaja and kaphaja,

        one from the mix of all three doshas – sannipataja, tridoshaja

It’s known as pandu roga due to the predominance of pallor / yellowish white color in all these sorts.

Pūrvarūpa – premonitory signs

त्वक्स्फोटनं ष्ठीवनगात्रसादौ मृद्भक्षणं प्रेक्षणकूटशोथः |
विण्मूत्रपीतत्वमथाविपाको भविष्यतस्तस्य पुरःसराणि ||५||

Under talked about are the premonitory signs of the illness (pandu roga) –

        cracking of the pores and skin,

        extreme spitting,

        common debility,

        need to eat mud,

        swelling of eye socket,

        yellowish white color of the faeces and urine and

        improper digestion of the meals

Paryāyanāma – synonyms

स कामलापानकिपाण्डुरोगः कुम्भाह्वयो लाघर(व)कोऽलसाख्यः |
विभाष्यते लक्षणमस्य कृत्स्नं निबोध वक्ष्याम्यनुपूर्वशस्तत् ||६||

Under talked about are the synonyms of Panduroga –

        Kamala,

        Apanaki,

        Panduroga,

        Kumbhakamala,

        Lagharaka and

        Alasa

Now, the options of those sorts will probably be described by me in succeeding order.

Vataja panduroga

कृष्णेक्षणं कृष्णसिरावनद्धं तद्वर्णविण्मूत्रनखाननं च |
वातेन पाण्डुं मनुजं व्यवस्येद्युक्तं तथाऽन्यैस्तदुपद्रवैश्च ||७||

Signs of Panduroga produced by Vata –

        eyes turn out to be black,

        outstanding community of black veins seem on the physique,

        black color of pores and skin, faeces, urine, nails and face and

        different signs of vata aggravation

Pittaja Panduroga

पीतेक्षणं पीतसिरावनद्धं तद्वर्णविण्मूत्रनखाननं च |
पित्तेन पाण्डुं मनुजं व्यवस्येद्युक्तं तथाऽन्यैस्तदुपद्रवैश्च ||८||

Signs of Panduroga brought on by Pitta –

        eyes turn out to be yellow in color,

        look of yellow community of veins on the physique,

        yellow color of the pores and skin, faeces, urine, nails and face and

        manifestation of different signs of pitta aggravation

Kaphaja panduroga

शुक्लेक्षणं शुक्लसिरावनद्धं तद्वर्णविण्मूत्रनखाननं च |
कफेन पाण्डुं मनुजं व्यवस्येद्युक्तं तथाऽन्यैस्तदुपद्रवैश्च ||९||

Signs of Panduroga brought on by Kapha –

        eyes turn out to be white in color,

        look of whitish community of veins on the physique,

        white color of the pores and skin, faeces, urine, nails and face and

        manifestation of different signs of kapha aggravation

Tridoşaja panduroga

सर्वात्मके सर्वमिदं व्यवस्येद् वक्ष्यामि लिङ्गान्यथ कामलायाः |

Signs of all of the doshas will probably be current collectively in Panduroga produced by all of the doshas collectively.

Kāmalāroga – Jaundice

यो ह्यामयान्ते सहसाऽन्नमम्लमद्यादपथ्यानि च तस्य पित्तम् ||१०||
करोति पाण्डुं वदनं विशेषात् पूर्वेरितौ [१] तन्द्रिबलक्षयौ च |११|

Now, the causes, pathogenesis and signs of Kamala will probably be described by me.

On the finish of Pandu Roga i.e. quickly after panduroga will get cured, if the individual indulges in meals that are bitter, consumes wine and indulges in unhealthy meals and actions, the pitta would get drastically aggravated. This aggravated pitta produces yellowish-white color, particularly within the face. Related to this, is stupor and lack of power.

भेदस्तु तस्याः खलु कुम्भसाह्वः शोफो महांस्तत्र च पर्वभेदः ||११||

Kumbhasahva or Kumbha Kamala is quite a lot of Kamala. This illness is marked by profound swelling (oedema) of the physique and ache within the joints.

