This document provides an Ayurvedic perspective on anemia from a guest lecture by Dr. Nayan P. Joshi. It begins with the Ayurvedic definition of anemia, called Pandu, describing its symptoms and color presentation. It then discusses the modern definition and components of blood. The rest of the document covers etiology, pathogenesis, classifications, and management of Pandu from Ayurvedic texts like Charak Samhita and modern medical understandings of anemia.

1. Dr. Nayan P. Joshi
M.D.(Ayurved)
Reader class-I
Ex.(H.O.D.) Panchakarma P.G./U.G.Department.
Govt. Akhandanand Ayurved
College/Hospital
Bhadra, Ahmedabad. 12-07-2016
Anaemia-An
Ayurvedic
Perspective
Guest lecture series By Himalaya Drug Co.

2. PANDOROG NIRUKTI- YUTPATTI

3. PANDU :-
The peculiar color presentation of the patient has been described
by Acharyas the color of the patient is like the 'Ketaki-Raj' which is similar to
the combination color of white and pale yellow in a particular proportion.
As Charak Mahrshi Pandu is a Rashprdoshaja Vikara,as
basic samprapti, but its signs & symptoms present as raktadhatu related.
ANEMIA :-
As per Modern science the various components of blood are
vitiate & involve for presentation of Anemia ,which is similer to Pandu .

4. Anemia also spelled
anaemia and anæmia; from Greek
ναιμία ἀ anaimia, meaning lack of blood)
is a decrease in number of red blood
cells (RBCs) or less than the normal
quantity of hemoglobin in the blood.
DEFINITION :-

5. Importance of Raktdhatu & Metabolism –As per Ayurved
Rasavahasrotas & Pranavahasrotas & Jivaniya Vyapar:

6. Whole Blood
Cellular Portion
45% Fluid Portion (55%)
(Plasma)
Red blood cells (RBC)
or Erythrocytes, white
blood cells (WBC) or
Leukocytes, Platelets
or Thrombocytes
Organic
(7.1% -
Inorganic
Gases
(Dissolved in
Proteins (7%)
• Albumin
• Globulin
• Fibrinogen
• Prothrombin
1).Internal
Secretions
(hormones)
2).Antibodies
(Immune bodies)
3).Enzymes
• Amylase
• Carbonic
Anhydrase
• Phosphatases
• Lipases
• Esterases
• Proteases
• Transaminases
1).Nonprotein
Nitrogenous
Substances
• Urea
• Uric acid
• Xanthine
•
Hypoxanthine
• Creatinine
• Ammonia
• Amino acids
2).Nonnitrogen
ous
Substances
• Natural fats
• Sodium
• Potassium
• Calcium
•
Magnesium
• Copper
•
Phosphorus
• Chlorine
• Flurine
• Iodine
•
Bicarbonate
• Sulphate
•
Phosphate
• Oxygen
• Carbon
dioxide
• Nitrogen

8. AETIOLOGY OR NIDANA OF PANDU ROGA
M.N.

9. ETIOPATHOLOGICAL ASPECT AND CLASSIFICATION
Anaemia can be defined as –
•A reduction in the oxygen transport capacity of the
blood.
•A reduction below normal limits of the total
circulating red cell mass.
•A reduction below normal in the volume of packed
red cells.
•A reduction in the hemoglobin concentration of the
blood.

10. RBC count : (Aprox.)-
In males : 5.5 million/Cumm.
In female : 4.5 million/Cumm.
Nomal Values
Mean corpuscular volume (M.C.V.) - This is the average volume of R.B.C.
Normal value of M.C.V. = 80-100 μ3
Mean corpuscular hemoglobin (M.C.H.) – (This is the amount of hemoglobin present in average R.B.C.)
Normal value of MCH = 25-30 Pico- gram
Mean corpuscular hemoglobin concentration (MCHC) - This is the amount of Hb present in 100 ml of RBC is
called MCHC.
Normal value of MCHC = 34.5 gm/100 ml of RBCs.

