i
“A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD
SMEAR IN DIFFERENT TYPES OF DOSHAJA PANDU ROGA”
BY
Dr. SHIVANI KAUNDAL B.A.M.S
Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bengaluru
In partial fulfillment of the requirements for the degree of
“AYURVEDA VACHASPATI”
DOCTOR OF MEDICINE(AYURVEDA)
In ROGANIDANA
GUIDE
Dr. VENKATESHA S M.D.(Ayu)
Reader & HOD Department of P.G. Studies in Roganidana
JSS Ayurveda Medical College. Mysuru
DEPARTMENT OF POST GRADUATE STUDIES IN ROGANIDANA JSS AYURVEDA MEDICAL COLLEGE MYSURU – 570028
2017 – 2018
ix
ABBREVIATIONS
Ch – Charaka Samhita
Chi – Chikitsa sthana
Vi – Vimana sthana
Su – Sushruta Samhita
Ut – Uttara tantra
A.H – Ashtanga Hrudaya
Ni – Nidana sthana
B.P – Bhavaprakasha
Y.R – Yogaratnakara
M.N – Madhava Nidana
G.N - Gada Nigraha
x
LIST OF TABLES
SL NO. HEADING PAGE NO.
1 Classification of Pandu roga 9
2 Aharaja nidana 11-12
3 Viharaja nidana 13
4 Manasika nidana 14
5 Nidana with effect on dosha- dushya 14-15
6 Samanya lakshana 20-21
7 Samanya lakshanas with Amshmsha kalpana 22-24
8 Vataja Pandu lakshana 24-26
9 Pittaja Pandu lakshana 26-27
10 Kaphaja Pandu lakshana 28-29
11 Tridoshaja Pandu lakshana 29-30
12 Upadrava of Pandu roga 44
13 Distribution of Subjects according to Age 61
14 Distribution of subjects according to the Gender 62
15 Distribution of subjects according to the Locality 63
16 Distribution of subjects according to the religion 64
17 Distribution of subjects according to the marital
status 65
18 Distribution of subjects according to the
educational status 66
19 Distribution of subjects according to the Socio 67
xi
economic status
20 Distribution of subjects according to the Diet 68
21 Distribution of subjects according to the appetite 69
22 Distribution of subjects according to the night sleep
70
23 Distribution of subjects according to the day sleep 71
24 Distribution of subjects according to the bowel
(consistency) 72
25 Distribution of subjects according to the tea
consumption 73
26 Distribution of subjects according to the type of
employment 78
27
Distribution of subjects according to the nature of
cycles
79
28 Distribution of subjects according to the Quantity 80
29 Distribution of subjects according to the
nourishment 82
30 Distribution of subjects according to the nadi 83
31 Distribution of subjects according to the Sparsha 84
32 Distribution of subjects according to the Akruti 85
33 Distribution of subjects according to the Prakruti 86
34 Distribution of subjects according to the Pramana 87
35 Distribution of subjects according to the satva 90
36 Distribution of subjects according to the 91
xii
Abhyavarana Shakti
37 Distribution of subjects according to the Jarana
shakti 92
38 Distribution of subjects according to the Vyayama
shakti 93
xiii
LIST OF FIGURES
LIST OF GRAPHS
SL NO. Graph name Page no.
1 Distribution of patients based on Age 61
2 Distribution of patients based on
Gender 62
3 Distribution of patients based on
Locality 63
4 Distribution of patients based on
Religion 64
5 Distribution of patients based on
Marital Status 65
6 Distribution of patients based on socio
economic status 66
7 Distribution of patients based on diet 68
8 Distribution of patients based on
Appetite 70
9 Distribution of patients based on
Night sleep 71
10 Distribution of patients based on Day
sleep 72
11 Distribution of patients based on
Bowel/ consistency 73
12 Distribution of patients based on Type
of employment 74
13 Distribution of patients based on
Nature of cycles 79
14 Distribution of patients based on
Quantity 80
xiv
15 Distribution of subjects according to
the nourishment 81
16 Distribution of subjects according to
the nadi 83
17 Distribution of subjects according to
the Sparsha 84
18 Distribution of subjects according to
the Akruti 85
19 Distribution of subjects according to
the Prakruti 86
20 Distribution of subjects according to
the Pramana 87
21 Distribution of subjects according to
the satva 90
22 Distribution of subjects according to
the Abhyavarana shakti 91
23 Distribution of subjects according to
the Jarana shakti 92
24 Distribution of subjects according to
the Vyayama shakti 93
25 Distribution of subjects according to
the Aharaja nidana 94
26 Distribution of subjects according to
the Viharaja nidana 96
28 Distribution of subjects according to
the Manasika nidana 97
29 Distribution of subjects according to
the Vataja Pandu lakshana 98
30 Distribution of subjects according to
the Pittaja Pandu lakshana 99
xv
31 Distribution of subjects according to
the Kaphaja Pandu lakshana 100
32 Distribution based on the Chromasia
of RBC’s 102
33 Distribution based on the Size of
RBC’s 104
34 Distribution based on the Shape of
RBC’s 106
35 Distribution of subjects based on the
presentation of Size & Color 108
LIST OF FIGURES
1. Figure showing Erythropoiesis
166
2. Figure showing RBC structure 166
3. Steps in the preparation of PBS 167
4. smear having Head, body and tail 167
5. Microcytic hypochromic picture of
RBC
167
6. Anisocytic hypochromic picture of
RBC
168
7. Target cells 168
8. Burr cells 168
Dr Shivani Kaundal 2018
xvii
“A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL
BLOOD SMEAR IN DIFFERENT TYPES OF DOSHAJA PANDU ROGA”
ABSTRACT
Loss in the normal color or discoloration of the body is called as Panduta. Along with
loss of normal color or discoloration of the body, loss or abnormalities are seen in the
texture and luster of body. Pandu roga has been regarded as Agnimandhya krita rasa
dushti janya pitta pradhana vyadhi1 which is characterized by Pandu vaivarnayata i.e.
ketaki dhuli samana varna2. The Pandu roga is included under the heading of
"Varnopalakshita Roga" i.e., Varna pradhanya vyadhi3. Pitta is responsible for the
normal color of the body but when it gets vitiated, there will be loss of complexion or
Panduta occurs. Pandu roga is referred as Vilohita, Harima, and Halima in Vedas and
Sushruta named it as Panaki, Lagharaka and Kumbhawayo.
Lakshanas have given a lot of importance in deciding or diagnosing a disease.
Samnaya lakshanas or general signs and symptoms which are present in the patient and
Vishishta lakshanas or specific signs and symptoms will depict the particular Dosha
involvement in the disease.
As in olden days there were no such modern technologies our Acharyas used their
keen observation in deciding the disease on the basis of Lakshanas. As with the
advancement of modern techniques like blood peripheral smear we are able to see the
changes in morphological structures of cells. Though numerous studies have been done
on Pandu roga but no work has been done to find out the morphological
changes/variations in cells in different types of Pandu roga. This study is aimed to find
Dr Shivani Kaundal 2018
xviii
out the relevance of morphological changes in the blood peripheral smear and to observe
scientific basis in various types of Pandu roga.
OBJECTIVES OF THE STUDY
1) To find out the relevance of peripheral blood smear in diagnosing different types of
Pandu roga.
2) To relate morphological changes in the RBC to the variants of Pandu roga.
METHODOLOGY
• After taking detailed history patient’s consent was taken and later they were subjected to
blood peripheral smear by finger prick technique. A drop of blood was taken and without
delay it was spread over the non-grease slide. Precautions such as length of the smear i.e.
3-4 cm, ideal thickness, and proper staining technique were adopted and slides were
thoroughly observed under the 100X oil immersion microscope.
• The distribution, size, shape and color of the red blood cell (RBC) and morphology of the
cells were carefully observed.
RESULTS
Amongst 50 subjects, 42 subjects were having Kaphaja Pandu,
Out of that 27 subject’s blood picture showed Microcytic Hypochromic RBC’s.
9 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
6 subject’s blood picture showed Normocytic Hypochromic RBC’s.
Dr Shivani Kaundal 2018
xix
Amongst 50 subjects, 3 subjects were having Vata Pitta pandu,
2 subject’s blood picture showed Microcytic Hypochromic RBC’s.
1 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
Amongst 50 subjects, 3 subjects were having Vata Kapha pandu,
1 subject’s blood picture showed Anisocytic Normochromic RBC’s
1 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
1 subject’s blood picture showed Normocytic Hypochromic RBC’s.
Amongst 50 subjects, 1 subject was having Vata pandu, blood picture blood picture
presented with Anisocytic hypochromic.
Amongst 50 subjects, 1 subject was having Pittaja pandu, blood picture blood picture
presented with Anisocytic hypochromic.
CONCLUSION
• Among the population studied, Kaphaja Pandu is being commonly found than other
types of Pandu. As the main cause of this is sedentary lifestyle and irregular food habits.
• Among Kaphaja Pandu lakshanas most predominantly seen are Gourava, Tandra,
Aruchi, Alasya. In Pittaja Pandu lakshanas like Trishna, Daha and Murchha are
commonly seen. Similarly in Vataja Pandu lakshanas like Angamarda, Shiroshoola,
Parshvashoola are commonly seen.
Dr Shivani Kaundal 2018
xx
• Kaphaja pandu being more commonly seen among the studied subjects, their peripheral
blood smear showed Microcytic Hypochromic and also Anisocytic hypochromic RBC
picture. If we get the blood picture of Microcytic Hypochromic & Anisocytic
hypochromic it can be considered as Kaphaja Pandu.
• As there were less subjects of Vataja and Pittaja Pandu in the study, their findings in the
morphological changes in RBC in peripheral blood smear are insufficient in drawing out
a proper conclusion.
• Even though in classics Vata piita and Vata kapha Pandu roga is not mentioned
separately but in this study it was found in few subjects. So we can consider these types
on the basis of presentation of Lakshanas.
Dr. Shivani kaundal 2018
A study on the diagnostic value of peripheral blood smear in different types of Doshaja Pandu roga Page 1
INTRODUCTION
Loss in the normal color or discoloration of the body is called as Panduta. Along
with loss of normal color or discoloration of the body, loss or abnormalities are seen
in the texture and luster of body. Pandu roga has been regarded as Agnimandhya
krita rasa dushti janya pitta pradhana vyadhi1 which is characterized by Pandu
vaivarnayata i.e. ketaki dhuli samana varna2. The Pandu roga is included under the
heading of "Varnopalakshita Roga" i.e., Varna pradhanya vyadhi3. Pitta is
responsible for the normal color of the body but when it gets vitiated, there will be
loss of complexion or Panduta occurs. Pandu roga is referred as Vilohita, Harima,
and Halima in Vedas and Sushruta named it as Panaki, Lagharaka and
Kumbhawayo.
“Rogaaha sarvepi mande agnow”4 - as said by Vagbhata, Mandagni is also the major
factor in the pathogenesis of Pandu. The resultant effect of Mandagni is Rasadushti
and Rasa is the Pradhana dhatu involved in Pandu roga. So, Acharya Charaka as
well as Sushruta have included Pandu roga in Rasa pradoshaja vyadhi.,5,6
In Pandu roga there will be loss of normal color of body, as Ranjaka pitta with its
Ushma gives Raga to the Rakta poshaka sara bhaga of Rasa and produces Rakta and
is responsible for imparting color.
To see the morphological changes in Pandu roga, peripheral blood smear is the best.
Though numerous studies have been made on Pandu roga based on comparison with
the types of anemia, this was an attempt made to diagnose Pandu roga based on the
Samanya and Vishishta lakshanas mentioned in the classics, and to find out the
relevance of morphological variations in the RBC’s by studying the peripheral blood
smear.
Dr. Shivani kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 2
OBJECTIVES OF THE STUDY
1) To find out the relevance of peripheral blood smear in diagnosing different types of Pandu
roga.
2) To relate morphological changes in the RBC to the variants of Pandu roga.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 3
REVIEW OF LITERATURE
HISTORIC REVIEW
On the scale of time next to Vedas are the Puranas, Upanishads, Samhita, Sangraha,
Nighantus. Pandu Roga is mentioned in different texts/literature. It may be observed that the
Brihatrayis, were the earliest in medical literature. History of Ayurveda can be divided into:
1. Vedic period
2. Purana period
3. Samhita / Sangraha period
4. Modern period
VEDIC PERIOD
The earliest literature is “Vedas” and Ayurveda is closely acquainted with it. In Vedas there
are many references about Panduroga.
In Atharvaveda7 there are references like Vilohita, Harima, Halima which can be taken as
synonyms of Pandu roga. The significance of sunrays is also stressed for changing the color
of Pandu roga.
As per Mahabharata8 it states that the king of Hastinapur has suffered from
Panduroga whose name was Pandu Raja acquired the disease as a curse from a saint.
This explains the Karma siddhanta of Panduroga. King Pandu acquired sterility due
to Panduroga as a complication and he even died of the disease.
In Rigveda this disease has been mentioned under the name of Harima. And
“Suryanamaskara” is mentioned as its treatment.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 4
Samhita and sangraha kala: It can be consider as golden period of Ayurveda, since
most of the classics like Charaka samhita, Sushruta samhita, Bhela samhita, Harita
samhita, kashyapa samhita were popular in this period. These Samhitas are the basis
of Ayurveda and are considered as Apta’s, and are practiced throughout the world.