ज्वराङ्गमर्दभ्रमसादतन्द्राक्षयान्वितो लाघर(व)कोऽलसाख्यः |१२|

The identical Kamala is called Lagharaka and Alasa when it’s related to the under talked about signs –

        fever,

        aches within the physique elements,

        giddiness,

        debility,

        stupor,

        depletion of tissues

तं वातपित्ताद्धरिपीतनीलं हलीमकं नाम वदन्ति तज्ज्ञाः ||१२||

The identical Kamala is known as as Halimaka when inexperienced, yellow or blue color seems attributable to aggravation of vata and pitta.

उपद्रवास्तेष्वरुचिः पिपासा छर्दिर्ज्वरो मूर्धरुजाऽग्निसादः |
शोफस्तथा कण्ठगतोऽबलत्वं मूर्च्छा क्लमो हृद्यवपीडनं च ||१३||

Under talked about are the problems of those illnesses –

        lack of style or urge for food,

        thirst,

        vomiting,

        fever,

        headache,

        weak point of digestive hearth,

        swelling of the throat,

        debility,

        fainting,

        exhaustion,

        discomfort within the area of the guts

Panduroga cikitsā – remedy of anaemia 

साध्यं तु पाण्ड्वामयिनं समीक्ष्य स्निग्धं घृतेनोर्ध्वमधश्च शुद्धम् |
सम्पादयेत् क्षौद्रघृतप्रगाढैर्हरीतकीचूर्णयुतैः प्रयोगैः ||१४||
पिबेद्घृतं वा रजनीविपक्वं यत्त्रैफलं तैल्वकमेव वाऽपि |
विरेचनद्रव्यकृतं पिबेद्वा योगांश्च वैरेचनिकान् घृतेन ||१५||

If the Pandu Roga is curable, it needs to be handled. In these curable circumstances, under talked about therapies needs to be given –

        oleation remedy needs to be given utilizing ghee, following which,

        purification in each upward and downward instructions needs to be administered i.e. each vamana – emesis and virechana – purgation needs to be given, after which,

        powder of Haritaki added with extra amount of honey and ghee needs to be given or

        ghee boiled with Rajani or

        Triphala Ghrta needs to be given,

        Tilvaka Ghrta or ghee boiled and ready with purgative herbs shall be administered

मूत्रे निकुम्भार्धपलं विपाच्य पिबेदभीक्ष्णं कुडवार्धमात्रम् |
खादेद्गुडं वाऽप्यभयाविपक्वमारग्वधादिक्वथितं पिबेद्वा ||१६||

Half pala (20 gm) of Nikumbha (Danti) needs to be boiled in cow’s urine. Half Kudava (80ml) of this preparation needs to be consumed.

Alternatively, guda – jaggery cooked with Abhaya needs to be given.

Or, Decoction of herbs belonging to Aragvadhadi Gana needs to be given for ingesting.

All these recipes are supposed to produce purgation.

अयोरजोव्योषविडङ्गचूर्णं लिह्याद्धरिद्रां त्रिफलान्वितां वा |
सर्पिर्मधुभ्यां विदधीत वाऽपि शास्त्रप्रदेशाभिहितांश्च योगान् ||१७||

Under talked about formulations could also be administered to the affected person –

        ayoraja i.e. iron fillings or ash of iron blended with powder of vyosa – trikatu and vidanga, or

        powder of haridra and triphala – added with ghee and honey or

        some other formulae of iron talked about elsewhere within the textual content

हरेच्च दोषान् बहुशोऽल्पमात्रान् श्वयेद्धि दोषेष्वतिनिर्हृतेषु |
धात्रीफलानां रसमिक्षुजं च मन्थं पिबेत् क्षौद्रयुतं हिताशी ||१८||

Many instances, the doshas needs to be expelled in small portions.

If the doshas are expelled in massive portions, they’d produce swelling.

In these circumstances, mantha needs to be ready by churning effectively the juice of Dhatri Phala – gooseberry fruits and Iksu – sugarcane. It needs to be consumed blended with honey.