11. Life span - Average life of RBCs is about 120 days.
Erythropoiesis means production of red blood cells i.e.
RBCs.
After birth, the main site of erythropoiesis is bone
marrow. During early years of life, all bones are filled
up with active marrow. But by 20th year, only upper
end of long bones contain active red marrow.
Complete erythropoiesis occurs in 7 days.(seven stages)
ERYTHROPOIESIS :-

12. FACTORS AFFECTING ERYTHROPOIESIS :
1) Anoxia:O2 tension in tissues. This stimulates bone marrow for Erythropoiesis.
2) Diet :
Diet rich in essential amino acids for the synthesis of globin part of hemoglobin.
3)Synthesis of DNA
4)Vitamins :
Maturation of RBC.
Vit C, B6, B12, Nicotinic acid and folic acid
(Vitamin B12 Cyanocobalamine) –(Extrinsic factor)
Its poor absorption from intestine by blood due to lack of intrinsic factor (I.F.)
which is secreted in gastric juice.( Ranjakpitt- As per A.H. Amashaya)
Vitamin B6 and C – Both of these are helpful in erythropoiesis.
Vitamin C is helpful in Iron metabolism.
5) Hormones : Certain endocrinal hormones induce erythropoiesis.
Metal : Effects erythropoiesis by affecting Hb synthesis

13. HEMOGLOBIN :
Hemoglobin is a red pigment of the blood, present in RBCs (adsorbed to the
lipid material of RBCs) and causes appearance of the blood to be red.
Normal Hb count : 14-18 gm/100 ml of blood.
GLOBIN :
Consist about 96% of total hemoglobin.
It is made up of simple protein, formed of four (2 pairs) polypeptide chains in
each Hb molecule.
HbA - in normal adults : 2 α-chains and 2 β-chains.
i) α - chains: each of which contains 141 amino acids.
ii) β - chains :each of which contains 146 amino acids.
Haem molecule is attached to the polypeptide chains.
HAEM:Haem is a metalloprotein in which metal is iron, Present in Ferrous
form.
Iron is absorbed in the ferrous form in stomach, duodenum and jejunum.
mainly in the upper part of small intestine.

15. PURVARUPA As per Cha./ Su./ A.H./ M.N./ Bha. /Ha.
1. Avipaka
2.AkshikutaShotha
3. Aruchi
4. Alpavahnita
5. Angasada
6.Gatrasada
7. Hridspandaman
8.Mutra Pitata
9.Mridbhakshanaechcha
10. Panduta
11. Rukshata
12. Swedabhava
13. Shrama
14. Sthivanadhikya
15. Twakasphutana
16. Varchapittatvam

17. LAKSHANA AS PER VARIOUS ACHARYAS:
1.Akshikutashotha
2.Aruchi
3.Arohaneayasa
4.Alpawaka
5.Annadwesha
6.Balakshaya
7.Bhrama
8.Durbalya
9.Dhatugaurava
10.Dhatushithilya
11.Gatramarda
12.Gaurava
13.Hatanala
14.Hatprabhatva
15.Jwara
16. Kopana
17.Karnashweda
18.Katiurupadaruka
19. Medalpata
20.Nidraluta
21. Nisharata
22. Ojagunakshaya
23.Pindikodweshtanam
24.Panduta
25. Raktalpata
26. Shishiradwesha
27. Swasha
28. Shirnalomata
29. Sadana
30. Shrama
31. Shthivanadhikya
32. Shithilendriya
33.Sannasakthi