Panduroga has been described in detail along with treatment in all the classics as
stated below:
NAME OF BOOK STHANA CHAPTER
1. CHARAKA SAMHITA Chiktsa 16th
2. SUSHRUTA SAMHITA Uttaratantra 44th
3. ASHTANGA SANGRAHA Nidana 13th
4. ASHTANGA SANGRAHA Chikitsa 18th
5. ASHTANGA HRUDYA Nidana 13th
6. ASHTANGA HRUDYA Chiktsa 16th
7. SHADANGADHARA SAMHITA Poorva khanda 7th
8. MADHAVA NIDANA 8th
9. BHAVA PRAKASHA Madhyamakhanda 8th
Even the works of Chakradatta, Vangasena, Yogaratnakara, also gives a detailed description
about Panduroga.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 5
DISEASE REVIEW
VYUTPATTI
The word “pandu” is originated from the root “padi nashne” with pratyaya “Ku” and
elaborating through “Ni”9
The word “Pandu” is formed from the dhatu “Padi Gatou”. Padi means “gati”10
i.e. parinamana or transformation.
The word Padi Gatau (transformation) signifies the formation of Rasa, Rakta and other
Dhatus. If the transformation process is hampered or having any variation then it leads to
Pandu.
NIRUKTI
In Ayurveda, diseases are named after considering certain criteria. In some aspects they are
named after the predominant Dosha and Dushya eg, Rakta-Pitta, Vata-Rakta, on the basis of
similes, eg: Shlipada, Kroshtukasheersha, anatomical structures e.g: Hridroga, Shiroroga;
discoloration of the body e.g. Pandu, and based on pain as in Hrutshoola and
Parinamashoola and so on.
Pandu roga is a disease based on the presentation of its varna. .
Pandu Varna is the combination of Shweta and Peeta.11
Pandu Varna is a combination of Shweta and Peeta Varna in equal proportions,
similar to pollen grains of Ketaki.12
Pandu Varna is the combination of Shukla and Peeta (Raja Nighantu).
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 6
By observing the above references, it may be considered that Pandu Varna is the
combination of Shweta and Peeta Varna. Pandu is a Varnoplakshita Roga 13 i.e. color
indicating name, hence, its meaning is : to destroy natural color. The physiological natural
color of mucous membrane is pink. Loss or destruction of this pink color leads to whiteness,
palor , therefore Pandu means whiteness, palor.
PARIBHASHA
Charaka classified Rogas according to Ruja, Varna, Samuthana, Samsthana
and Sthana. In this classification the disease Pandu falls in the group of Varna. In
Pandu roga there is some significant change in the normal color of the body.
There are many definitions in Ayurvedic literature. A/c to Vijaya rakshit commentator
on Madhava nidana :
“Pandutwena upalakshito rogaha pandu rogaha” 14
which defines that a disease which is understood by its pandu varnatvam is a pandu roga.
“Panduna vakshayamana haritadivarnebhya pradhanena varnena upalakshito
rogaha pandu rogaha.” 15
a condition characterized by change in normal color (complexion) of the body that is
dominated by Pandu varna.
“Sarveshu cheteshivaha pandubhavo yatoadhikoatah khalu pandurogaha” 16
it stated that prevalence of Pandu vaivarnayta among the patients is more, hence it is
called as Pandu roga.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 7
“Panduharidraharitan Pandutwam teshu chaditam yatoataha pandurityuktasa
rogaha”17
Although several types of complexions like haridra, harita etc. are described. Among
all of these the dominant one is Panduta. Hence, this is called as Pandu Roga.
“Panduhu swetavarna ketakidhuli sannibha peetabhagarda
varnabhedcha” (Shabdasthoma)
Pandu has been compared with ketaki dhooli or ketaki pushpa color i.e. can be
considered as a combination of white and yellow colors.
“Swetha peeta samayukta panduvarna prakirtitaha”
(Amarakosa)
The combination of white and yellow colors in equal proportion are called
Pandu roga.
It can be concluded on the above basis that Pandu roga has been regarded as disease
associated with discoloration of the skin or mucous membrane of the patient.
PARYAYA
“Sa kamala panaki pandu roga kumbhwayo lagharakoalasakhya vibhashyate
lakshanamasya kritsanm nibodha vakshyamyanupoorvashasthoth”
Sushruta used the terms Kamala, Panaki, Panduroga, Kumbahwayo, Lagharaka, Alasa 18 as
synonyms of the disease. Though Kamala etc. are considered as synonyms of Pandu, even
then, Pandu and Kamala are separately explained in terms of Nidana, Lakshana and Chikitsa.
Dalhana clarifies that Acharya Sushruta has considered it as a synonym only on the basis of
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 8
Kamala being an Avastha Vishesha of Pandu. Charaka also includes Haridra, Harita and all
other skin discolorations under Pandu. The synonyms of Pandu roga available from Vedic
literature are Vilohita, Harima, Halima.19
BHEDA
In vedic literature there is no evidence of any classification regarding Pandu roga.
Only synonyms such as Harima, Halima, Vilohita are found in the literature.
The detail description of Pandu roga and is classification starts from Ayurvedic
samhitas only. The classification of Pandu roga most of the Acharyas accepted 5 types.
Those are (1) Vataja (2) Pittaja (3) Kaphaja (4) Sannipataja (5) Mrudbhakshanaja.
Acharya Sushruta excluded the Mridbhakshanaja Pandu, but he included under Vatadi
doshaja Pandu’s according to the Rasa pradhanata of Mrit20
In Harita Samhita one of the 5 types of pandu roga, “Rukshana”21 is mentioned. The
term Rukshana may be used, because Mridbhakshanaja Pandu mainly causes the Rukshtwa
of the body.
Astanga sangraha and many other texts followed Sushruta as they mentioned four
types. Some commentators classified Pandu into eight types as follows:
1. Vataja 5. Pittaja
2. Kaphaja 6. Sannipataja
3. Mritbhakshanajanya 7. Shakhasrita kamala
4. Koshtashrita kamala 8. Haleemaka
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 9
A Classification states that Mritbhaskhanajanya Pandu22 falls under Sannipataja Pandu
because of the following reasons:
Intake of Kashaya rasa predominant Mritika leads to Vataja Pandu.
Intake of kshara rasa predominant Mritika leads to Pittaja
Pandu.
Intake of Madhura rasa predominant Mritika leads to Kaphaja,
Pandu.
Sushruta might have included Mritbhaskhanajanya Pandu under Sannipataja Pandu due to
the above said reason.
Table no: 1
Classification of Pandu according to different authors
S.No Samhita Types Vata Pitta Kapha Tridosha Mritbhakshan
a
1. Charaka 5 + + + + +
2. Sushruta 4 + + + + -
3. Ashtanga
sangraha
5 + + + + +
4. Ashtanga
Hrudaya
5 + + + + +
5. Madhav Nidana 5 + + + + +
6 Shadangadhara 5 + + + + +
7 Bhavaprakash 5 + + + + +
8 Harita 5 + + + + Rukshana
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 10
9 Yogaratnakara 5 + + + + +
NIDANA 23,24
“Nimitta hetwayatana pratyayothana karnahinnilaka mahuparyaythi”
“Seti kartavyatako rogotpadaka heturnidanam”
Ahitha ahara vihara leads to the vyadhi by vitiating Doshas and Dhatus. The following are
the nidanas of pandu roga.
Nidanas25 can be divided into following three types:
1. Ahara nidana
2. Vihara nidana
3. Manasika nidana
1) AHARAJA & VIHARAJA NIDANA :
Improper diet and routine practices are the prime factors responsible for the disease
manifestation particularly when taken in excess. Such etiological factors are:
1) Rasa – Amla, lavana, kshara.
2) Guna – Ruksha, ushna, tikshna.
3) Veerya – Ushna.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 11
4) Dravya – Vidagdha anna, nishpava, pinnyaka, matsya, amisha, pista, paya, tila taila,
masha atisevana, Madya.
TABLE 2:
Nidanas of Pandu Roga
Sl. no
NIDANA C.S. Su. S. A.H. M.N.
AAHARJA NIDANA
RASA VISHESHA
1 Kshara ati sevana + - - -
2 Amla ati sevana + + + +
3 Lavana rasa ati
sevana
+ + + +
4 Kashaya rasa ati
sevana
GUNA VISHESHA
5 Ati Ushna bhojana + - - -
6 Ati Tikshana ahara
sevana
- + + +
7 Ati Ruksha ahara
sevana
AAHARA KRAMA
8 Viruddha bhojana + - - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 12
VIHARAJA NIDANA
The viharaja nidana plays a vital role in the manifestation of the vyadhi. These are:
1) Diwaswapna: Diwaswapna vitiates Tridosha and depresses the function of Jathraagni
and Dhaatwagni.
2) Madya: Madya does Pitta vitiation.
3) Ati vyayama: leads to Pitta prakopa.
4) Ati maithuna: causes Tridosha prakopa
5) Panchakarma vaishamya & Vegadharana: does vitiation especially to Vata.
9 Vidhagdha anna + - - -
DRAVYA VISHESHA
10 Nishpava sevana + - - -
11 Tilataila sevana + + - -
12 Pinyaka ati sevana + - - -
13 Masha ati sevana + + - -
14 Madya sevana - + - +
15 Mrut bhakshana + + - +
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 13
Table no 3:
Showing the viharaja nidana of pandu roga according to various authors
MANASIKA NIDANA
Only Charaka has mentioned Manasika Nidana which can lead to Pandu. These are as
follows:
1) Kama, Shoka, and Bhaya vitiates Vata.
2) Krodha vitiates Pitta.
3) Chinta and Manasantapa vitiates Vata & Kapha.
S.No Nidana C.S Su.S A.H M.N
1 Ati Maithuna + - - -
2 Vega Vidharana + - - -
3 Panchakarma
vaishamya
+ - - -
4 Rutu vaishamya + - - -
5 Divaswapna + + - +
6 Ati Vyayama + + - +
7 Nidra nasha - - - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 14
Table no 4:
Manasika nidana of pandu roga according to various authors.
Table No:5 Nidana with effect on Dosha-Dushya
S.no Nidana C.S Su.S As.H M.N
1 Bhaya + - - -
2 Chinta + - - -
3 Krodha + - - -
4 Manasantapa + - - -
5 Shoka + - - -
S.No
Dravya
Guna
Effect on dosa - dushya
1. Nishpava Ruksha guna,
Amla vipaka,
Ushna veerya
Glanikaraka, Sukranashaka, Vidahi,
Pitta vata vardaka
2. Masha Madhura rasa,
Guru vipaka
Kapha prakopaka, Kledakaraka
Klaibyakaraka
3. Pinyaka Ruksha guna,
Guru paki,
Ushna veerya
Vidahi , Vata pitta vardaka, Sukra
nashaka, Raktapitta prakopaka
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 15
4. Tila taila Madhura kashaya
rasa, Ushna veerya
Raktha pitta prakopaka
5. Tila pishta Ushna & Guru Pitta karaka,
Rakta prakopaka
6. Paya
sevana
Madhura rasa,
sheeta veerya,Guru
snigdha
Kapha vardaka ,
Kleda karaka
7. Matsya
(Samudra)
Ushna veerya,
Kapha-pittakara
Kapha-pitta vardaka,
Rakta prakopaka
8. Amisha
(mamsa)
Ruksha & sheeta Vata- pitta prakopaka,
Rasa rakta dusti karaka
9. Ikshu
sevana
Madhura rasa,
Sheeta veerya
Snigdha, sara guna
Kapha prakopaka,
Ama karaka,
Abishyandaka
10. Ruksha, ati
sevana
Katu, ushna Vata prakopaka,
Rakta dusti karaka,
Kapha soshaka
11. Maruta
sevana
Kashaya- vata
Katu- pitta
Madhura - kapha
Tridosha prakopaka
Sroto avarodhaka,
Krimi janaka
12. Madya Amala rasa
Katu vipaka
Ushna, vidahi
Pitta prakopaka - Ojo nashaka
Kapha shoshaka- Rakta dusti
karaka
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 16
POORVA ROOPA
“Sthanasamsraymaha kruddha bhavi vyadhi Prabhodhakam,
Doshaha kurvanti yallingam poorvaroopam, Taduchyute.”
Based on Dosha - Dushya Sammurchanna the Sthana Samshraya takes place in the
body during fourth phase of kriyakala. As a result Doshas dushti will manifest which
indicates the actual disease manifestation. In Pandu Roga, Poorva Roopa and Roopa are
intermixed with each other, because most of the symptoms of Poorva Roopa avastha can be
appeared in Roopavastha too. Acharyas have mentioned Poorvaroopa in Pandu roga which
are as follows:
According to Charaka26:
1. Hridaya spandanadhikya
2. Roukshyam
3. Swedabhava
4. Shrama
According to Sushruta27:
1. Twaksphotana
2. Steevana
3. Gatrasada
4. Mrid Bhakshana iccha
5. Prekshana akshi koota shotha
6. Avipaka
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 17
7. Vitpeetata
8. Mootra peetata
According to Astanga Hridya28
1. Hridaya spandana
2. Ruksha twacha
3. Aruchi
4. Peeta mutrata
5. Sweda abhava
6. Alpa vanhita
1) Hridaya Spandanadhikya: This is due to the Prakopa of Pitta pradhana tridosha. In the
Hridaya, the Chala guna of Vyana vayu along with Sara guna of Sadhaka pitta causes Rasa
dhatu kshaya and reduced Preenana to the Dhatus. It causes increased functioning of
Hridaya, which is its mulasthana, producing Spandanadhikya.
