Acharya Charaka describes five types of Pandu Roga in Cha. Chi. 16 Adhyaya along with its samprapti and chikitsa according to causative factors and doshas involved in vyadhiprakara. Four types of Pandu such as Vataja, Pittaja, Kaphaja and Sannipatika caused due to doshaprakopa and agnimandya but because of specific cause of Mrudbhakshanjanya Pandu i.e. consumption of soil, for that Charakacharya described a separate samprapti and chikitsa. The consumption of soil causes Pandu by vitiating dosha and thus it should be considered as doshajbheda. It also causes excessive dryness of the body (Rauksya) and obstructs the srotas without getting digested in the body. This srotorodha restricts the nourishment of uttarottar dhatus, thus giving rise to Panduvyadhi. It does not get cured when treated as per dosha predominance. Because it does not help in digestion of the soil responsible for obstruction in the srotas, it does not allow digestion and absorption of rest of the substances. So, it disturbs the formation of Rasa dhatu as well as successive dhatus, thus resulting in loss of strength of sense organs, physical strength and Oja due to lack of nourishment of dhatu. Separate line of treatment is mentioned for this type of Pandu vyadhi having specific causative factor. Teekshnasan shodhan is advised in Mrudbhakshnjanya Pandu after proper examination of vyadhibala (stage of disease) and bala (strength) of patient. Looking at this unique approach of Ayurveda in treating Mrudbhakshanjanya Pandu,topic was selected

Keywords: Mrudbhakshanjanya Pandu, Srotorodha, Teekshnashodhana.

Introduction:

Acharya Charaka described types of Pandu, samprapti and vishesha chikitsa with details in Chikitsasthana16 Adhyaya. Charakacharyahas also described a separate samprapti and chikitsa for Mrudbhakshanjanya Pandu caused due to consumption of soil. As,

मृत्तिकादनशीलस्यकुप्यत्यन्यतमोमल: ।

कषायामारुतं, पित्तमूषरा, मधूराकफ़म॥

कोपयेन्मृदरसादींश्चरौक्ष्यादभुक्तंविरुक्षयेत।

पूरयत्यविपक्वैवस्रोतांसिनिरुणद्धिच॥

इन्द्रियाणांबलंहत्वातेजोवीर्यौजसीतथा।

पाण्डुरोगंकरोत्याशुबलवर्णाग्निनाशनम॥च.चि.१६/२७-२९

शूनगण्डाक्षिकूटभ्रू: शूनपान्नाभिमेहन: ।

क्रिमिकोष्ठोऽतिसार्येतमलंसासृककफ़ान्वित्म॥च.चि.१६/३०

The doshaprakopa remains the same as per the taste of soil, it also causes excessive dryness of the body (Raukshya) and obstructs the srotas without getting digested in the body. This srotorodha restricts the nourishment of the uttarottar dhatu, thus giving rise to Pandu vyadhi. It does not get cured when treated as per dosha predominance because it does not help in digestion of the soil responsible for obstruction in srotas, it does not allow digestion and absorption of rest of the substances. It disturbs the formation of Rasa dhatu as well as successive dhatu, thus resulting in loss of strength of sense organs, physical strength and oja due to lack of nourishment of dhatu. So, it should be considered and studied as a separate entity.

निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक ।

युक्तिज्ञ: शोधनैस्तीक्ष्णै: प्रसमीक्ष्य बलाबलम ।

शुद्धकायस्य सर्पींषि बलधानानि योजयेत ॥  च.चि.१६/११७

Separate line of treatment is mentioned for this type of Panduvyadhi having specific causative factor. Teekshnasan shodhana is advised in Mrudbhakshanjanya Pandu to clear the obstruction of the srotas caused due to soil. But this sanshodhana should be performed after proper examination of vyadhibala (stage of disease) and rugnabala (strength of patient). Once sharirashuddhi is achieved with sanshodhana, ghruta medicated with bala vardhaka and agnivardhaka aushadhi should be administered in which Vyoshadi ghruta, Kesharadi ghruta proved to be effective.