18. Five Types of Pandurog:-
M.N CH./8

19. VATAJA PANDU :
The lakshanas of Vataja pandu according to Cha./Su. /A.H. /M.N. /Bha. /Ha.
1.Krishnapanduta
2.Krishnetratavam
3.Krishnanakhatva
4.Krishnananatva
5.Arunanakhatva
6.Arunanetrata
7. Twakapitata
8. Netrapitata
9. Nakhapitata
10.Rukshangata
11.Rukshanakhatva
12. Rukshanetrata
13.Paruushta
14.Angamarda
15.Angaruka
16. Kampa
17. Parshvaruka
18.Shiroruka
19.Shirogaurava
20. Asayavairasya
21. Anaha
22. Shofa
23.Balakshaya
24.Bhrama
25.Varchshosha
26. Krishnavitaka
27. Arunavitaka
28.Rukshamutrata
29.Darunakoshthata
30.Muttrapitata
31.Rukshakrishnaruna Twak

20. Pittaja Pandu : As per LAKSHANA Cha. /Su. /A.H. /M.N. /Bha. /Ha.
1.Pitata
2.Haritabhata
3.Pitanakhatva
4.Pitananatva
5.Pitachhavi
6.Haritasiratva
7.Jwara
8.Daha
9.Trishna
10.Chardi
11.Murcha
12.Sweda
13.Shitakamita
14.Annabhinandana
15.Katukasayata
16.Ushnanupashayata
17.Amlanupashyata
18.Vidaha
19.Amlodgara
20.Daurgandhya
21.Daurbalya
22.Tama
23.Shosh
24.Shofa
25.Pitamutrata
26.Pitavitakta
27.Bhinnavarchasatva
28.amatva

21. kaphaja Pandu : As per LAKSHANA Cha. /Su. /A.H. /M.N. /Bha. /Ha.
1.Shvetavabhasta
2.Shveklakshita
3.Shuklanantva
4.Shuklanakhtva
5.Gaurava
6.Tandra
7.Chhardi
8.Praseka
9.Lomaharsha
10.Sada
11.Murcha
12.Bhrama
13.Klama
14.Swasha
15.Kasa
16.Alasya
17.Aruchi
18.Vakagraha
19.Swaragraha
20.Katukamata
21.Rukshakamata
22.Ushnakamata
23.Shoth
24.Madhurasyata
25.Lavanaktrata
26.swarkshaya
27.Shuklamutrata
28.Shuklavarchasa
29.Shuklatwaka

22. SANNIPATAJA PANDU : As per LAKSHANA Cha. /Su. /A.H. /M.N. /Bha.
/Ha.
All the symptoms of Vataja, Pittaja and Kaphaja Pandu (Cha. /Su. /A.H.)
Madhava and Bhavaprakasha described some
special symptoms of Tridoshaja
pandu and mentioned that this type of Pandu is
‘Asadhya’. ( M.N.8, B.P.Chi.8) The
symptoms of Tridoshaja pandu according to these
Acharays are Jwara, Arochaka,
Hrillasa, Chhardi, Trishna, Klama and the patient
becomes Kshina and Hatendriya.

23. MRIDBHAKSHANAJANYA PANDU : LAKSHANA As per Cha.
/A.H./M.N.
1. Anananashopha
2. Akshikutashotha
3. Asyashotha
4. Arsha
5. Atisara
6. Balakshaya
7. Gandashotha
8. Krimikoshta
9. MehanaShotha
10.Nabhishotha
11.Purishasakaphama
12.Purishasakrimi
13. Padashotha

24. Complications ( Upadrava )
PROGNOSIS :- SADHYASADHYATA

25. PANDU : SAMPRAPTI
On the basis of various Hetus, Samprapti of Pandu can be
divided into two Parts-
1) Santarpanottha Pandu
2) Aptarpanottha Pandu

26. Cause of Anemia:-
Anemia is either caused essentially through two basic pathways
(1)by a decrease in production of red blood cell or hemoglobin.
(2)by a loss or destruction of blood.
Anemia results when the balance between production and destruction is disturbed
as follows
(A) Inadequate production of RBC in Marrow due to:
Lack of raw materials required for erythropoiesis.e.g. iron, B12, folic
acid,proteins.
(B) Depression of the bone marrow.e.g.chonic infections, chronic renal
failure,radiation, cytotoxic drugs,hypothyroidism, sensitivity reaction to drugs, or
viral infections, congenital.
(C) Infiltration of marrow by leukemia cells, fibrosis,metastasis, lymphoma,e.t.c.