उमे बृहत्यौ रजनीं शुकाख्यां काकादनीं चापि सकाकमाचीम् |
आदारिबिम्बीं सकदम्बपुष्पीं विपाच्य सर्पिर्विपचेत् कषाये ||१९||
तत् पाण्डुतां हन्त्युपयुज्यमानं क्षीरेण वा मागधिका यथाग्नि |२०|

Decoction of the under talked about components needs to be ready –

        two sorts of brhati,

        rajani,

        sukakhya,

        kakadani,

        kakamaci,

        adari,

        bimbi,

        kadamba puspi

This decoction is added with ghee, processed and medicated ghee is ready. When this ghee is consumed together with milk or Magadhika – Pippali, it cures Panduroga – anaemia.

हितं च यष्टीमधुजं कषायं चूर्णं समं वा मधुनाऽवलिह्यात् ||२०||

Decoction of Yastimadhu – licorice needs to be taken with equal amount of honey. Alternatively, the powder of Yasthimadhu may also be administered blended with honey.

गोमूत्रयुक्तं त्रिफलादलानां दत्त्वाऽऽयसं चूर्णमनल्पकालम् |
प्रवालमुक्ताञ्जनशङ्खचूर्णं लिह्यात्तथा काञ्चनगैरिकोत्थम् ||२१||

Under talked about formulations taken for lengthy intervals of time cures Pandu Roga –

        Triphala and Ayas (iron) with cow’s urine or

        Powder of Pravala, Mukta, Anjana, Sankha and Kancana Gairika (Suvarna Gairika)

आजं शकृत्स्यात् कुडवप्रमाणं विडं हरिद्रा लवणोत्तमं च |
पृथक् पलांशानि समग्रमेतच्चूर्णं हिताशी मधुनाऽवलिह्यात् ||२२||

1 kudava (160 gm) of the powder of excreta of goat needs to be consumed (lick) together with 1 pala every (40 gm) of Bida Lavana, Haridra and Saindhava Lavana blended with honey by the affected person who wishes good well being.

मण्डूरलोहाग्निविडङ्गपथ्याव्योषांशकः सर्वसमानताप्यः |
मूत्रासुतोऽयं मधुनाऽवलेहः पाण्ड्वामयं हन्त्यचिरेण घोरम् ||२३||

Equal elements of the under talked about components needs to be taken –

        Mandura Loha – iron slag,

        Agni – Citraka,

        Vidanga,

        Pathya and

        Vyosa

This needs to be added with equal elements of (of all of the above components) tapya (iron pyrites) and soaked in cow’s urine for some days. Later this needs to be consumed. This recipe would remedy even dreadful (extreme) circumstances of Pandu Roga rapidly.

बिभीतकायोमलनागराणां चूर्णं तिलानां च गुडश्च मुख्यः |
तक्रानुपानो वटकः प्रयुक्तः क्षिणोति घोरानपि पाण्डुरोगान् ||२४||

The great powder of equal portions of Vibhitaki, Ayomala (iron slag), Nagara and Tila is added with equal portions of jaggery and made into drugs. When these drugs are consumed adopted by ingesting buttermilk, they remedy Pandu Roga, even when it’s of extreme nature.

सौवर्चलं हिङ्गु किराततिक्तं कलायमात्राणि सुखाम्बुना वा |
मूर्वाहरिद्रामलकं च लिह्यात् स्थितं गवां सप्तदिनानि मूत्रे ||२५||

Equal portions of powder of Sauvarcala, Hingu and Kiratatikta are taken. They’re made into drugs the dimensions of pea. These drugs could also be consumed together with heat water.

Alternatively, powder of Murva, Haridra and Amalaka are saved soaked in cow’s urine for seven days and is later consumed.

मूलं बलाचित्रकयोः पिबेद्वा पाण्ड्वामयार्तोऽक्षसमं हिताशी |
सुखाम्बुना वा लवणेन तुल्यं शिग्रोः फलं क्षीरभुजोपयोज्यम् ||२६||

Powder of root of Bala and Citraka, one aksa (10 gm) in amount needs to be consumed by sufferers of Pandu Roga together with comfy heat water.