2) Twak Roukshya or Twak Sphutana: Twak Roukshya or Twak Sphutana are produced
due to:
Increased Vyana Vata
Raktadhatu kshaya
Sara hani
3) Swedabhavata: Swedabhava can be caused by Srotorodha due to Kapha.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 18
4) Shrama: Shrama can be produced by:
Vyanavayu vriddhi
Rasa, Mamsa, Meda, Asthi, Shukra and Ojokshaya
5) Steevana and Hrillasa: Due to Malaroopi kapha vriddhi produced by Rasa
dhatwagnimandya, Shteevana and Hrillasa are seen in Pandu.
6) Gatrasada: It is caused by Vyana vayu prakopa and Ojokshaya.
7) Mrit-bhakshana Iccha: It is due to the vitiation of Sadhaka pitta, which disturbs Dhriti
and Medha which leads to the disturbed mental state and provoke the patients to do such
activities.
8) Prekshana Koota shotha: when there is increased Malaroopi kapha which lead to
Srotorodha, thus cause Prekshana koota shotha.
9) Aruchi, Avipaki: Increased Pitta (drava rupi) when produces Agnimandya produces
Aruchi, avipaka.
10) Peetata of Vit and Mootra: Dravyataha vriddhi of pitta due to Nidana and the vicious
cycle of Rakta-agnimandya, thus increases Ranjaka pitta and causes increased coloration
of Vit and Mootra.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 19
ROOPA
“Tadeva vyaktata yatam roopam iti abhidheeyate”29.
The Poorva roopa which has attained vyaktavastha known as roopa. This is the stage of a
disease where the signs and symptoms of the disease are totally manifested is fifth kriya
kaala termed as ‘vyaktibhava’. When the disease starts to take its stage forth kriyakala
namely in the Stanasamshrayaavastha or Poorvaroopavasta and when it is not treated the
doshas get accumulated and manifestation into the diseased state – “ROOPA”.
Hence, Rasa being the Dhatu where Doshas undergoes Sthanasamshraya, almost all of
Rasavaha sroto dushti lakshanas can be observed in Pandu Roga. They are Aruchi,
Ashraddha, Agnimandya, Hrillasa, Arasagnatha, Gourava, Tandra, Angamarda, Pandu,
Jwara, Klaibya, Sada, Krishnagata and Palitya.
SAMANYA LAKSHANA30,31,32,33
1. Panduta: It is the Pratyatma lakshana of Pandu. Pandu roga is named on the basis
of discoloration of body parts. This is due to Rasa pradosha.
2. Dourbalya: Means reduction in the normal Bala, Normal Bala is measured by
Vyayama shakti. In Pandu it is reduced due to Dhatukshaya.
3. Karshya: Reduction of various Dhatus in body leads to affliction of Samhanana
leading to emaciation of Spik, Udara, Greeva.
4. Karna Kshweda: Due to weakness in the sense organs, increased Vata produces this
symptom and is one of the Vataja nanatmaja vyadhi.
5. Gatra peeda: Different types of pain in the different parts of the body caused by
Vata vriddhi due to Dhatu kshaya.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 20
6. Shoonakshi koota shotha and steevana: these lakshanas can be observed from
Poorvaroopa avastha. Kapha vriddhi producing Srotorodha leads to Shoonakshi
koota shotha.
7. Sheerna loma: Asthi dhatu kshaya.
8. Hridrava: Means increased sensation of Hrit Gati. Involvement of Sadhaka pitta,
Vyana vayu, Raktavaha srotodushti causes Hridrava.
9. Shwasa: Due to Dhatu kshaya and Dourbalya shwasa is produced. Even debility in
the Hridaya can cause Shwasa. Prakopa of Pranavayu can also cause Shwasa.
There, it refers to Arohana Ayasa (exertional dyspnoea). But in Upadrava stage, it is
severe state of Kshudra Shwasa.
10. Bhrama: Vata-pitta-rajogunadhikya leading to various Dhatu kshaya like Majja and
Rakta will lead to Bhrama.
11. Anna dwesha: Charaka mentioned both Annadwesha and Aruchi in Samanya
lakshana. Sushruta has mentioned this in Upadrava stage and is caused due to
Kapha vriddhi and Agnimandya.
12. Gourava: Heaviness of body indicates Kapha and Ama vriddhi and is one of
Kaphaja nanatmaja vikara.
13. Jwara: Indicates Pitta prakopa.
14. Harita Varna: Indicates Pitta vriddhi.
15. Hata prabha: Pitta prakopa, Oja kshaya cause Prabha hani.
Table No. 6.
Showing Samanya Lakshana’s
Sl.NO LAKSHANA C.S Su.S As.H As.S K.S
1 Twak Vaivarnayata + + - - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 21
2 Anna Dwesha + - + + -
3 Alpa Vak + - + + -
4 Hatanala + - + + +
5 Nidralu + - - - -
6 Shuna Akshi Koota + - + + +
7 Anga Sada/ gatra peeda + - - - -
8 Sthivana + - + + -
9 Kopana + - + + -
10 Shishira Dweshi + - + + -
11 Sheerna Loma + - + + -
12 Jwara + - + + -
13 Shwasa + - + + -
14 Karna Kshwedi + - + + -
15 Bhrama + - + + -
16 Shrama + - + + -
17 Hataprabha + - - - -
18 Dourbalya + - + + -
19 Pindikodwestana + - - - -
20 Kati,Uru, Pada Ruk + - - - -
21 Sadana + - + + -
22 Arohana Ayasa + - - - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 22
TABLE No 7:
Samanya Lakshana’s with their amshamsha kalpana 34:
Sl.
No
Lakshana Dosha Gunathah Amsamsa
kalpana
1. Karna kshweda Vyana Vata Chala guna,
Shabdtah
2. Hrudaya
spandana
Vyana vata
Sadaka pitta
Chala gunataha
Sara gunataha
-
3. Dourbalya Vata vridhi,
Ojo Kshaya
Karmatah
4. Twak rukshata Vyana vata Ruksha
gunataha
-
5. Sweda abhava Kapha Medo-mala
vridhi
Srotoavarodh
a
6. Shrama Vata Vyana
vata
- Rasa kshaya
7. Bhrama Vata vriddhi,
pittavriddhi
kapha kshaya
chala guna,
sara guna,
8. Twak spotana Vata Ruksha
gunataha
-
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 23
9. Steevena Kapha - Rasa/ Ama
10. Gatra shoola Vata Vridhi Sheeta
gunatah-
Ojo kshaya
11. Mrid bhakshana Tridosha - Prabhava
12. Prekshana akshi
koota shotha
Kapha vridhi - Srotoavrodha
13. Shwasa Vata kshaya, Chala guna,
Sukshma guna
-
14. Vin-mootra
peetata
Pitta Roopata vridhi -
15. Avipaka Pitta Drava-roopa
vridhi
-
16. Aruchi Kapha vridhi Guru guna,
Drava-roopa
vridhi
-
17. Hataprabha Pitta Kshaya Rooptah -
18. Pippasa Vata-pitta
vridhi
Udaka kshaya -
19. Shishira Dweshi Pitta vridhi,
Vata vridhi
Drava-roopa
vridhi
-
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 24
VISHISHTA LAKSHANA
They are the specific features observed independently in every disease because of the
involvement of dosha, dushya and strotas. Vishishta lakshanas help us in diagnosing the type
of disease in particular and also in planning the treatment accordingly.
Vataja Pandu35,36,37,38:
If there is Vata vriddhi, it produces various Vataja lakshana like Krishnata, Panduta in body
parts and various types of Shoola.
Table No.8:
VATAJA PANDU LAKSHANA
Sl. No. Lakshana C.S. S. S. A.H. A.S. M.N. B.P.
1 Krishna pandutwa + - - - - -
2 Ruksha angata + - + + + +
3 Arunangata + - - - + +
4 Angamarda + - - - - -
5 Raja + - + + - -
6 Toda + - + + + +
7 Kampa + - + + + +
8 Parshwa shoola + - + + - -
9 Shirashoola + - + + - -
10 Varcha shosha + - + + - -
11 Asya vairasya + - + + - -
20. Nidralu Kapha vridhi Guru Guna -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 25
12 Shopha + - + + - -
13 Anaha + - + + + +
14 Bala kshaya + - - - - -
15 Krushna akshi - + + + - -
16 Krishna Sira - + - - - -
17 Krishna Varnatwa - + - - - -
18 Krishna mala - + + + - -
19 Krishna mootra - + + + - -
20 Krishna nakha - + + + - -
21 Krishna anana - + - - - -
22 Aruna sira - - + + - -
23 Aruna nakha - - + + - -
24 Aruna mala - - + + - -
25 Aruna mootra - - + + - -
26 Aruna akshi - - + + - -
27 Bhrama - - - - - -
28 Vata upadrava - + - - - -
29 Krishna sira - - + + - -
30 Aruna sira - - + + - -
31 Twak krishnabhata - - - - + +
32 Mootra krishnabhata - - - - + +
33 Nayana krishnabhata - - - - + +
34 Twak arunabhata - - - - + +
35 Mootra arunabhata - - - - + +
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 26
36 Nayana arunabhata - - - - + +
37 Rakta netra - - - - - -
38 Aruna twak - - - - - -
Pittaja Pandu 39,40,41,42:
Pitta vriddhi produces various Pittaja lakshana like Peetabhata, Haritabhata, Jwara.
Table No. : 9
Showing Pittaja Pandu Lakshana
Sl. no.
Lakshana
C.S
S. S
A.H
A.S
.
M.N
.
1 Peetabha + - - - -
2 Haritabha + - + - -
3 Jwara + - + + +
4 Daha + - + + +
5 Trishna + - + + +
6 Moorcha , pipassa + - - - -
7 Peeta mootra + + - - +
8 Peeta shakrut + + - - +
9 Swedana + - - - -
10 Sheeta kamita + - + + -
11 Na annam bhinandathi + - - - -
12 Katukasya + + + - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 27
13 Anupashaya - - - - -
14 Ushna + - - - -
15 Amla + - - - -
16 Amla udgara + - - - -
17 Vidahata + - - - -
18 Vidagdhata + - - - -
19 Dourgandhya + - + + -
20 Bhinna varcha + - + + +
21 Dourbalya + - - - -
22 Tama + - + + -
23 Peeta akshi - + - - +
24 Peeta Sira - + - - -
25 Peeta nakha - + - - -
26 Peeta anana - + - - -
27 Moorcha - - + - -
28 Amlata - - + - -
29 Atipeetabha - - - - +
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 28
Kaphaja Pandu43,44,45,46:
Kapha vriddhi produces various Kaphaja lakshana like Shuklavarnata, Gourava and
Shwayathu.
TABLE NO. 10:
Showing kaphaja Pandu Lakshana
SL no. LAKSHANA C.S. S. S. A.H. M.N
.
1 Gourava + - - -
2 Tandra + - + +
3 Chardi + - + -
4 Shewatavabhasata + - - -
5 Praseka + - - +
6 Lomaharsha + - + -
7 Sada + - - -
8 Moorcha + - - -
9 Bhrama + - - -
10 Klama + - - -
11 Shwasa + - - -
12 Kasa + - + -
13 Alasya + - - +
14 Aruchi + - - -
15 Vatagraha + - - -
16 Swasa graham + - - -
17 Shukla motra + - - +
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 29
18 Shukla akshi + - - +
19 Shukla varcha + - - -
20 Katu kamatwam + - - -
21 Ruksha kamata + - - -
22 Ushna kamata + - - -
23 Shwayatu + - - +
24 Madhura asya + - - -
25 Shukla sira - + + -
26 Shukla nakha - + - -
27 Shukla anana - + - +
28 Lavana asyata - - + -
29 Swara kshaya - - + -
30 Ati gourava - - - +
31 Shukla twacha - - - +
Tridoshaja Pandu47,48,49,50:
Tridosha prakopa causes presentation of all the Tridoshaja lakshanas.
TABLE NO. 11
Showing Tridoshaja Pandu Lakshana
Sl.No. Lakshana G.N. H.S.
1 Jwara + +
2 Arochaka + -
3 Hrillasa + +
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 30
4 Vamana + +
5 Trishna + +
6 Bhrama + -
7 Tandra - +
8 Alasya - +
9 Shotha - +
10 Kasa - +
11 Shosha - +
12 Vitbandha - +
13 Parushata - +
14 Klama - +
15 Moha - +
SAMPRAPTI51,52,53,54
The genesis (evolution, process of manifestation) of the disease by the Dushti of Doshas
which are constantly circulating is called as Samprapti. Every factor connected with the
process of disease at various stages is considered in detail in samprapti. The disease process
starts with Nidana and then passes through Sanchaya, prakopa, prasara, Sthana samsraya
and finally manifestation of Vyaktavastha, i.e. manifestation of Pandu. This complete disease
process is called as samprapti.
In other words Samprapti gives detail information about the pathogenesis of the disease. It
gives a clear idea of the disease process helping management of the condition. Both Charaka
and Sushruta considers Pandu to be a Rasa vaha sroto vikara 5,6 and clearly projects Pitta
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 31
dosha as the major factor behind the whole pathogenesis in Pandu. Due to the involvement of
rasa, rakta and Ojas the main presenting symptom is Panduta, Indriya-Bala- Varnahani and
the Nidanas for Pandu is Pittaja nidanas.
Samprapti of Pandu can be explained and understood based on Shatkriyakala- Sanchaya,
Prakopa, Prasara, Sthanasamsraya, Vyaktha and Bheda.