27. ( 2)Excessive Destruction of Red cells due to:
(A)Abnormality of hemoglobin molecule, e.g.various hemoglobinopathies and
Thalassemias
(B)Deficiency of red cell enzymes: e.g. glucose-6-phosphate dehydrogenase.
Pyruvate kinase. Glutathione synthesis e.t.c.
(C) Abnormality of red cell membrane.
E.g. hereditary spherocytosis & non- sphyrocytosis hemolytic anemias
e.t.c.
(D) Auto-immune hemolytic anemias.

28. CLASSIFICATION :
A) Morphological classification :
This is based on the variation in average mean corpuscular volume (MCV) and
average Mean Corpuscular Hemoglobin Concentration (MCHC
1) Microcytic Hypochromic Anaemia :
Nutritional anaemia
Pyridoxine responsive anaemia
Post hemorrhagic anaemia Dys-erythropoietic anaemia
Thalassemia Lead poisoning
2) Microcytic Normochromic Anaemia :
Chronic infections
Malignant diseases
3) Normocytic- Normochromic Anaemia :
Infections
Aplastic Anaemia
Pure red cell aplasia
Hypothyroidism
Chronic hepatic and renal diseases
Myeloproliferative disorders - Leukemia
Hemolytic anaemia : G-6-PD deficiency, hereditary spherocytosis,
Sickle cell anaemia
4) Normocytic- Hypochromic Anaemia :
Deficiency of iron through
- defective absorption.
- excessive demand i.e. infancy, puberty and pregnancy.

29. 5) Macrocytic- Normochromic Anaemia :
Deficiency of haemopoietic factors like Vit B12, folic acid, Vit. C
and thyroxin.
Liver diseases.
6) Macrocytic- Hypochromic Anaemia :
Intense activity of the bone marrow as in hemolytic anemia,
thalassemia etc.
B) Etiological classification
1)Impaired production of RBC
a) Due to deficiency of substance essential for erythropoiesis :
b) For the complete formation of RBCs certain factors are necessary
as - Iron, Vitamin B12 (extrinsic factor), folic acid, Vitamin C,
Vitamin B6 etc.

30. (2)EXCESSIVE BLOOD LOSS (HEMORRHAGIC ANAEMIA) :
a) Acute : - Trauma
Scurvy
Hemophilia
b) Chronic :- Lesion of G.T. Tract –
Bleeding peptic ulcer,
bleeding piles
Gynecological disturbances.

31. EXCESSIVE BLOOD DESTRUCTION (HEMOLYTIC ANAEMIA)
a) Intrinsic (Intracorpuscular) abnormalities of Red cells –
Abnormal shape : - Spherocytosis
Elliptocytosis
Abnormal Hb : - Sickle cell anaemia
B) Extrinsic (Extra corpuscular) abnormalities
Antibody mediated : -Transfusion reactions
Erythroblastosis faetalis
Drug associated
S.L.E.
Mycoplasma infection
(c)Mechanical trauma to red cells:-
Thrombocytopenic purpura
DIC
Infection : , Malaria
Chemical injury : -Lead poisoning
Animal poison : - Snake venom

32. Clinical feature of Anaemia :
The development of clinical features in anemia depends upon following
factors –
1) Rate of development of anemia : Rapidly progressive anemia causes
more symptoms.
2) Severity of patient : Mild anemia produces no sign or symptoms but a
rapidly severe anemia (Hb below 6gm/dl) may produce significant clinical
features.
3) Age of the patient : The young patients due to good cardiovascular
compensation tolerate anemia .
Elderly patients develop cardiac and cerebral symptoms more
prominently due to associated cardiovascular diseases.

