A very common health problem found today is Anaemia, usually seen in females and children. As per modern science, Anaemia is not classified as a disease. It is a state or condition in which the level of Haemoglobin in blood is below the normal range appropriate for a particular age and sex. In this condition decreased Oxygen supply to the tissues occur leading to tiredness, muscle weakness, headache, lack of concentration, faintness, dizziness, dyspnoea on exersion, palpitation etc. The patient when examined, shows pallor of tongue, nails and mucosa. Sometimes tachycardia and systolic flow murmer. In severe cases ankle oedema and cardiac manifestations are also found.
The history of patient when taken in detail may include malnutrition (inadequate diet, iron deficiency, folate deficiency, Viatmin B12 deficiency etc), pregnancy, menorrhagia, heamolysis, rheumatoid arthritis, SLE, jaundice, any surgery, drugs like NSAID, family history of pernicious aneamia, malignancy etc. Any one of these conditions when found in the history of patient may clearly indicate aneamia.
Causes for Aneamia
- Lack of Iron, Viatamin B12, folate deficiancy, Viatmin C Deficiency
- Renal problems
- Anaemia of any chronic diseases
- Blood loss
- Protein energy malnutrition.
- Pathology of bone marrow.
- Defect in RBC size (Normocytic, Microcytic, Macrocytic)
- Genetic disorders like Thalessemia.
Normal values of Hb or Haemoglobin in gm/dl
Males – 13.5 to 17.5
Females – 12 to 16
Treatment as per Modern Medicine
After knowing the correct cause of Aneamia, Iron preparations may be administered either Oral or Parental. Food rich in Iron and Viatmin C are administered. In case of pregnancy, Iron tablets are prescribed by the physicians after the end of first trimester till delivery.
Siddha science has placed Anaemia not as a state or condition but a disease. In Siddha, the term Pandu may be used instead of Aneamia. Pandu is other wise called Veluppu noi, Venpandum etc. In this disease- the body, conjunctiva, nail bed, oral mucosa etc appears pallor. This is due to poor quality of blood.
There are six types of Pandu. Three are caused due to derrangement of a specific humour, Vatham or Pitham or Kapham. One of the classifications is caused due to derrangement of the three humours together known as the Mukkutram Pandu. Another one type is caused due to toxic manifestion in blood known as Nanju Pandu. This type is incurable one. The last one is caused due to Pica (intake of mud, ash, chalk, camphor, brick powder etc) known as Mannun Pandu. Worm infestation may be caused due to pica leading to Aneamia. This type is most commonly seen in pregnant ladies and children.
Signs and Symtoms
Tiredness on mild exertion, Nausea, Loss of appetite, Giddiness, Palpitation, Loss of general health and stamina, Loss of weight, Pallor of conjunctiva, Pallor and thickening of nail bed.
Siddha causes of Pandu
- Excessive intake salt, sore or pungent food.
- When affected by diseases like fever, diarrhoea, arthritis, bronchial asthma, vomitting etc.
- Conditions causing increased blood loss – Perumpadu (Menorrhagia), Kuruthiazhal, Kuruthivanthi (Bloody vomitting), Kuruthikazhichal (Bloody diarrhoea)
- Blood loss due to wounds and injuries.
- Intake of toxic substances
- Worm infestation.
- Liver diseases.
- Pica or intake of tobacco, betle leaves, arecuanut, sacred ash, camphor etc.
- Increased intake of alchohol
- Increased sexual activities.
- Increased sleep during the day time.
- All these activities lead to increased Pitham humour leading to change in normal complexion of body, palor of the entire body, especially nail and conjuctiva.
- Severity of Pandu leads to Manjal noi or Kamalai (Jaundice), then Sobia (Dropsy) and finally Peruvayiru (Ascites).
Primary cause of Pandu is Pitham humour resulting from any one of the etiological factors. The digestive fire or the Anal pitham of the patient decreases leading to poor quality of blood and nourishing juice. Finally Paravukaal or the Viyanan gets derranged leading to improper and insufficient circulation of nutrients leading to Pandu or Veluppu noi.
Treatment as per Siddha Medicine
The drug of choice is done according to the type of Pandu. Initially mild purgation is administered to normalise the Pitham humour. Drakshai or dried grapes can be used for this.
Ponnavarai tablet one or two can be administered at bed time along with milk.
In case of worm infestation caused in Mannun Pandu, Agathi keerai (Sesbania grandiflora) is boiled along with panai kalkandu and given.
Murukkan vithai tablet half to one can be administered for purgation in case of worm infestation.
If the patient is suffering from diarrhoea, Theleesathi Choornam, Elathi choornam, Chundai vatral choornam can be given.
Medicines to improve quality of blood is then administered.
Karpa drugs like Aya Sambeera Karpam, Karisalai karpa tablets, Aya Bringaraja Karpam etc are preffered.
Parpams and Chendooram like Aya chendooram, Kantha Chendooram, Velli Chendooram, Armugha Chendooram, Ayakantha Chendooram are good haematincs. Annabedhi chendooram and Vediannabedhi chendooram are more commonly used and best haematinics.
While using Iron containing Parpam and Chendoorams, after a course of 10 days of medication, a gap of 10 days is kept before the next course so as to avoid chronic constipation. Mild laxatives should also be given to prevent constipation.
Vitamin C supplements like Nellikkai, Thriphala choornam or Citrus fruits should be given during medication for better absorption of iron.
Tonics like Nellikkai Lehyam, Tetrankottai Lehyam are admistered. Digestives and appetizers like Thaleesathi Vadagam, Thaleesathi Choornam, Eladi Choornam, Ashta Varga Choornam etc are administered.
Diet should include Greens like Ponnankani, Aru keerai, Murunga keerai, Manathakkali keerai, Pumpkin, Gooseberry, Pomegranate, Dates, Grapes, Seasame, soup of liver of goat etc.
Patient is advised to take adequate water, fruit juices and Vitamin C containing foods.
Proper sleep at night is advised. Yoga, Exercises and Outdoor games are advised to keep the health sound. Meditation is advised to improve concentration as well as to reduce tiredness and depression.