A/ c to Madhavanidana, samprapti can be understood as below:
"Yatha dushtena doshena yatha cha anu visarpatu
Nivrutti Ramaya - Syasan samprapti jati ragati" 55
Samprapti can also be called dosha dooshya sammurchana avastha of a particular vyadhi. In
Pandu Roga generally three Doshas are involved and in particularly Pittadosha. The Pitta
prakopakara Ahara and Vihara are the causative factors of Pandu. Because of these nidanas
pitta vridhi takes place. Physiologically, the formation of Acchapitta, occurs in Grahani
during ahara parinama. But due to katu, amla, lavana, ushna ahara and other causes
mentioned earlier, vitiation of Pitta takes place. Since Pachaka pitta is situated in Grahani,
the vitiated Pitta affects the Agni. The Drawatwa in this vidagdha pitta reduces its
teekshanatwa. This Agni cannot digest the ahara consumed, there by leading to vidagdha
bhava.
Generally, after pachana, the food consumed is divided into Sarabhaga and Kittabha by
Samana vayu and the saarabhaga is taken to Hridaya. But due to vidagdha pitta, pachana
does not occur properly leading to dooshita annarasa. The Annarasa is taken by samanavayu
to Hridaya and transforms it into Rasadhatu. The viharas like Vyayama, Vyavaya etc cause
vitiation of vyanavayu. The vitiated Vyana vayu along with pitta - dooshita rasadhatu
circulates throughout the body through Dasa Dhamanis which emerge from Hridaya. The
pitta dooshita rasa dhatu flows into the next dhatu for its nourishment malformed rasa dhatu
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 32
due to Pitta vidagdata, destructs the Raktadhatu poshakamsas and attains pandu roga, which
will not be in a position to nourish Dhatus. Finally rasadhatu lodges in the space between
twak and mamsa. Then by vitiating the kapha, vata, rakta, twak, and mamsa, it produces
pandu, haritha and haridra varnas, or various other discoloration of the skin. Of these colors,
Pandu is seen predominantly. The formation of all the other dhatus is also impaired. As a
results of this, the formation of next dhatu i.e. Raktadhatu is affected. Even the essence which
comes out from each Dhatu also reduces in it’s quantity. As the essence of all Dhatus is Ojus,
its kshaya lakshanas can also be observed on progression of the diseases.
Schematic representation of Samanya Samprapti of Pandu Roga.
NIDANA SEVANA
PITTA PRADHANA TRIDOSHA PRAKOPA
HRIDAYA KHA VAIGUNYA
RASA DUSHTI
PITTA + DUSHITA RASA
CIRCULATES THROUGH DASHADHAMANI VYANAVAYU
ASHRAY IN TWAK & MAMSA
VITIATES RAKTA, KAPHA, VATA, TWAK, MAMSA
PRODUCES HARIDRA, HARITA AND PANDU VARNA.
PANDU ROGA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 33
Samprapti ghatakas:
The components involved in Samprapti or pathogenesis of a Vyadhi are called as Samprapti
ghatakas. Understanding these components and their Samprapti ghatakas status helps
Samprapti vighatana and paves the way for Chikitsa .
1) Dosha- Pitta pradhana tridosha
2) Dooshya- Rasa, Rakta
3) Agni- Jatharagni dusti, Rasa agni, Rakta agni (mandagni)
4) Srotas- Rasa vaha srotas, Raktavaha srotas, Annavaha srotas
5) Udbhava sthana – Amashaya
6) Vyakta sthana – Sarva shareera
7) Sanchara sthana- Dashadhamanis and Sarvashareera
8) Ashraya- Twak and Mamsa
9) Roga Marga- Bahya
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 34
1. DOSHAS:
A. VATA:
a. Vyanavata56
Sthana: Hridaya – Seat of Vyanavata (Vagbhata)
Both Charaka and Sushruta did not mention about the place of Vyanavata.
Gunas: In general, it possesses all the gunas of vayu. These are Ruksha, Laghu, Sheeta,
khara, Sookshma, and Chala.
Karmas:
1. The Movement is entirely dependent on Vyana Vayu.
2. Rasa Raktadi samvahana
3. Sweda & Asrik sravana.
4. Sareera Chestha: Prasarana, akunchana, vinnamana, unnamana and
tiryaggamana
5. Jrimba pravartana
6. Anna dwesha
7. Sroto vishodhana
8. Dhatu tarpana
b) Samana Vata57: The Vayu that gives strength to Pachaka pitta is called Samana
Vayu.
Sthana: Samana vata resides near pachaka pitta. It courses between Amashaya and
Pakwashaya. It is also been said that it also occurs in Sweda, Rakta, and Ambu vaha srotas.
Gunas: In general, it possesses all the gunas of vayu.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 35
Karma: The important function of Samana Vayu is to strengthen Jataragni. Thus it
helps in the digestion of food. After digestion, it divides Ahara into Saara and Kitta bhaga.
According to Vagbhata, samana vata does the Ahara graham (accepts food) into koshta,
Anna grahana, Saara-Kitta vibhajana and it pushes the Kitta into Pureesha vaha srotas.
B. Pitta:58
a) Pachaka Pitta: The Pachaka piita or Pachakagni is made up of Panchamahabhutas, but
owing to its Tejo guna and action like pachana etc. this does the Annapachana and regulates
digestive capacity, Dhatu parinama and provides nutrition for the body. It has also been said
that vitiation of Pachaka pitta leads to disease.
Sthana: Pachaka pitta is located in between Amashaya and Pakwashaya. The region
between Amashaya and Pakwashaya is termed as Grahani and it contains Pittadhara kala. In
other words, Pittadhara kala or Grahani is seat of Pachaka Pitta.
Gunas: Laghu, Visra, Sara, Drava, Sneha, Teekshna, Ushna, and Visada
In Pachaka pitta, the Tejo guna pradhanta is seen and because of it, the drava guna in
Pachaka pitta is less when compared to other types of Pitta.
Karma:
Pachaka pitta has numerous functions. The important functions among them are as follows:
i. It digests the four types of food and liquids we consume.
ii. It differentiates Saara bhaga and Kitta bhaga of the food after digesting it and
absorbs into the body.
iii. It is termed as ‘Jatara Agni’ many times, because it controls the action of other 12
types of Agni in the body.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 36
iv. The other factors that are dependent on the action of Pachaka pitta are given below.
Ojas
Ayu.
Deha pushti
Bala
Utsaha.
It is also said that if Kayagni is healthy, then the person achieves longevity, else he
acquires diseases and if the Kayagni is totally diminished, the person dies.
b. Ranjaka Pitta59: The Pitta that imparts color to Rasa dhatu and transforms it into
Rakta dhatu is called Ranjaka pitta or Ranjakagni pitta.
“Amashayaashrayam Pittam ranjakam rasaranjanat”
Sthana: According to Sushruta – Yakrit and pleeha
According to Vagbhata – Amashaya
According to Sharangadhara - Hridaya
Gunas: Laghu, Visra, Sara, Drava, Sneha, Teekshna, Ushna, and Visada
Karma: Ranjaka pitta gives color to the Rasa Dhatu when it is circulated through Yakrit and
Pleeha and transforms it into Rakta Dhatu. This act is even controlled by Rakta Dhatwagni.
c. Bharajaka Pitta 60: The temperature of the body as well as the color of the skin
depends on Bhrajaka pitta.
“Twakstham bhrajakam bhrajana twachaha”
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 37
Sthana: Twak is the sthana of Bhrajaka pitta. Avabhasini, which is the first layer of Twak,
lodges Bhrajaka pitta according to Dalhana.
Gunas: Laghu, Visra, Sara, Drava, Sneha, Teekshna, Ushna, and Visada.
Karma:
I. The main action of Bhrajaka pitta is to maintain the normal body temperature.
II. In general, Bhrajaka pitta imparts different colors to the body depending upon the
Mahabhoota composition of the skin.
According to Charaka:
Jala & Akasa Mahabhoota predominance leads Gowra Varna.
Prithvi Mahabhoota predominance leads Krishna Varna.
Prithvi & Akasa Mahabhoota predominance leads Krishna Shyava Varna
C. Kapha:61
a) Kledaka kapha
Sthana: kledaka kapha resides in Urdhwa Amashaya.
Gunas: In general, it possesses all the gunas of Kapha such as Snigdha, Seetha, Guru,
Manda, Slakshna, Sandra, and Sthira.
Karma: 1. Anna sanghata 2. Kledana
The impairment of these functions is supposed to vitiate ahara which may result into
Pandu.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 38
2. DHATUS:
The Dhatus which are involved in the pathogenesis of Pandu are Rasa, Rakta, Mamsa
and Meda.
a) Rasa Dhatu 62:
The involvement of Rasadhatu is not directly related in the Pathogenisis of Pandu roga
samprapti. Pandu is included under rasa prodoshaja vyadhi.
Location: Hridaya and Dashadhamanis. It circulates throughout the body along with Rakta
with the help of Vyanavata.
Pramana: 9 Anjalis
Rasa: Madhura
Varna: Swetha/Shukla
Formation: It is formed from Saarabhaga of ahararasa after it has been subjected to
jatarapaka and Rasa dhatwagnipaka. It circulates upwards like Agni, downwards like jala
and transversely like shabda.
Karma: 1. Tarpana
2. Jeevana & Preenana
3. Vardhana
4. Dharana
5. Yapana
6. Uttarottara dhatu poshana
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 39
b) Rakta Dhatu63The essence of Ahaara after being subjected to Paaka by Ranjaka pitta
attains red color and becomes rakta dhatu. Therefore the Ranjaka pitta 64 plays an essential
role in the formation of the Rakta dhatu.
The nidana of Raktadusti are similar to that of Panduroga . The characteristic features
of Pandu are quite opposite to the Shuddha rakta purusha lakshana. The Pandu roga is
mentioned under Rakta kshaya lakshanas.
Sthana: Yakrit, Pleeha, Hridaya, Rakta vahadhamanis and Sa-rakta medas. It
circulates in the entire body along with Rasadhatu.
Pancha bhoutika Sanghatana of rakta 65:
“Panchabouthikam twapare Jeevarakta maharacharyaha
Visratha Dravatha Ragada spandanam Laghuta tatha
Bhooamyadenaam gunahyethe dryshantey chatra shonity”
Qualities of Rakta dhatu Mahabhoota Pradhanyata
1. Visrata - Fleshy odour Prodhweebhuta
2. Dravta – Fluidity Jalabhuta
3. Raga – coloration Agnibhuta
4. Spandana – movement Vayubhuta
5. Laghuta – lightness Aakashabhuta
Rasa: Madhura, lavana rasas.
Varna of shuddha rakta dhatu66:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 40
“Tapaniyendra Gopabham padmalaktaka sannibha
Gunjaphala savarnacha vishuddam vidhisonitam”
The pure blood resembles a bright “Indragopa” (firefly)
Looks like Padma (Lotus flower) and Latuka (Laksha)
Gunjaphala Sa-varnam – Bright red like gunja seed.
Pramanas: Eight Anjalis.
Gunas: Anushna, Seetha, Snigdha, Guru, Visra and Asamhata and Gunas of
Panchamahabhutas.
Karma: Jeevana, Dharana, Bala, Varna, Sukhakara, Ayushkara, Pushtikara,
Indriyaprasannatwa, mamsapushti and sparshagnanakara.
Shuddha Raktasaara Purusha Lakshanas67: A person whose karna, mukha, jihwa,
nasa, osthta, pani, paadatala nakha, lalata and mehana are having snigdha and rakta Varna
is regarded as Shudda Raktasaarapurusha.
3. OJAS68:The involvement of Ojas is specifically mentioned in Charaka Chikitsa 16th
Chapter. Ojas is the essence of all the sapta dhatus, from Rasa to Shukra and is responsible
for the strength of an indivisual. As the formation of all Dhatus is impaired in Pandu, the
formation of the essence of all Dhatus also impairs and ojokshaya lakshanas can be seen. In
classics Prakruta Kapha, Rasa, Rakta, Shukra, Sarva dhatu sara and Agni are also referred to
as Ojas 69.
Sthana: Hridayam, Sarva shareeram
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 41
Bheda: Para and Apara
Pramana: Para Ojus – Ashta bindu
Apara Ojus – Ardha anjali
Rasa: Madhura
Varna: Eshatpeeta varnam (or) Sarpi varnam.
Karma: Sthiropachita mamsaata , Swara-varna prasaada,
Vyadhikshamatwakaram.
4. SROTAS:
The Strotas that are affected in Pandu are Rasavaha and Raktavaha.
a) Rasavaha srotas70:
The Moolasthana of Rasa dhatu is Hrudya and dashadhamanis. Pandu is a Rasa pradoshaja
vikara. In Pandu due to Agnimandya, Rasa dhatu is first affected, the Prakupita pitta having
sthanasamshraya in Hridaya (mula sthana) spreads all over the body through
Dashadhamanis and causes different Rasa vaha srotodushti lakshanas 71
like-
Ashraddha
Aruchi
Asaya vairasya
Arasa sagnata
Hrillasa
Gourava
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 42
Tandra
Jwara
Angasada
Pandutwa
Thus, producing Rasa kshaya along with the kshaya of other Dhatus, as its Preenana
karma is affected.
b) Raktavaha srotas72
Yakritmoola and Pleeha are the Raktavaha strotomula. Rasaranjana takes places in Yakrit
and Pleeha. The improper formation of Rasa dhatu leads to improper formation of Rakta
dhatu. Along with it Pachaka pitta, Sadhaka and Ranjaka pitta are also affected. Thus
producing Rakta kshaya by vitiating Raktavaha srotas.