Alternatively, fruit of Sigru could also be consumed with equal portions of Saindhava Lavana, with meals, together with milk.

न्यग्रोधवर्गस्य पिबेत् कषायं शीतं सिताक्षौद्रयुतं हिताशी |
शालादिकं चाप्यथ सारचूर्णं धात्रीफलं वा मधुनाऽवलिह्यात् ||२७||

Decoction of herbs belonging to Nyagrodadi Gana group needs to be consumed by sufferers desirous of remedy from Pandu Roga. This decoction needs to be consumed with sugar and honey in a chilly state.

Alternatively, the affected person ought to eat powder of herbs belonging to the Saladi Gana group or powder of Amalaka blended with honey.

विडङ्गमुस्तत्रिफलाजमोदपरूषकव्योषविनिर्दहन्यः |
चूर्णानि कृत्वा गुडशर्करे च तथैव सर्पिर्मधुनी शुभे च ||२८||
सम्भारमेतद्विपचेन्निधाय सारोदके सारवतो गणस्य |
जातं च लेह्यं मतिमान् विदित्वा निधापयेन्मोक्षकजे समुद्गे ||२९||
हन्त्येष लेहः खलु पाण्डुरोगं सशोथमुग्रामपि कामलां च |३०|

Powder of under talked about components needs to be ready –

        Vidanga,

        Musta,

        Triphala,

        Ajamoda,

        Parusaka,

        Vyosa,

        Vinirdahani (Citraka),

        Guda – jaggery and

        Sarkara – sugar

This powder is cooked within the decoction of herbs belonging to Salasaradi Gana group and confection is ready.

Honey and ghee is added to this confection and it’s preserved in a field ready from Muskaka tree wooden.

When consumed, this confection cures Pandu Roga related to oedema. It additionally cures extreme circumstances of Kamala – jaundice.

Kāmalā cikitsā – remedy of jaundice

सशर्करा कामलिनां त्रिभण्डी हिता गवाक्षी सगुडा च शुण्ठी ||३०||

Powder of Tribhandi (Trivrt) or Gavaksi needs to be added with jaggery and ginger and administered to the sufferers of Kamala.

कालेयके चापि घृतं विपक्वं हितं च तत् स्याद्रजनीविमिश्रम् |३१|

Medicated ghee ready with Kaliyaka can be helpful when consumed, blended with powder of Rajani.

धातुं नदीजं जतु शैलजं वा कुम्भाह्वये मूत्रयुतं [१] पिबेद्वा ||३१||
मूत्रे स्थितं सैन्धवसम्प्रयुक्तं मासं पिबेद्वाऽपि हि लोहकिट्टम् |३२|

The affected person affected by Kumbha Kamala ought to eat the under talked about formulations –

        powder of Nadija Dhatu (Maksika) or Silajatu with cow’s urine or

        Loha Kitta or Mandura (iron slag) together with Saindhava Lavana

These formulation needs to be saved soaked in cow’s urine for one month after which consumed.

दग्ध्वाऽक्षकाष्ठैर्मलमायसं वा गोमूत्रनिर्वापितमष्टवारान् ||३२||
विचूर्ण्य लीढं मधुनाऽचिरेण कुम्भाह्वयं पाण्डुगदं निहन्यात् |

Ayomala (iron slag) is burnt within the hearth of wooden of aksa / bibhitaki (hearth obtained by burning wooden of aksa) to type ash.

This ash needs to be soaked in cow’s urine for seven instances. Then that is powdered and licked with honey. This rapidly cures pānduroga named kumbahvaya or kumbhakamala.