33. CLINICAL FEATURES OF ANEMIA

34. Symptoms:
1) Tiredness 11) Tinnitus
2) Easy fatigability 12) Drowsiness
3) Generalized muscular weakness 13) Tingling numbness
4) Lethargy 14) Amenorrhoea
5) Headache 15) Loss of libido
7) Confusion 16) Anorexia
8) Visual disturbances 17) Constipation
9) Dyspnoea on exertion 18) Weight loss
10) Faintness, giddiness 19) Palpitation
Signs :
1) Pallor - in mucous membranes (conjuctiva and skin)
2) Tachycardia
3) Collapsing pulse
4) Cardiomegaly (CCF)
5) Mid systolic flow murmur
6) Mild proteinuria

35. Iron deficiency anemia :-
Iron deficiency anemia is the most common form of anemia. Iron
is a key part of red blood cells.
Body normally gets iron through your diet and by re-using iron
from old red blood cells.
You lose more blood cells and iron than your body can replace or
does not absorbing iron. Your body is able to absorb iron, but you are not
eating enough foods with iron in them .Your body needs more iron than
normal (such as if you are pregnant or breastfeeding)
Iron loss can be due to bleeding. Common causes of bleeding are:
Heavy, long, or frequent menstrual periods. Cancer in the esophagus,
stomach, or colon, Esophageal varices.
The use of aspirin, ibuprofen, or arthritis medicines for a long
time .Peptic ulcer disease.

36. Due to Celiac disease -Crohn's disease -Gastric bypass
surgery. Taking too many antacids that contain calcium. You may not get
enough iron in the diet if You are a strict vegetarian .
Symptoms
No symptoms if the anemia is mild.
Most of the time, symptoms are mild at first and develop slowly.
Symptoms may include: Feeling grumpy, weak or tired more often than
usual, or with exercise.
Headaches, Problems concentrating or thinking , Blue color to the whites of
the eyes,
Brittle nails, Light-headedness when you stand up,
Pale skin color ,Shortness of breath
Atrophic glossitis, Angular stomatitis, Dysphasia.
Heavy menstrual bleeding (women).
Pain in the upper belly (from ulcers). Weight loss (in people with cancer

37. Investigatios:-
As per usaual. R.B.C. & Hb% reduced than normal
The peripheral smear will show red cells – Hypochromic &
microcytic.
In sever Anemia-Hb% less than 7gm.
Serum iron reduced(less than 50 mcg/dl) . Serum ferritin level is
decresed
D/D:-
Tests that may be done to look for the cause of iron
deficiency
Colonoscopy,
Fecal occult blood test
Upper endoscopy

38. Treatment;-
Easily corrected with iron therapy.with oral or parenteral
rout. Mild to moderate iron deficiency anemia is treated by oral
iron supplementation with ferrous sulfate, ferrous fumarate,
or ferrous gluconate . (most often ferrous sulfate) are needed
to build up the iron stores in your body.
Hematocrit should return to normal after 2 months of iron
therapy.
However, keep taking iron for another 6 - 12 months to replace
the body's iron stores in the bone marrow.
Iron-rich foods include:

39. Anemia is chercterised by an abnormal erythropoiesis resulting in
macrocytic anemia,usually occurs due to deficiency of folate and vitamin B12.
Causes of this type of anemia consists of- inadequate ingestion,
inadequate absorption& utilization, increased requirement & excreition or
destruction .
Folate-deficiency anemia:-
Folate, also called folic acid, is necessary for red blood cell formation and
growth. You can get folate by eating green leafy vegetables and liver.
The minimum daily requirement of folte is 50 to100ng for adult.Daily.
Require dose for pregnant woman is 400ng.In poor people there is
deficiency of B12 & folic acid.
The red cells are abnormally large. That is why this anemia can also be
called megaloblastic anemia .
MEGALOBLASTIC ANEMIA

40. Causes of this anemia :-
Certain Drugs:- phenytoin [Dilantin]
methotrexate, sulfasalazine, triamterene,
pyrimethamine, trimethoprim sulfamethoxazole, and
barbiturates. Chronic alcoholism, Crohn's disease, celiac disease,
tapeworm, or poor dietary intake & Poor absorption of folic acid.
surgeries that remove certain parts of your stomach or small
intestine, such as some weight-loss surgeries,
malignancy, hyperthyroidism.
Treament:-
The goal is to identify and treat the cause of the folate deficiency.
Folic acid supplements may be given by mouth (oral) or through a vein
(intravenous) on a short-term basis until the anemia has been corrected.