5. UDBHAVA STHANA73:
Aetiological factors cause vitiation of Dosha and the place through which they sprout is
called Udbhava sthana. Pandu being an Amashaya samuttha vyadhi, after reaching to
Hridaya (Strotomula) the Doshas spreads throughout body.
6. SANCHARA STHANA74:
After spreading from the Udbhava sthana it all depends on the route through which the
Doshas spread. This decides the systemic involvement and the disease in particular. This is
further decided by the Nidana sevana and status of the system. In Pandu, Sanchara is
through the Dasha dhamanis.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 43
7. ASHRAYA75:
In Pandu, the Doshas take Ashraya between Twak and Mamsa thereby causing vitiation of
different Dhatus and producing different Varnas.
UPADRAVA76
This is the stage of complication of main disease. The main or primary disease in the due
course of time or kala proceeds further and as a result of indulgence in dosha prakopaka
ahara vihara leads to upadrava.
The following have been mentioned as upadrava of Pandu Roga:
1. Aruchi 11. Hridaya peedana
2. Pipasa 12. Shwasa
3. Jwara 13. Atisara
4. Moordharuja 14. Trasa
5. Agnisada 15. Shoola
6. Sopha 16. Daha
7. Chardi 17. Avipaka
8. Avalatwam 18. Swarabhedha
9. Moorcha 19. Swarasada
10. Klama 20. Shotha
Table No. : 12
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 44
Showing Upadrava of pandu Roga
Sl. no. Lakshana S.S A.H.
1 Aruchi + -
2 Pipasa + -
3 Chardi + -
4 Jwara + -
5 Shiroruja + -
6 Agnisada + -
7 Shopha + +
8 Kantagata abalatwam + -
9 Moorcha + -
10 Klama + -
11 Hrdaya avapeedanam + -
12 Shwasa + -
13 Atisara + -
14 Kasa + -
15 Daha + -
16 Avipaka + -
17 Swarabheda + -
18 Sada + -
19 Adhmana - -
20 Tandra - -
21 Pandu danta - -
22 Pandu nakha - -
23 Pandu netra - -
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 45
MODERN ASPECT
HISTORY77:
The first person to describe Red blood cells was the Dutch biologist Jan Swammerdam who
had used an early microscope in 1658 to study the blood of frog. Unaware of this work,
Anton van Leeuwenhoek provided another microscope description in 1674, also described the
size and shape of “red corpuscles.” Even approximating the size of RBC, 25,000 times
smaller than a fine grain of sand.
ERYTHROPOEISIS78,79,80
It is the process of production of RBC’s. Erythropoeisis starts with a big, nucleated cell called
haemocytoblast which becomes CFU-E, differentiates into PROERYTHROBLAST- RBC
precursor and become a mature RBC at the end of 7-8 days which is a small, non- nucleated
and with Hb.
SITES OF ERYTHROPOISIS
IN FOETAL LIFE-
1. MESOBLASTIC STAGE- upto 3 months of foetal life, RBC’s are formed from
AREA VASCULOSA (mesodermal layer of yolk sac).
2. HEPATIC STAGE- after 3 month of foetal life, LIVER and SPLEEN will be primary
sites of Erythropoiesis.
3. MELOID STAGE- after 5th month, it occurs in bone marrow i.e, in all bones (with red
bone marrow) along with Liver and Spleen.
IN ADULTS-
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 46
RBC’s are produced exclusively in the BONE MARROW of adults.
STAGES OF ERYTHROPOEISIS
a) Proerythroblast : It is a big cell of diameter of 14-20 μm. There are several nucleoli in
the nucleous, which are round. The chromatin in the nucleous consists of red purple
strands. Proerythroblasts undergo rapid division and gives rise to basophilic
erythroblasts.
b) Early normoblasts : It is a round cell with the diameter of 12-16 μm, and have more
basophilic cytoplasm than the pro erythroblasts. It undergoes rapid proliferation. The
nucleous of the proerythroblasts have coarser and more basophilic chromatin strands.
c) Intermediate normoblast: It is a round cell between 12 – 14 μm in diameter. Nucleous
becomes much smaller and cells divide by Mitosis. Nuclear chromatin is in coarse,
deeply basophilic clumps, and proliferative activity ceases after this stages.
Heamoglobin starts to appear.
d) Late normoblast : diameter of cell is 8-10 μm nucleous becomes very small and it is
having INK SPOT nucleous. Quantity of Hb increases and cells stop dividing.
Cytoplasm becomes ACIDOPHILIC.
e) Reticulocyte : it is having a diameter of 7-8 μm, slightly larger than a mature RBC.
Cytoplasm is deeply stained with Acidophilic cytoplasm. The amount of Hb increases.
The cytoplasm contains a reticulum network which is formed by the remenants of RNA,
Mitochondria, Ribosomes and Endoplasmic reticulum. They enter the general circulation
through blood capillaries.
f) Erythrocyte: the diameter is about 7-8 μm. Nucleous and all cell organalles are absent.
Reticular network disappears and cell becomes RBC’s and attain biconcave shape.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 47
Reticulocytes develop into mature RBC within 1-2 days after their release into general
circulation.
MORPHOLOGY AND FUNCTIONS OF THE RED BLOOD
CORPUSCLES81
Mature red cell is a circular, biconcave disc containing pigmented protein called heamoglobin
and is bound by the cell membrane. It is having a mean diameter of about 7.8 μm and
thickness of 2.5 micrometers. The shape of Cells can frequently change as they squeeze
through capillaries.
On peripheral smear, they appear as pale red cells with central one third pallor. The normal
range for young female adults is 12-16g/dL; for young male adults it is 14-18g/dL.
Life span: The mature erythrocyte has a life span of approximately 120 days in the
circulation. As red blood cells age, the surface area decreases relative to cytoplasmic volume
resulting in a sphere form which is more rigid and is ultimately trapped in splenic cords.
FUNCTIONS82:
1. They provide an environment for the iron-containing respiratory pigment, heme,
which is complexed to two alpha and two beta globin chains comprising the
hemoglobin molecule.
2. The major function of Red Blood cells, is to transport hemoglobin, which in turn
carries oxygen from the lungs to the tissues.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 48
3. The erythrocyte also contains enzymes that participate in the glycolytic and hexose
monophosphate biochemical pathways. Under normal circumstances, red blood cells
never leave the circulatory system.
BLOOD PERIPHERAL SMEAR83
Examination of a fixed and stained blood film is an essential part of a haematological
investigation. The best place to examine blood cell morphology is the feathered edge of the
blood smear where red cells lie in a single layer, side by side, just barely touching one
another but not overlapping. Red cells are examined for:
1) Size
2) Shape
3) Color
SIZE:
1) Normocytes: Normal RBC is biconcave, 7.2 μm in diameter.
2) Microcytic: RBC’s are smaller than normal and less than 6 μm in diameter.
3) Macrocyte: Larger than normal, more than 9 μm.
SHAPE:
Red cells can take on a variety of different shapes. Some of the morphological abnormality
which is seen in RBC’s is:
1) Poikilocytes: these are abnormally shaped red cells are spherocytes: Small red cells
without the central pallor, they can be seen in hereditary spherocytosis.
2) Dacrocytes: are teardrop- shaped cells. It is also called pear shaped cell.
3) Schistocytes: are small, irregular, triangular or speculated cells. Also called as
helmet-shaped cells.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 49
4) Echinocytes: are very small, irregular shrunken cells with pointed projections. These
resembles to small thorny ‘burrs’.
5) Acanthocytes: are Irregularly crenated cells with irregularly spaced sharp projections.
6) Small number of spicules of length, thickness, shape, irregularly disposed over the
surface of the cell.
7) Elliptocytes: are elliptical-shaped red cells that can reflect an inherited defect in the
red cell membrane.
8) Stomatocytes: these are red cells in which the area of central pallor
takes on the morphology of a slit instead of the usual round shape.
9) Spherocytes: small densely staining spherical red cells with no central pallor area.
10) Ovalocytes: these are oval shaped red cells. About 10% RBC in a normal blood film,
particularly at the tail end, appear oval and less commonly elliptical in shape.
11) Sickle Cells: thin, elongated, slightly curved and have shape of sickle.
CHROMASIA:
1) Normochromic: Cells with central 1/3 pallor.
2) Hypochromic: Cells with more than 1/3 central pallor.
3) Polychromic: Cells stained purple and are larger than normal.
STAINS FOR BLOOD SMEARS84
The blood cells contain cellular structures which vary in their pH, some are acidic and others
are basic.
All stains which are made up of combinations of acidic and basic dyes are called
Romanowsky stains.
Romanowsky Stains
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 50
It is a mixture of methylene blue (basic stain) and eosin (acoidic stain). Methylene blue on
oxidation produces colored compounds called Azures that have the ability to combine with
eosin. Oxidation is achieved during maturation/chemical treatment of the stain. The Azures
are responsible for different shades of staining in the smears ( i.e RBC’s pink, granules of
eosinophils red- orange, granules of basophils bluish black, granules of neutrophil- iliac).
Leishman stain comes under Romanowsky stains. It contains Leishman powder and acetone
free Methyl Alcohol (Methanol)
METHOD OF PREPARING STAIN
Blood peripheral smear will be done by using Lieshman’s stain, as it provides excellent stain
quality.
* Leishman stain comes in a dry powder form.
* This dry powder is to be mixed well into good quality anhydrous methanol in ratio of
0.6gm powder into 400ml methanol.
* The stain (usually 50-100 ml) should be filtered into a dispensing unit.
PREPRATION OF THE PERIPHERAL OF BLOOD SMEAR85
1) A drop of blood is obtained by capillary puncture and it is placed about 1cm from the end
of a grease free slide.
2) A spreader slide is held between thumb and fingers of the right hand at an angle of about
40 degree to the horizontal.
3) A thin layer of blood is obtained and the slide is air dried.
4) About 8-10 drops of lieshman’s stain is dropped over the dried slide using a dropper such
that the stain covers the entire surface of the slide and time is noted.
5) The slide is left undisturbed for two minutes.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 51
6) Distilled water is added drop by drop till it covers the entire slide surface. The stain and
distilled water are mixed by blowing through a glass tube. This is allowed to stand for 8
minutes.
7) After the stipulated time, the mixture is poured off and slide is washed with running water
and air dried.
8) The slide can be viewed under the microscope first under 10X and then under oil
immersion 100X.
FEATURES OF WELL MADE SMEAR86
Length: smear should be 2/3 to ¾ of the length of the slide.
Shape: the smear should be either tongue or finger- shaped (smooth without any
irregularities or holes)
Well made smear has three parts namely head, body, and tail.
FIXATION OF THE SMEAR
The blood should be fixed within 4 hours for good staining.
Blood films are fixed by acetone free methyl alcohol which is present in Leishman
stain, Wright or Giemsa stain.
NORMAL PICTURE OF WELL STAINED SMEAR87
In a well stained peripheral blood smear:
COLOR: Rose pink smear
RBCs: Orange to salmon pink
NEUTROPHILIS: Deep purple nucleus, liliac cytoplasm, barely visible granules.
EOSINOPHILS: 2-3 thick lobes of nucleus, bright orange granule.
EXAMINATION OF PERIPHERAL BLOOD SMEAR88
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 52
The best area of the smear to study the morphology of cells is the body, where the cells are
well separated out and touch one another without overlapping. Apply a thin layer of Cedar
wood oil over the smear which makes the appearance of cells very clear. First slides are
viewed under low power (10X), followed by high power (100X) and following observations
are noted:
1. The quality of the film and uniformity of staining.
2. Red Blood Cells: Red cells examination can be best noticed between the tail and
body of the smear where those are evenly placed and just touch each other. Look for
number, distribution and staining of the red cells, degree of Rouleaux formation if
present.
3. Likewise, White Blood Cells, Platelets, Hemoparasites should be observed.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 53
METHODOLOGY
Source of data:
50 patients, both male and female, of the age between 16 to 60 yrs, attending O.P.D, I.P.D of
JSS Ayurveda Medical College and Hospital, Mysuru. Special camps were held at JSS
School and degree college, Sutturu, NSS camp at Bidargudu, JSS College for Women,
Saraswathipuram. Subjects were selected at random without bias of social, economic,
educational or religious status.
METHOD OF COLLECTION DATA:
a) Sample size: 50 subjects were selected for this study.
b) Diagnostic criteria:
Through detail history of patients who were having Pratyatma lakshana of Pandu roga
(Panduta) was done and patients were screened for the following Samanya lakshanas of Pandu
roga.
Twak vaivarnayata (pale skin color)
Anna dwesha (aversion to food)
Alpa vak (diminished speech)
Hatanala (loss of digestion)
Nidralu (oversleep)
Shuna akshi koota (peri orbit swellings)
Anga Sada (malaise)
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 54
Shtivana (spitting)
Kopana (irritability)
Shishira dweshi (aversion to cold)
Sheerna loma (falling of hairs)
Jwara (fever)
Shwasa (dyspnoea)
Karna kshwedi (tinnitus)
Bhrama (giddiness)
Shrama (exhaustion)
Hataprabha (loss of luster)
Durbala (debility)
Pindikodweshtana (cramps)
Kati, uru, pada ruk (pain in waist, thigh, legs)
Sadana (lassitude)
Arohana ayasa (exertional dyspnoea)
Those patients were assessed for Vishista lakshana of Pandu roga mentioned in various classics
to diagnose the type of Pandu roga. Later patients were subjected to Peripheral Blood Smear
through capillary puncture and smear was studied under 100X oil immersion microscope.
c) Inclusion criteria:
Patients of either sex.