In such condition, nidanparivarjan (avoiding consumption of causative factors) is also equally important. If patient cannot resist the habit of eating soil, the soil triturated with the medicines useful in getting rid of the doshas caused by Mrudbhakshan should be given to him. It includes Vidanga, Ela, Ativisha, Nimba, etc.also, this mrudbhakshan can give rise to krumi, which further causes Panduvyadhi, So, these patients should be treated for krumi also.

 So, I have selected a case having classical signs and symptoms of Mrudbhakshanjanya Pandu given Teekshna Shodhan after amapachaka-agnideepaka and krumighna chikitsa. After sanshodhana, balavardhaka and rakatavardhaka chikitsa is also given and it is observed that Teekshnashodhana is very important in Mrudbhakshanjanya pandu.

Aim and Objectives:

1. To study the effect of Teekshnashodhana in Mrudbhakshanjanya Pandu.

2. To study the Mrudbhakshanjanya Pandu as a separate entity.

Case Report:

The present case study is successful Ayurvedic management of case of Mrudbhakshanjanya Pandu.

40 yrs. / Female patient came with

C/O: Mrudbhakshaneccha

Kshudhamandya

Ganda-Akshi-Bhru-ShunaSince 6 months                                                                      

Samanya Daurbalya

AayasenShwasa

Chittodwega

Medical History: K/C/O of DM-II since 4 yrs. On regular treatment.

Surgical History: Not specific.

Menstrual History: 3-4/30 days, Regular, Moderate bleeding, painless.

O/H: G₃P₃L₃A₀D₀

Personal History: Habit of chewing roasted Multani Mati (Fuller’s earth), 5-10 gms. per day since 6 months.

O/E: Nadi(Pulse)- 84/min.           Ura- AEBE clear

Mala (Stool)-Samyakapravrutti Udara- Soft, Not tenderness

Mutra(Urine)-Prabhuta, Varanvar pravrutti Kshudha- Mandya

Jivha(Tongue)-Saam Nidra- Khandita

Bala- MadhyamDruka (Eyes)-Panduta

Shabda (Speech)- Normal                            Nakha(Nails)- Panduta

Akruti-MadhyamTwak- Rukshta

B.P.- 110/70 mmHg

Materials and Methods:

First visit: Deepana-Pachana-KrumighnaChikitsa

Sr. No.	Medicine	Dose	Anupana	Kala
	AmapachakKwatha	20 ml BD	Jala	Before meal
	HingwashtakChoorna	3 gms BD	Cow ghee	Before meal
	Vidangarishta	20 ml BD	Jala	After meal
	GandharvaHaritakiChoorna	3 gms HS	Koshnajala	Bed time

 

Vaman Karma:Purvakarma: SarvangaSnehana-Swedana

VamanaKalpa	Madanphala (12 gm) + Pippali (6 gm) + Vacha (3 gm) + Saindhava (5 gm) + Madhu (q.s.)
Vamanopaga	YashtimadhuPhanta
Pariksha	Vaigiki: 8 vega
	Laingiki: Laghavata, Klama
	Antiki: KramatKapha-Pittanta
	Maniki: 6 lit.
Pashchat Karma	Dhoomapan, Vishranti, Sansarjankarma

 

Virechana Karma:Purvakarma: SarvangaSnehana-Swedana

VirechanaKalpa	AbhayadiMadaka 3 Vati
Anupana	Sheetajala
Pariksha	Vaigiki: 10 vega
	Laingiki: Klama, Shirshula, Alpahrullasa, Vatanulomana
	Antiki: Kramat Pitta-Kaphanta
Pashchat Karma	Vishranti, Sansarjankarma

 

Abhyantara Chikitsa: Balya and Raktavardhakachikitsa

Sr. No.	Medicine	Dose	Anupan	Kala
1	ShatavariKalpa	5 gm	Cow milk	At morning
2	PunarnavaMandoora	250 mg BD	Cow ghee	After meal
3	RaktajeevanAvaleha	5 gm BD	Jala	After meal
4	Dadimavaleha	10 ml BD	Jala	After meal
5	Vidangarishta	20 ml BD	Jala	After meal
6	HingwashtakChoorna	3 gm BD	Goghruta	Before meal

 Pathya-Apathya:

As a ApunarbhavaChikitsa:

Nidanparivarjana:For withdraw of the habit of chewing Mulatanimati the soil medicated with Krumighna and Tikta medicine is used such as Vidanga, Nimba, etc.