41. Vitamin B12 (Cobalamin; Cyanocobalamin)deficiency Anemia
Vitamin B12, like the other B vitamins, is important for metabolism.It helps
in the formation of red blood cells and in the maintenance of the central nervous
system.
Vitamin B12 is found in:- Eggs, Fortified foods such as soymilk, Meat, Milk
and milk products, Organ meats (liver and kidney), Poultry, Shellfish. The body
absorbs animal sources of vitamin B12 much better than plant sources. Non-animal
sources of vitamin B12 vary in their amount of B12.
Pernicious anemia (Macrocytic achylic anemia;)
Malabsorption of B12 due to lack gastric intrinsic factor.
A clinical feature is the neurological manifestations- paresthesia to severe
weakness and spasticity due to myelin degeneration of peripheral nerves and
posteriolateral colmns of the spinal cord.
There are symptoms like- Confusion or change in mental status (dementia)
in severe or advanced cases.Depression, Loss of balance. Numbness and tingling of
hands and feet. Serum vitamin B12 level is less than normal in blood.

43. Treatment :-
Monthly vitamin B12 injections are prescribed to correct the
vitamin B12 deficiency. This therapy treats the anemia and may correct the
neurological complications if taken early enough. In people with a severe
deficiency, the injections are given more often at first.
Preparation of vitamin B12 that may be given through the nose. For
some people, taking vitamin B12 tablets by mouth in a very high dose can be
an effective treatment.
A well-balanced diet is essential to provide other elements for
healthy blood cell development, such as folic acid, iron, and vitamin C.

44. NIDANARTHAKARA ROGAS OF PANDU
Raktattipravartana Katikataruna marmavedha
Raktavahidhamniveda Raktarbuda
Upadravas of raktapitta
Raktapradara Raktakshaya-Yakritapliha vedha
Raktasrava
Punaravartaka jwara Jeerna jwara
Grahani Raktarsha
Kaphajarsha
Plihodara
Shotha
Rajayakshama Swasa
Santarpanajanyaroga Rasapradoshaja roga

45. Hemolytic anemia
Hemolytic anemia is a condition in which there are not enough
red blood cells in the blood, due to the premature destruction of red
blood cells. There are a number of specific types of hemolytic anemia.
The defect may be in the red blood cell itself (intrinsic factors), or
outside the red blood cell (extrinsic factors).
Intrinsic factors are often present at birth (hereditary). They
include:-Abnormalities in the proteins that build normal red blood cells &
HB.
Extrinsic factors include:-Abnormal immune system responses,
Blood clots in small blood vessels, Certain infections, Side effects from
medications.There are some immunological disorders. some special
conditions-in new born child & paroxysmal nocturnal hemoglobinuria in
adult.

46. SYMPTOMS & SIGNS :-
Chills, Dark urine, Enlarged spleen, Fatigue, Fever, Pale skin color
(pallor), Rapid heart rate, Shortness of breath, Yellow skin color(jaundice)
Tests :-
Absolute reticulocyte count,
Free hemoglobin in the serum or urine
,
Red blood cell count (RBC), hemoglobin, and hematocrit (HCT)
Serum indirect bilirubin levels
Coombs' test, indirect &direct test .
Peripheral blood smear, Platelet count, Protein electrophoresis-
serum, RBC indices, Serum creatinine,
Serum ferritin, Serum iron & potassium level.