Patients of 16 – 60 years of age.
The individual having the clinical features of pandu roga ( samanya lakshanas of pandu)
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 55
d) Exclusion criteria:
Patients with history of metabolic disorders.
Patients with history of congenital disorders related with haemopoetic system like sickle
cell anemia, leukemia, hemophilia.
Patients suffering with any infectious diseases like malaria
Gastro intestinal bleeding.
Pregnant.
Drug induced anemia.
Recent blood donation.
Acute and chronic illness.
Alcoholic patients.
Study design:
1) Patients fulfilling the inclusion criteria were selected.
2) The diagnosis of the type of Pandu roga present was done based on the Vishista
Lakshanas.
3) Patients were then subjected to blood peripheral smear.
4) Smear was stained with Leishman stain and slides were observed for the RBC
morphology under oil immersion (100X) microscope.
5) Findings were statistically analysed.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 56
ASSESSMENT CRITERIA
SUBJECTIVE PARAMETERS:
Samanya lakshanas mentioned above.
Vishista Lakshanas mentioned in Pandu Roga are as follows:
Vataja Pandu lakshana:
Angamarda
Toda
Kampa
Krishna, ruksha, aruna sira
Nakha vin mutra netra
Shopha
Anaaha
Aasya vairasya
Varcha sosha
Parshva shola
Shiro ruja
Balakshaya
Ruja
Bhrama
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 57
Pittaja pandu lakshana:
Peeta / harita varna
Jwara
Daha
Trishna
Murchha
Peeta mutra, vin, nakha
Peeta sira
Sweda
Sheeta iccha
Dourgandhya
Katu asya
Varcha bheda
Amla udgara
Vidaha
Vidagdha anna
Dourbalya
Tama
Kaphaja pandu lakshana:
Gourava
Tandra
Chardi
Shvetaabhasa
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 58
Praseka
Lomaharsha
Sada
Murchha
Bhrama
Klama
Shwasa
Kasa
Aalasya
Aruchi
Vak swara graha
Shukla mutra akshi varchas
Katu ruksha ushna kamta
Shvaythu
Madhura asya
Swara kshaya
Tridoshaja pandu lakshana:
Tandra
Aalasya
Shwayathu
Vamathu
Kasa
Hrillasa
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 59
Shosha
Netra parusha
Jwara
Kshudha
Moha
Trishna
Klama
OBJECTIVE PARAMETERS89,90:
Peripheral blood smear. 5 fields (100X) oil emersion were observed in each slide. For the
morphology of RBCs range was given for the size and chromasia as :
1. 5- 25% (10-50 cells) - few
2. 25-50% (51-100 cells) - moderate
3. >50% (>100 cells) - many
Range given for abnormal shape of RBCs as:
1. 1-2 cells per field - few
2. 3-5 cells per field - moderate
3. >5 cells per field - many
METHOD OF PREPARING STAIN
Blood peripheral smear will be done by using Lieshman’s stain, as it provides
excellent stain quality.
Leishman stain comes in a dry powder form.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 60
This dry powder is to be mixed well into good quality anhydrous methanol in
ratio of 0.6gm powder into 400ml methanol.
The stain (usually 50-100ml) should be filtered into a dispensing unit.
METHOD OF STAINING OF BLOOD FILM
1) A drop of blood is obtained by capillary puncture and it is placed about 1cm
from the end of a grease free slide.
2) A spreader slide is held between thumb and fingers of the right hand at an
angle of about 40 degree to the horizontal.
3) A thin layer of blood is obtained and the slide is air dried.
4) About 8-10 drops of lieshman’s stain is dropped over the dried slide using a
dropper such that the stain covers the entire surface of the slide and time is noted.
5) The slide is left undisturbed for two minutes.
6) Distilled water is added drop by drop till it covers the entire slide surface. The
stain and distilled water are mixed by blowing through a glass tube. This is
allowed to stand for 8 minutes.
7) After the stipulated time, the mixture is poured off and slide is washed with
running water and air dried.
8) The slides were viewed under the microscope first under 10X and then under
oil immersion 100X.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 61
RESULTS
Table-13: Distribution of Subjects according to Age
Age, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
< 16 3 6.0 6.0 6.0
17 - 30 31 62.0 62.0 68.0
31 - 60 16 32.0 32.0 100.0
Total 50 100.0 100.0
Graph -1: showing Distribution of Subjects according to Age
The above table showed that the majority of study population belonged to 17- 30 years
(62%), followed by age group of 31-60 years (32%). The least are below the age of 16years
(6%).
0
5
10
15
20
25
30
35
Less than 16 17 to 30 31 to 60
Frequency 3 31 16
AGE, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 62
Table-14: Distribution of subjects according to the Gender
GENDER, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Female 44 88.0 88.0 88.0
Male 6 12.0 12.0 100.0
Total 50 100.0 100.0
Graph -2: showing Distribution of Subjects according to gender
Amongst the 50 subjects, the highest incidence i.e. 44 (88%) was in females, followed by
male 6 (12%).
0
10
20
30
40
50
feMale male
Frequency 44 6
GENDER, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 63
Table-15: Distribution of subjects according to the locality
LOCALITY, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Urban 28 56.0 56.0 56.0
Rural 22 44.0 44.0 100.0
Total 50 100.0 100.0
Graph -3: showing Distribution of Subjects according to locality
The above table shows that majority of the study population 28(56%) belonged to urban
place, and 18 (44%) belonged to rural place.
56%
44%
LOCALITY, n=50
urban
rural
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 64
Table-16: Distribution of subjects according to the religion
RELIGION, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Hindu 48 96.0 96.0 96.0
Muslim 1 2.0 2.0 98.0
Christian 1 2.0 2.0 100.0
Total 50 100.0 100.0
Graph -4: showing Distribution of Subjects according to religion
Among 50 subjects, highest number i.e. 96% (48) was Hindus, 2% (1) was Muslim,
2% (1) was Christian.
0
10
20
30
40
50
Hindu Muslim Christian
Frequency 48 1 1
RELIGION, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 65
Table-17: Distribution of subjects according to the marital status
MARITAL STATUS, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Married 19 38.0 38.0 38.0
Unmarried 28 56.0 56.0 94.0
Widow 3 6.0 6.0 100.0
Total 50 100.0 100.0
Graph -5: showing Distribution of Subjects according to marital status
The above table shows that majority of subjects were unmarried 28(56%) and 28(38%) of
subjects were married. And 3( 6%)were widows.
Married Unmarried Widow
Frequency 19 28 3
0
5
10
15
20
25
30
MARITAL STATUS, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 66
Table-18: Distribution of subjects according to the educational status
EDUCATIONAL STATUS, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Uneducated 4 8.0 8.0 8.0
Primary 6 12.0 12.0 20.0
High school 3 6.0 6.0 26.0
PUC /diploma 9 18.0 18.0 44.0
Graduate 19 38.0 38.0 82.0
Postgraduate 9 18.0 18.0 100.0
Total 50 100.0 100.0
8%
12%
6%
18%38%
18%
EDUCATIONAL STATUS, n=50
Uneducated
primary
highschool
puc/diploma
graduate
postgraduate
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 67
Graph -6: showing Distribution of Subjects according to educational status
Amongst 50 subjects, 38% (19) were Graduates, 18% (9) subjects were PUC/diploma and
postgraduates, 12% (6) were having primary Education, whereas 8% (4) and 6% (3) were
uneducated and high school respectively.
Table-19: Distribution of subjects according to the Socio economic status
Socio Economic Status
Frequency Percent
Valid
Percent
Cumulative
Percent
Poor 7 14.0 14.0 14.0
Lower
middle
8 16.0 16.0 30.0
Upper
middle
23 46.0 46.0 76.0
Rich 12 24.0 24.0 100.0
Total 50 100.0 100.0
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 68
Graph -7: showing Distribution of Subjects according to socio-economic status
Amongst 50 subjects, 46%(23) belonged to upper middle class, 24% (12) belonged to rich
class, 16%(8) belonged to lower middle and 14% (7) were poor.
Table-20: Distribution of subjects according to the Diet
DIET, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Vegetarian 30 60.0 60.0 60.0
Mixed 20 40.0 40.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
poor lowermiddle
uppermiddle
rich
SOCIO ECONOMIC STATUS, n=50
Frequency
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 69
Graph -8: showing Distribution of Subjects according to diet
Amongst 50 subjects, 60% (30) were vegetarians, whereas 40% (20) were on mixed
diet.
Table-21: Distribution of subjects according to the appetite
APPETITE, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Increased 2 4.0 4.0 4.0
Reduced 37 74.0 74.0 78.0
Not
altered
11 22.0 22.0 100.0
Total 50 100.0 100.0
60%
40%
DIET n=50
vegetarian
mixed
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 70
Graph -9`: showing Distribution of Subjects according to appetite
Amongst 50 subjects, 74% (37) were having reduced appetite, 22% (11) appetite was not
altered and 4% (2) appetite was increased.
Table-22: Distribution of subjects according to the night sleep
night sleep
Frequency Percent
Valid
Percent
Cumulative
Percent
sound 34 68.0 68.0 68.0
disturbed 16 32.0 32.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
35
40
increased reduced not altered
Frequency 2 37 11
APPETITE, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 71
Graph -10: showing Distribution of Subjects according to night sleep
Amongst 50 subjects, 66% (33) were having sound night sleep whereas 34% (17) were
having disturbed night sleep.
Table -23: showing Distribution of Subjects according to day sleep
DAY SLEEP, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
present 11 22.0 22.0 22.0
absent 39 78.0 78.0 98.0
Total 50 100.0 100.0
68%
32%
NIGHT SLEEP, n=50
sound
disturbed
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 72
Graph -11: showing Distribution of Subjects according to day sleep
Amongst 50 subjects, 78% (36) were habituated for day sleep, 22% (11) were not sleeping in
day time.
Table-24: Distribution of subjects according to the bowel (consistency)
BOWEL/CONSISTENCY, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Hard 15 30.0 30.0 30.0
Soft 34 68.0 68.0 98.0
Loose 1 2.0 2.0 100.0
Total 50 100.0 100.0
22%
78%
DAY SLEEP, n=50
absent
present
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 73
Graph -12: showing Distribution of Subjects according to bowel consistency
Amongst 50 subjects, 68% (34) were having soft bowel consistency, 30% (15) were having
hard bowel consistency, and 2% (1) were having loose bowel consistency.
Table-25: Distribution of subjects according to the tea consumption
TEA, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Present 37 74.0 74.0 74.0
Absent 13 26.0 26.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
35
hard soft loose
Frequency 15 34 1
BOWEL CONSISTENCY, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 74
Graph -13: showing Distribution of Subjects according to tea consumption
Amongst 50 subjects, 74% (37) were habituated for tea consumption and 26% (13) were not
habituated for tea.
Table-26: Distribution of subjects according to the coffee consumption
COFFEE, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Present 12 24.0 24.0 24.0
Absent 38 76.0 76.0 100.0
Total 50 100.0 100.0
74%
26%
TEA, n=50
present
absent
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 75
Graph -14: showing Distribution of Subjects according to coffee consumption
Amongst 50 subjects, 76% (38) were not taking coffee whereas 24% (12) were taking coffee.
Table-27: Distribution of subjects according to the smoking
SMOKING, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Present 4 8.0 8.0 8.0
Absent 46 92.0 92.0 100.0
Total 50 100.0 100.0
24%
76%
COFFEE, n=50
present
absent
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 76
Graph -15: showing Distribution of Subjects according to smoking
Amongst 50 subjects, 92% (46) were nonsmokers whereas 8% (4) were smokers.
Table-28: Distribution of subjects according to the Alcohol
ALCOHOL, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Present 3 6.0 6.0 6.0
Absent 47 94.0 94.0 100.0
Total 50 100.0 100.0
0
10
20
30
40
50
present absent
SMOKING, n=50
Frequency
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 77
Graph -16: showing Distribution of Subjects according to alcohol consumption
Amongst 50 subjects, 94% (47) were nonalcoholic whereas 6% (3) were alcoholic.
Table-29: Distribution of subjects according to the type of work
TYPE OF WORK, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Sedentary 40 80.0 80.0 80.0
Moderate 7 14.0 14.0 94.0
Heavy 3 6.0 6.0 100.0
Total 50 100.0 100.0
present absent
Frequency 3 47
0
5
10
15
20
25
30
35
40
45
50
ALCOHOL, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 78
Graph -17: showing Distribution of Subjects according to type of work
Amongst 50 subjects, 80% (40) were having sedentary work, 14% (7) were having moderate
work and 6% (3) were having heavy work.
Table-30: Distribution of subjects according to the time of work
Time Of Work, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Day 41 82.0 82.0 82.0
Night 1 2.0 2.0 84.0
Day&
night
8 16.0 16.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
35
40
sedentary moderate heavy
Frequency 40 7 3
TYPE OF WORK, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 79
Graph -18: showing distribution of Subjects according to time of work
Amongst 50 subjects, 82% (41) were day workers, 16% (8) were day and night workers
whereas 2% (1) was doing night shifts.
Table-31: Distribution of subjects according to the nature of cycles
Nature of cycle
Frequency Percent
Valid
Percent
Cumulative
Percent
no 6 12.0 12.0 12.0
Regular 34 68.0 68.0 80.0
Irregular 10 20.0 20.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
35
40
45
day night day & night
Frequency 41 1 8
TIME OF WORK, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 80
Graph -19: showing distribution of Subjects according to nature of cycle
Amongst 50 subjects, 44 were females, 68% (34) were having regular menstrual cycles
whereas 20% (10) were having irregular menstrual cycle.