सिन्धूद्भवं वाऽग्निसमं च कृत्वा क्षिप्त्वा च मूत्रे सकृदेव तप्तम् ||३३||
लौहं च किट्टं बहुशश्च तप्त्वा निर्वाप्य मूत्रे बहुशस्तथैव |
एकीकृतं गोजलपिष्टमेतदैकध्यमावाप्य पचेदुखायाम् ||३४||
यथा न दह्येत तथा विशुष्कं चूर्णीकृतं पेयमुदश्विता तत् |
तक्रौदनाशी विजयेत रोगं पाण्डुं तथा दीपयतेऽनलं च ||३५||

Saindhava lavana needs to be burnt sizzling (on the hearth of bibhitaki wooden) and dipped in cow’s urine. Later lohakitta needs to be burnt sizzling (on the hearth of bibhitaki wooden) and dipped in cow’s urine. This lohakitta is burnt many instances and dipped in cow’s urine many instances. This needs to be carried out for at least seven instances. Equal portions of saindhava lavana and lohakitta are floor in mortar with cow’s urine. The combination is put in a giant pan having cow’s urine and is boiled. Whereas the contents are being boiled they’re continually stirred in order that the contents don’t get burnt / charred. When the contents get dried (devoid of wetness), the pan is faraway from the hearth. The contents are additional dried, floor, made into powder and saved in an hermetic container. This needs to be consumed together with dilute buttermilk. After the digestion of drugs one ought to partake meals together with buttermilk. This recipe cures anaemia (kumbhakamala) and likewise kindles digestion.

द्राक्षागुडूच्यामलकीरसैश्च सिद्धं घृतं लाघर(व)के हितं च |
गौडानरिष्टान् मधुशर्कराश्च मूत्रासवान् क्षारकृतांस्तथैव ||३६||
स्निग्धान् रसानामलकैरुपेतान् कोलान्वितान् वाऽपि हि जाङ्गलानाम् |
सेवेत शोफाभिहितांश्च योगान् पाण्ड्वामयी शालियवांश्च नित्यम् ||३७||

To remedy Lagharaka, medicated ghee ready with Draksa, Guduci and juice of Amalaki needs to be administered.

Sufferers of Pandu Roga ought to use the under talked about –

        arista ready with jaggery, honey and sugar,

        asava ready with urines and ksaras,

        soup of meat added with fat and juice of Amalaka,

        soup of meat of animals dwelling in arid lands processed (added) with Kola

One must also eat the formulations defined within the context of sopha (remedy of swellings / oedema). He must also eat meals ready from Sali (rice) and Yava (barley) on a regular basis.

श्वासातिसारारुचिकासमूर्च्छातृट्छर्दि शूलज्वरशोफदाहान् |
तथाऽविपाकस्वरभेदसादान् जयेद्यथास्वं प्रसामीक्ष्य शास्त्रम् ||३८||

Problems of the illness talked about under needs to be cured following the recommendation of the science –

        dyspnoea,

        diarrhoea,

        lack of style,

        cough,

        fainting,

        thirst,

        vomiting,

        stomach ache,

        fever,

        oedema,

        burning sensation,

        improper digestion,

        hoarseness and

        weak point of the physique

अन्तेषु शूनं परिहीनमध्यं म्लानं तथाऽन्तेषु च मध्यशूनम् |
गुदे च शेफस्यथ मुष्कशूनं प्रताम्यमानं च विसञ्ज्ञकल्पम् ||३९||
विवर्जयेत् पाण्डुकिनं यशोऽर्थी तथाऽतिसारज्वरपीडितं च ||४०||

The sufferers having under talked about signs of Pandu Roga needs to be rejected by a doctor desirous of repute –

        swelling in extremities,

        emaciation within the center portion of the physique (trunk), or

        swelling in extremities and trunk and likewise in anus, penis and scrotum,

        fainting usually,

        lack of consciousness and

        diarrhoea and

        fever

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे पाण्डुरोग प्रतिषेधो नाम (षष्ठोऽध्यायः, आदितः) चतुश्चत्वारिंशत्तमोऽध्यायः।।४४।।

Thus ends the forty fourth chapter by identify Panduroga Pratiședha in Uttara Sthana of Suśruta Samhita.



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