PathyaAhar:

Food: Old wheat, rice (shashtika), Barly, Jwar, Green gram

Vegetables: Dudhi, Palaka, Padaval, Shepu

Non-vegetables: Goat meat, Jangal meat

 Fruits: Amala, Grapes, Dadima, Anjeer, Khajoora, Chiku, Banana, Mango

Milk products: Cow milk, Cow ghee, Takra

 Liquids: Gomutra, Lajamanda, Koshnajala, Laghupanchmoola siddha jala

Apathya Ahar:

Oily, spicy, junk food

Diwaswapa, Atapasevan, Ativyayama, Ativyavaya, Chinta, Shoka, Krodha

Observations and Results:

1. Patient had slight increases in appetite after Vamana karma
2. After Virechana, appetite is good and marked improvement in symptom Ganda-Akshi-Bhrushuna.
3. Due to balya and rakta vardhaka chikitsa, decreases the symptoms Samanya Daurbalya, Ayasen shwasa,
4. Only symptomatic relief was observed. No haemoglobin levels were measured before and after the procedures.

Discussion:

Mrudbhakshanjanya Pandu is a peculiar type of Pandu caused due to the consumption of soil. Consumption of soil in excess leads to the vitiation of all the three doshas, which further vitiate the Rasa-Raktadhatu and causes Mrudbhakshanjanya Pandu. This soil doesn’t get digested by the metabolic fire so, fill up the channels of circulation (Srotas) in the body and deplete the cells and organs from nutrition, causes dryness and damage of the system. So, Teekshna shodhana is one of important treatment of Ayurveda which deal with elimination of aggravated dosha from body causes purification of vitiated dhatu and this improves the jatharagniand dhatavgni ultimately improves digestion.

Hetu: Habit of chewing roasted Multanimati (Fuller’s earth)

Samprapti:Hetusevana (Roasted Multanimati)

Kashay - Vataprakopa -->Madhur – Kaphaprakopa -->Srotorodha -->Agnimandya -->DhatuposhanAbhava (Rasa, Rakta) -->Twakrukshata -->Indriya, Bala, Varna Hani -->PANDU

Samprapti Ghataka:

Dosha: Vata-Kapha

Dushya: Rasa, Rakta

Agni: Jatharagni, Dhatvagni

Srotas: Rasavaha, Raktavaha

Samprapti Bhanga:

Deepan-PachanChikitsa: Reduces Amadosha that increases Agni.

Vaman-Virechana Karma: Reduces Kapha-Raktadushti by removing obstruction from srotas causes improvement in jatharagni and dhatvagni.

Balya-Raktavardhaka Chikitsa: Improves bala and formation of sarayukta Rasa-RaktaDhatu.

Conclusions:

Teekshna shodhana removes aggravated doshas from body permanently causes improvement in Agni (Metabolic fire) and opens the channels of circulation which provides the nutrition and energy to cells and organs. So, reduces Dhatushaithilya and gives bala and sarayukta dhatu.

* MD Scholar

** HOD and Professor of Kayachikitsa Department

References:

1. Charak Samhita- Chakrapanidattatika edited by Vd. J.T. Acharya, Chaukhamba Sanskrit Sansthan (5^th edition 2001).
2. Bhavaprakash (Uttarardh)- Edited by Vd. Boamhashankar Mishra (9^th edition 2005).
3. Madhav Nidan with Madhukosh commentary with extracts from Atankadarpanaby Vd. Vachaspati Vaidya, Chaukhamba Orientalia, 1^stedition 1986.
4. Yogratnakar : Vidyotini Tika published by Chaukhamba Sanskrit Sansthan.
5. Ayurvediya Panchakarma Vidnyan: By Vaidya H.S.Kasture, published by Shri Baidyanath Ayurved BhavanLtd. 3rd edition.

 

Download Article