Table-32: Distribution of subjects according to the Quantity
Quantity
Frequency Percent
Valid
Percent
Cumulative
Percent
No 6 12.0 12.0 12.0
Heavy 12 24.0 24.0 36.0
Scanty 9 18.0 18.0 54.0
Moderate 23 46.0 46.0 100.0
Total 50 100.0 100.0
05
101520253035
34 10
regular irregular
Frequency 34 10
NATURE OF CYCLE, n =50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 81
Graph -20: showing distribution of Subjects according to quantity
Amongst 50 subjects, 44 were females, 46% (23) were having moderate menstrual flow, 24%
(12) were having heavy menstrual flow, and 18% (9) were having scanty flow. Remaining 6
subjects were males.
Table-33: Distribution of subjects according to the clots
clots
Frequency Percent
Valid
Percent
Cumulative
Percent
No 6 12.0 12.0 12.0
Present 20 40.0 40.0 52.0
Absent 24 48.0 48.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
heavy scany moderate
Frequency 12 9 23
QUANTITY, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 82
Graph -21: showing distribution of Subjects according to clots
Amongst 50 subjects, 44 were females, 48% (24) were not having clots in menstrual cycles,
whereas 40% (20) were having clots. Remaining 6 were males.
Table-34: Distribution of subjects according to the nourishment
NOURISHMENT, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Poor 35 70.0 70.0 70.0
Well 14 28.0 28.0 98.0
Over 1 2.0 2.0 100.0
Total 50 100.0 100.0
18
19
20
21
22
23
24
20 24
present absent
Frequency 20 24
CLOTS , n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 83
Graph -22: showing distribution of Subjects according to nourishment
Amongst 50 subjects, 70% (35) were poorly nourished, 28% (14) were moderately nourished
and 2% (1) was over nourished
Table-35: Distribution of subjects according to the nadi
NADI, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Vata 11 22.0 22.0 22.0
Pitta 34 68.0 68.0 90.0
Kapha 5 10.0 10.0 100.0
Total 50 100.0 100.0
malnourished well norished over nourished
Frequency 35 14 1
0
5
10
15
20
25
30
35
40
NOURISHMENT, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 84
Graph -23: showing distribution of Subjects according to nadi
Amongst 50 subjects, 68% (34) were having pittaja nadi, 22% (11) were having Vataja nadi
and 10% (5) was having Kaphaja nadi.
Table-36: Distribution of subjects according to the Sparsha
SPARSHA, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
Cold&
rough
16 32.0 32.0 32.0
Hot &
moist
8 16.0 16.0 48.0
Wet &
cold
26 52.0 52.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
35
vata pitta kapha
Frequency 11 34 5
NADI, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 85
Graph -24: showing distribution of Subjects according to sparsha
Amongst 50 subjects, 52% (26) were having wet & cold touch, 32% (11) were having cold &
rough touch and 16% (8) was having Hot & moist touch.
Table-37: Distribution of subjects according to the Akruti
Akruti
Frequency Percent
Valid
Percent
Cumulative
Percent
Krusha 36 72.0 72.0 72.0
Madhayama 13 26.0 26.0 98.0
Sthoola 1 2.0 2.0 100.0
Total 50 100.0 100.0
32%
16%
52%
SPARSHA, n=50
1
2
3
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 86
Graph -25: showing distribution of Subjects according to Akruti
Amongst 50 subjects, 72% (36) were having krusha akruti, 26% (13) were having
madhayama akruti and 2% (1) was having sthoola akruti.
Table-37: Distribution of subjects according to the Prakruti
PRAKRUTI, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
vata pitta 30 60.0 60.0 60.0
pittakapha 7 14.0 14.0 74.0
vata kapha 13 26.0 26.0 100.0
Total 50 100.0 100.0
72%
26%
2%
AKRUTI, n=50
krusha
madhayama
sthoola
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 87
Graph -26: showing distribution of Subjects according to prakruti
Amongst 50 subjects, 60% (30) were having vata-pitta prakriti, 26% (13) were having vata-
kapha prakriti and 14% (7) were having pitta-kapha prakriti.
Table-38: Distribution of subjects according to the sara
SARA, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
madhayama 38 76.0 76.0 76.0
avara 12 24.0 24.0 100.0
Total 50 100.0 100.0
vata pitta pittakapha vata kapha
Frequency 30 7 13
0
5
10
15
20
25
30
35
PRAKRUTI, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 88
Graph -27: showing distribution of Subjects according to sara
Amongst 50 subjects, 76% (38) were having madhayama sara and 24% (12) were having
avara sara.
Table-39: Distribution of subjects according to the Samhanana
Samhanana
Frequency Percent
Valid
Percent
Cumulative
Percent
madhayama 48 96.0 96.0 96.0
avara 2 4.0 4.0 100.0
Total 50 100.0 100.0
0
10
20
30
40
madhayama avara
Frequency 38 12
SARA, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 89
Graph -28: showing distribution of Subjects according to samhanana
Amongst 50 subjects, 96% (48) were having madhayama samhanana and 4% (2) were having
avara samhanana.
Table-40: Distribution of subjects according to the Pramana
Pramana
Frequency Percent
Valid
Percent
Cumulative
Percent
pravara 1 2.0 2.0 2.0
madhayama 25 50.0 50.0 52.0
avara 24 48.0 48.0 100.0
Total 50 100.0 100.0
0
10
20
30
40
50
madhayama avara
Frequency 48 2
48
2
SAMHANANA, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 90
Graph -29: showing distribution of Subjects according to pramana
Amongst 50 subjects, 50% (24) were having madhayama pramana and 48% (24) were having
avara pramana.
Table-41: Distribution of subjects according to the satva
SATVA, n=50
Frequency Percent
Valid
Percent
Cumulative
Percent
pravara 1 2.0 2.0 2.0
madhyama 44 88.0 88.0 90.0
avara 5 10.0 10.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
pravara madhayama avara
1
25 24
PRAMANA, n=50
Frequency
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 91
Graph -30: showing distribution of Subjects according to satva
Amongst 50 subjects, 88% (44) were having madhayama satva and 10% (5) were having
avara satva.
Table-42: Distribution of subjects according to the Abhyavarana shakti
Abhyavarana Shakti
Frequency Percent
Valid
Percent
Cumulative
Percent
pravara 2 4.0 4.0 4.0
madhyama 32 64.0 64.0 68.0
avara 16 32.0 32.0 100.0
Total 50 100.0 100.0
2%
88%
10%
SATVA, n=50
pravara
madhyama
avara
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 92
Graph -31: showing distribution of Subjects according to Abhyavarana Shakti
Amongst 50 subjects, 64% (32) were having madhayama Abhyavarana shakti
and 32% (16) were having avara Abhyavarana Shakti and 4%(2) were having pravara
Abhyavarana Shakti.
Table-43: Distribution of subjects according to the Jarana shakti
Jarana shakti
Frequency Percent
Valid
Percent
Cumulative
Percent
pravara 2 4.0 4.0 4.0
madhyama 28 56.0 56.0 60.0
avara 20 40.0 40.0 100.0
Total 50 100.0 100.0
pravara madhyama avara
Frequency 2 32 16
0
5
10
15
20
25
30
35
ABHYAVARANA SHAKTI, n=50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 93
Graph -32: showing distribution of Subjects according to Jarana Shakti
Amongst 50 subjects, 56% (28) were having madhayama jarana shakti
and 20% (40) were having avara jarana shakti and 4%(2) were having pravara jarana shakti.
Table-44: Distribution of subjects according to the Vyayama shakti
Vyayama Shakti
Frequency Percent
Valid
Percent
Cumulative
Percent
pravara 2 4.0 4.0 4.0
madhayma 32 64.0 64.0 68.0
avara 16 32.0 32.0 100.0
Total 50 100.0 100.0
0
5
10
15
20
25
30
pravara madhyama avara
JARANA SHAKTI, n=50
Frequency
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 94
Graph -33: showing distribution of Subjects according to Vyayama Shakti
Amongst 50 subjects, 64% (32) were having madhayama Vyayama shakti and 32% (16) were
having avara Vyayama shakti and 4% (2) were having pravara Vyayama Shakti.
2
32
16
0
5
10
15
20
25
30
35
pravara madhayma avara
VYAYAMA SHAKTI, n=50
Frequency
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 95
Graph -34: Distribution of subjects showing Aharaja nidanas
Amongst 50 subjects, more predominantly aharaja nidanas were Ati lavana (98%), excessive
use of Masha (90%), Nishpava (90%), Ati tikshna (72%), Ati ushna (64%), viruddha ahara
(62%), katu (58%), amla (58%).
0% 20% 40% 60% 80% 100%
KSHARA
LAVANA
KATU
KASHAYA
ATI TIKSHNA
ATI USHNA
VIRUDDHA
VIDAGDHA
ASATMAYA
NISHAPAVA
MASHA
TILA TAILA
MADHYA
AMLA
MRITTIKA BHAKSHANA
0%
98%
58%
22%
72%
64%
62%
10%
20%
90%
90%
8%
14%
58%
32%
AHARAJA NIDANAS, n=50
present
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 96
Graph -35: distribution of subjects showing viharaja nidanas
Amongst 50 subjects, more predominantly viharaja nidanas were Diwaswapna (72%), Shrama
(70%), Nidra nasha (56%)
0% 20% 40% 60% 80%
DIVASWAPNA
VYAYAMA
MAITHUNA
PANCHAKARMA VAISHMYA
RUTU VAISHMYA
NIDRA NASHA
SHRAMA
VEGA VIDHARANA
72%
28%
24%
0%
26%
56%
70%
34%
VIHARAJA NIDANA, n=50
present
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 97
Graph -36: distribution of subjects showing manasika nidanas
Amongst 50 subjects, more predominantly manasika nidanas were chinta (70%), krodha
(66%), bhaya (44%).
0%
10%
20%
30%
40%
50%
60%
70%
44%
70%66%
14% 16%
MANASIKA NIDANAS, n=50
present
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 98
GRAPHS SHOWING VISHISHTA LAKSHANA OF PANDU
Graph -37: showing distribution of vataja pandu lakshana
Amongst 50 subjects, lakshanas which were commonly seen were Angamarda(80%), shiro
ruja (60%), balakshaya (48%).
0%10%20%30%40%50%60%70%80%
80%
4% 8%0% 4% 0%
8%14%
4%
16%
60%
48%
12%
44%
VATAJA PANDU LAKSHANA, n=50
PRESENT
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 99
Graph -38: showing distribution of pittja pandu lakshana
Amongst 50 subjects, lakshanas which were commonly seen are Dourbalya (74%), trishna
(24%), sweda (20%).
2% 6%16%
24%
6% 2% 4%
20% 16%
4% 2% 2%10%
4% 4%
74%
10%
0%10%20%30%40%50%60%70%80%
PITTAJA PANDU LAKSHANA, n=50
PRESENT
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 100
Graph -39: showing distribution of Kaphaja pandu lakshana
Amongst 50 subjects, lakshanas which were commonly seen were gourava (82%), aruchi
(80%), alasya (78%), tandra (74%), bhrama( 62%).
0%10%20%30%40%50%60%70%80%90%
GO
UR
AV
A
TAN
DR
A
CH
AR
DI
SHV
ETA
AB
HA
SA
PR
ASE
KA
LOM
AH
AR
SHA
SAD
A
MU
RC
HH
A
BH
RA
MA
KLA
MA
SHW
ASA
KA
SA
AA
LASY
A
AR
UC
HI
VA
K SW
AR
A G
RA
HA
SHU
KLA
MU
TRA
AK
SHI…
KA
TU R
UKS
HA
USH
NA
…
SHV
AYT
HU
MA
DH
UR
A A
SYA
SWA
RA
KSH
AYA
82%74%
22%26%
12%6%
12%20%
62%
4%
38%34%
78%80%
4% 4%14%
4% 6% 2%
KAPHAJA PANDU LAKSHANA, n=50
PRESENT
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 101
OBSERVATIONS
Amongst 50 subjects, 41 subjects were presenting with Kaphaja pandu lakshana, 3 subjects
were having more Vata-Pitta lakshana, 3 subjects were having more Vata-Kapha lakshana,
2 subjects found to have Vataja pandu lakshana, whereas 1 subject was having Pittaja
Pandu lakshana.
Table- 58: Distribution of subjects based on the color of RBC’s.
NORMOCHROMIC HYPOCHROMIC ABSENCE OF
CENTRAL PALOR
TOTAL
Frequency Percent
(%)
Frequency Percent
(%)
Frequency Percent
(%)
VATAJA 0 0.0 1 2.0 0 0.0 1
PITTAJA 0 0.0 1 2.0 0 0.0 1
KAPHAJA 0 0.0 42 84.0 0 0.0 42
VATA
PITTAJA
0 0.0 3 6.0 0 0.0 3
VATA
KAPHAJA
1 2.0 2 4.0 0 0.0 3
SANNIPATAJA 0 0.0 0 0.0 0 0.0 0
TOTAL 1 49 0 50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 102
Graph 36: Showing distribution based on the chromasia(color) of RBC’s.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
0% 0% 0% 0%2%
0%2% 2%
84%
6%4%
0%
NORMOCHROMIC
HYPOCHROMIC
ABSENCE OF CENTRAL PALOR
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 103
Table- 58: Distribution of subjects based on the Size of RBC’s.