47. G-6-PD deficiency; Hemolytic anemia due to G6PD deficiency;
Anemia - hemolytic due to G6PD deficiency
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is a hereditary condition
in which red blood cells break down when the body is exposed to certain drugs or the
stress of infection.
Causes, incidence, and risk factors
G6PD deficiency occurs when a person is missing or doesn't have enough of an
enzyme called glucose-6-phosphate dehydrogenase, which helps red
blood cells work properly.
Idiopathic aplastic anemia
Blood picture:–
Anemia+Leucopenia+ Thrombocytopenia.(congenital & acquired
form)
Mostly Drug induced., some viral infections.

48. APLASTIC ANEMIA

49. Idiopathic aplastic anemia
.
Idiopathic aplastic anemia is a condition in which the bone marrow fails to
properly make blood cells. Bone marrow is the soft, fatty tissue in the center of bones.
Causes, incidence, and risk factors
Aplastic anemia results from injury to the blood stem cells, immature cells in
the bone marrow that give rise to all of other blood cells types.
PANCYTOPENIA:-
The injury causes a decrease in the number of every type of blood
cell in the body -- red cells, white cells, and platelets. Low numbers of red cells, white
cells, and platelets .
Aplastic anemia may also be caused by certain medical conditions (such as
pregnancy or lupus) or exposure to some toxins or drugs (including chemotherapy).
See: Secondary (acquired) aplastic anemia
In some cases, aplastic anemia is associated with another blood disorder called
paroxysmal nocturnal hemoglobinuria (PNH).

50. Symptoms
Symptoms are the result of bone marrow failure and the loss of blood cell
production.
Low red cell count (anemia) can cause:
Fatigue
Pallor (paleness)
Rapid heart rate
Shortness of breath with exercise
Weakness
Low white cell count (leukopenia) causes an increased risk of infection.
Low platelet count (thrombocytopenia) results in bleeding, especially of
the mucous membranes and skin. Symptoms include:
Bleeding gums
Easy bruising
Frequent or severe infections
Nose bleeds
Rash--small pinpoint red marks on the skin (petechiae)

51. Treatment
Mild cases of aplastic anemia may require no treatment.
Symptoms will be treated as appropriate.
In moderate cases, blood transfusions and platelet
transfusions will help correct the anemia and the risk of bleeding.
Severe aplastic anemia occurs when blood-cell counts are
very low, and is a life-threatening condition. Bone marrow
transplant or stem cell transplant is recommended for severe
disease in patients under age 40.
Bone marrow transplant has been successful in young
people, with long term survival rates of about 80%. Older people
have a survival rate of 40 - 70%.

52. SICKLE CELL ANEMIA

54. Sickle cell anemia
Sickle cell anemia is a disease passed down through
families in which red blood cells form an abnormal crescent
shape. (Red blood cells are normally shaped like a disc.)
Sickle cell anemia is caused by an abnormal type
of hemoglobin called hemoglobin S.
Thalassemias:-
causing deficient globin synthesis.there are two
types-by impaired production of polypeptide chains.
(1) Alpha(2)Beta types.

57. Acharya Charak has advocated both type of Snehan--Vahya as well
asAbhyantarSnehan.
Snehnartha-Yoga :
1 Pancha-gavya Ghrit (Cha.Chi.10/18-24)
2 Maha-tikta Ghrit (Cha.Chi. 7/144-150)
3 Kalyanak Ghrit (Cha.Chi 9/35-41)
4 Dadimadi Ghrit (Cha.Chi. 16/44-46)
5 Katukadya Ghrit (Cha.Chi. 16/47-49)
6 Pathya Ghrit (Cha.Chi. 16/50)
7 Draksha Ghrit (Cha.Chi 16/52)
8 Haridradi Ghrit (Cha.Chi. 16/53)
9 Murvadya Ghrit (Chakradatta 8/54)
10 Rajni Ghrit (Vangsen Pandu 39)
11 Triphaladi Ghrit (Vangsen Pandu 39)

58. Avaleha used in Pandu :
1Darvyadi Leha (Ch.Chi.16/97)
2 Dhatrayvaleha (Ch.Chi.16/100-101)
3 Drakshadi Avleha (As.Hri.16/29-31)
4Manduradya Avaleha (Y.R.)
5 Triphaladya Avaleha (Y.R.)
Charak Sushruta(Asava-Arista)
1 Goudakarista
2 Bijakarista
3 Dhatryrishta
4 Abhyarishta
5 Madhavsav
6 Sharkarasav
7 Lohasav

59. Loha alone Loha in Yoga
1 Loha Bhasma
2 Shuddha Mandoor Churna
3 Tikshna Loha
4 Shuddha Kasis Bhasma
5 Suwarna Makshika
6 Shuddha Shilajit
7 Shuddha Gairik
8Navayas Churna
9 Tapyadi Loha
10 Punarnava Mandur

60. “NISHA LOHA VATI” ( Bhaishajya-ratnavali Pandu rogadhikara )
NAVAYAS LOHA VATI ( Charak samhita Pandurog chikitsa )
NISHA – LOHA VATI
Ref. :- Bhaishajya – Ratnawali Adhikara :- Pandu Rogadhikara
01. Haritaki Terminalia Chebula 1 Part
02. Bibheetaki Terminalia belerica 1 Part
03. Amalaki Embelica Officinalis 1 Part
04. Haridra Curcuma Longa 1 Part
05. Daruharidra Berberis Aristata 1 Part
06. Kutaki Picrorhiza Kurroa 1 Part
07. Lauha Bhasma 6 Part
Thesis on Pandurog-2006 –Dr. Deepmala Patil
Guide-Dr. Nayan joshi

62. Thesis on Pandurog- Dr.M.N.Shaikh-2009
Guide-Dr.Nayan joshi
V K TABLET
“V K TABLET” Modified reference of Ashtang hridaya1 and Rasatarangini2 for Pandurog chikitsa with comparison to
Dhatri Loha-23 as a control.
Ingredients :-
01. Vasa Adhatoda Vasika 1 Part
02. Kasis bhasma ------- 3 Part
03. Haritaki Termanalia chebula 1 Part
04. Bibheetaki Terminalia belerica 1 Part
05. Amalaki Embelica Officinalis 1 Part
06. Guduchi Tinospors cordifolia 1 Part
07. Kirat tikta Swertia chiraita 1 Part
08. Nimb Twaka Azadiracta indica 1 Part
The tablets of 500mgs.
DHATRI LOHA-2
Ingredients :-
01. Amalaki Embelica Officinalis 8 Part
02. Lohabhasma ------- 4 Part
03. Yashtimadhu Glyseriza glabra. 2 Part
Bhavanaarth: Giloy Kwath

63. PANDU PATHYA-APATHYA
1) Pathya Ahar :
Food : Old wheat, rice (Shastika), Barly, Jwar, Green Gram,
Vegetables : Dudhi, Patol, Bimbi, Chakvat, Palak, Shepu, Jeevanti,
Guduchi, Punarnava, Haridra.
Non vegetables : Shigada fish, Goat meat, Jangal meat
Fruits : Amala, Grapes, Anjeer, Chiku, Banana, Falash, Mango, Khajoor,
Keshar.
Roots : Shingada, Kamalkunda, Lasona, Ginger
Milk and Milk Products : Cow milk, Ghee, Navneeta Takra
Liquids : Go-mutra, Laja-Manda, Koshna Jal, Laghu Panchamula Siddha-jal.
As per New Science- SoyaProducts-Dairy products-Buttermilk-e.t.c.

64. 3) Apathya Ahar :
Shak Varga - Except above
Shimbi Varga - Matar, Masha, Pinyak
Dal Varga - Til, Sarshapa
Tail Varga - Bijowar Tail
Jal Varga - Atyambu Pan
4) Apthya Vihar
Divaswapa, Atapsevan, Ativyayama, Ativyavaya,
, Chinta, Shoka ,
Krodha etc.
As per Ayurved Nidan Parivarjanam.