NORMOCYTIC MICROCYTIC ANISOCYTIC TOTAL
Frequenc
y
Percent
(%)
Frequen
cy
Percent
(%)
frequency Percent
(%)
VATAJA 0 0.0 0 0.0 1 2.0 1
PITTAJA 0 0.0 0 2.0 1 0.0 1
KAPHAJA 6 4.0 27 84.0 9 2.0 42
VATA
PITTAJA
0 0.0 2 6.0 1 2.0 3
VATA
KAPHAJA
2 0.0 0 4.0 1 2.0 3
SANNIPATAJA 0 0.0 0 0.0 0 0.0 0
TOTAL 8 29 13 50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 104
Graph 37: Showing distribution based on the Size of RBC’s.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
0% 0%4%
0% 0% 0%0% 2%
84%
6%4% 0%
2% 0%2% 2% 2%
0%
NORMOCYTIC
MICROCYTIC
ANISOCYTIC
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 105
Table- 58: Distribution of subjects based on the Shape of RBC’s.
PANDU
TYPE
NORMA
L
ABNORMAL
TOT
AL
Freq
uenc
y
(%
age
)
poikiloc
yte
(%ag
e)
Burr
cells
(%ag
e)
Targ
et
cells
(%ag
e)
Dacroc
yte
(%ag
e)
VATAJA 1 2.
0
0 0.0 0 0.0 0 0.0 0 0.0 1
PITTAJA 1 2.
0
0 0.0 0 0.0 0 0.0 0 0.0 1
KAPHAJ
A
36 76
.0
1 2.0 1 2.0 3 9.0 1 2.0 42
VATA
PITTAJA
3 9.
0
0 0.0 0 0.0 0 0.0 0 0.0 3
VATA
KAPHAJ
A
2 9.
0
0 0.0 0 0.0 0 0.0 1 2.0 3
SANNIP
ATAJA
0 0.
0
0 0.0 0 0.0 0 0.0 0 0.0 0
TOTAL 43 1 1 3 2 50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 106
Graph 38: Showing distribution based on the abnormal Shape of RBC’s
Amongst 50 subjects, 76% subject’s blood smear picture showed normal shape of the RBC’s,
whereas 2% presented with the poikilocyte, 2% presented with burrcells, 9% presented with
target cells and 2% presented with dacrocyte.
0%
10%
20%
30%
40%
50%
60%
70%
80% 76%
2%
2% 9%
2%
VATAJA
PITTAJA
KAPHAJA
VATA PITTAJA
VATA KAPHAJA
SANNIPATAJA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 107
Table- 58: Distribution of subjects based on the presentation of size & Color
S.no Normocytic/
Normochromic
Normocytic/
hypochromic
Microcytic/
hypochromic
Anisocytic/
normochromic
Anisocytic/
hypochromic
Total
1. KAPHA 0 6 27 0 9 42
2. VATA
PITTA
0 0 2 0 1 3
3. VATA
KAPHA
0 2 0 1 0 3
4. PITTA 0 0 0 0 1 1
5. VATA 0 0 0 0 1 1
6. SANNIPATA 0 0 0 0 0 0
TOTAL 50
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 108
Graph 39: Showing distribution based on the Size & shape of RBC’s
Amongst 50 subjects, 42 subjects were having Kaphaja Pandu,
Out of that 27 subject’s blood picture showed Microcytic Hypochromic RBC’s.
9 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
6 subject’s blood picture showed Normocytic Hypochromic RBC’s.
Amongst 50 subjects, 3 subjects were having Vata Pitta pandu,
2 subject’s blood picture showed Microcytic Hypochromic RBC’s.
1 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
Amongst 50 subjects, 3 subjects were having Vata Kapha pandu,
1 subject’s blood picture showed Anisocytic Normochromic RBC’s
1 subject’s blood picture showed Anisocytic Hypochromic RBC’s.
0
5
10
15
20
25
30
6
02
0 0 0
27
20 0 0 0
9
10
1 10
Normocytic/ Normochromic
Normocytic/ hypochromic
Microcytic/ hypochromic
Anisocytic/ normochromic
Anisocytic/ hypochromic
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 109
1 subject’s blood picture showed Normocytic Hypochromic RBC’s.
Amongst 50 subjects, 1 subject was having Vata pandu, blood picture blood picture
presented with Anisocytic hypochromic.
Amongst 50 subjects, 1 subject was having Pittaja pandu, blood picture blood picture
presented with Anisocytic hypochromic.
s
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 110
DISCUSSION
This is the most important part of any research work. It comprises the discussion of results
obtained from applied study. Discussion is the logical reasoning of observations. A rational
discussion alone helps in drawing a proper conclusion.
The present study is a diagnostic study on Pandu roga, in which the diagnosis was made
on the basis of Samanya and Vishista lakshanas and morphology of RBC’s was observed in
blood peripheral smear.
DISCUSSION ON OBSERVATION:
Incidence studies of the subjects are as follows –
Age incidence: Majority of patients in the study were in between the age 17 to 30 years
(62%) and 31 to 60 years (32%). This may be because of excessive physical strain, pre-
menopausal stage (where there is irregular and excessive menstruation) and also due to
their food habits and change in the lifestyle.
Sex incidence: Majority of the patients was females nearly about 88%; menstruating
females require more quantity of dietary iron supplement than males. This may be the
probable cause for maximum prevalence among the females.
Socio-economical incidence: Since majority of the study subjects were students, it was
observed that the upper middle class showed more percentage i.e. (46%) and rich class
showed (24%) than people with poor socio economic background. As the samples were
collected from the schools and colleges this might not be related. Lack of knowledge
about proper nutritious food, worm infestation and lifestyle may be the prime factor in
causation of the disease.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 111
Marital incidence: About Marital status, 56% were unmarried and 38% were married. It
might not be related.
Religion Incidence: Study records larger number of Hindus (96%), when compared to
Muslim (02%) and Christian (02%) religions. Data reflects more on the geographical
predominance of a particular sector as Hindus being dominant in Mysuru.
Locality incidence: patients were more from urban area (56%) than rural area (44%).
This may be due to the lagging of time for proper food intake and lifestyle modification.
Educational Status: Majority of the subjects was graduates (38%) followed by
PUC/diploma and post graduates (18%), primary education (12%), followed by
uneducated (8%) and high school children (6%). Due to the change in the lifestyle,
mental stress, and lack of balanced diet it is more common in the students.
Incidence of habit: majority of the subjects had habit of taking tea (74%), followed by
coffee (24%). Some of the subjects were taking tea along with the food; this might be the
aggravating factor as some studies have emphasized that tea consumption hampers the
iron absorption, while people with adequate iron stores remain unaffected.
Sleep pattern: most of the subjects (72%) were habituated for excessive sleep at day
hours and were also taking at night. About (68%) were taking more than 8hours sleep in
night time. Diwaswapna leads to the aggravation of kapha dosha and it is one among the
nidana of Pandu roga .
Type of work: majority of the subjects (80%) were having sedentary type of work,
(14%) subjects were having moderate work pattern. It results in jatharaagni mandhya
and kapha vriddhi which in turn hampers the absorption of ahara.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 112
Dietary incidence: Detail questioning was done during the study and observed that
patients suffered from Pandu roga were vegetarians (70%) and (30%) were on mixed
diet. Their food mainly comprised of less calorie diet, vegetables. Patients had the habit
of taking fried food, pickles, spicy food items and junk food items. In vegetarians, non-
heme iron is not as easily absorbed by the body as meat-based heme iron. This might be
the probable cause Pandu roga.
Exercise: Maximum i.e. (32%) were not doing any exercise, while (64%) patients were
occasionally doing exercise whereas only (4%) patients were doing exercise regularly.
The reason for this might be lack of time and busy life.
Bowel (consistency): In this study (68%) were having soft bowel, (30%) were having
constipated bowels and only (1%) were having loose bowel.
Built & nourishment: Maximum i.e. (80%) of subjects were poorly built, (70%) were
poorly nourished, where (18%) were well built and (28%) were well nourished. It shows
that the persons who are poor in built and nourishment will prone to have pandu roga.
Because improper nutrition leads to improper formation of Dhatus.
Nature & quantity of menstrual cycle: Majority of the study subjects were females and
it was observed that 20% (10) had irregular periods where 24% (12) had heavy flow. As
there will be excess loss of blood which may results in Pandu.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 113
Discussion on Nidana:
In this study it was found that Aharaja, Viharaja and Manasika nidanas were
contributing and precipitating factors for the Pandu roga.
Aharaja nidanas like Ati lavana (98%), excessive use of Masha (90%), Nishpava (90%),
Ati tikshna (72%), Ati ushna (64%) were predominantly seen. With the change in
lifestyle, the readymade and easy to cook food have become more popular. This type of
ahara satisfies hunger but have less nutritive value.
Jatharagni mandhyata which was caused due to improper intake of Ahara, was
further vitiated by the above nidanas which lead to improper rasa dhatu formation and
uttarottara dhatus were affected.
Thus, improper diet and regime like excessive usage of Masha, Nishpava which
causes stroto sangha will vitiates kapha, and excessive use of amla, Lavana, which are
Rakta dushti karaka and Ojo kshaya karaka will vitiates the Pitta pradhana tridosha.
This resulted in jatharagni mandhyata. And later it resulted in improper formation of
Adhya dhatu i.e. Rasa dhatu due to Dhatwagni mandhaya. If Rasa itself is deficient then
Uttarotara dhatus will also be deficient, as Dhatu poshana nyayas explains that Rasa
dhatu being the Adhya dhatu will help in nourishment of the Uttarotara dhatus.
Viharaja nidanas like Diwaswapna (72%), Shrama (70%), Nidra nasha (56%),
vega dharana were some of the routine activities which were practiced.
Diwaswapna lead to kapha prakopa as it possesses abhishyandi guna it resulted
in rasa kshaya and it caused pandu.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 114
Shrama and nidra nasha were caused due to the vata prakopa, leading to
jathragni mandhyata thus ended up in Rasa kshaya.
By doing vega dharana, vata gets vitiated and it may results in altered physiology
of gut thereby leading to impaired vata karma.
Manasika nidanas like chinta (70%), krodha (66%), bhaya (44%) would have
contributed to the Nidanas of Pandu roga which would have caused vitiation of all
the tridoshas. This might have affected the digestion, metabolism and assimilation
occurring inside the body. Even contemporary science has explored role of mental
stress behind almost all diseases.
Discussion on Lakshana:
In the present study, the lakshanas of kaphaja pandu were predominantly seen.
Symptoms like Gourava (82%), Tandra (74%), Bhrama (62%), Shwasa (38%), Aalasya
(78%), Aruchi (80%) etc. were found in the majority of the subjects. It might be due to
the kapha prakopa, mainly because of aharaja nidanas like excessive usage of Masha
and Nishpava and Viharas like excessive indulgence in Diwaswapna.
Most of the features of Vataja pandu like Angamarda (80%), Shiro ruja (60%),
Balakshaya(48%), Bhrama (62%) were found. This might have caused due to Vata
prakopaka ahara & vihara.
Amongst Pittaja Pandu lakshanas like Dourbalya (74%), Trishna (24%) and
Sweda (20%) were also observed in some subjects. This might be due to the Pitta
prakopaka ahara & vihara.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 115
In this study though Vata-pitta pandu & Vata kapha pandu have not been
mentioned separately but Vata pradhana piitaja pandu was also seen with the
predominance of both Vata and Pitta pandu lakshanas. And cases of Vata pradhana
kaphaja pandu were also found in this study with the predominance of both Vata as well
as Kapha pandu symptoms.
Discussion on blood peripheral smear findings:
Along with the pratyatma lakshana i.e. Panduta and samanya lakshana of of Pandu roga
majority of the subjects ( %) with the vishista lakshana of kaphaja pandu lakshana the
capillary blood of these subjects were subjected to the peripheral smear, stained and
examined through the 100X oil immersion microscope. The RBC’s morphology
predominantly was Microcytic hypochromic (%). This might be due to the predominance of
Kapha which could have resulted in Rasa dushti and Stroto sangha resulting in the
Uttarottara dhatu kshaya.
Microcytosis is the reduction in the size and hypochromia is the reduction in the color of
RBC’s than normalcy. RBC’s carry oxygen to all the tissues and thus sustain the tisuues.
This can be said as Dharana karma. So RBC’s can be considered as Dhatus.
The morphology of RBC’s the peripheral blood smear of the subjects of Kaphaja pandu
showed microcytosis i.e reduction in the size and hypochromia reduction in the colour. This
reduction may be considered as Dhatu kshaya as there is reduction in its normal size and
reduction in the physiological constituents. Dusta kapha causing stroto sangha might end up
in Dhatu kshaya leading to microcytic hypochromic RBC’s picture in peripheral blood
smear.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 116
Few cases of Kaphaja pandu (9%) also showed Anisocytosis i.e. abnormal variation in
shape of RBC’s which can be understood as Dusta kapha leading to stroto sangha and
reduced Dhatu poshana ending up in Dhatu kshaya with abnormal morphological changes.
When stroto dusti in terms of Sangha is partial, the RBC’s have picture of normocytosis
(normal size) with reduced red color (hypochromia).
Subjects with clinical picture of Vata kaphaja pandu, though very less in number (9%)
have RBC’s picture of Anisocytosis hypochromic & Anisocytosis normoytic which gives a
mixed picture, the cause which can be related to Samprapti of kapha dusti leading to Dhatu
kshaya.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 117
CONCLUSION
• Among the population studied, Kaphaja Pandu is being commonly found than other
types of Pandu. As the main cause of this is sedentary lifestyle and irregular food
habits.
• Among Kaphaja Pandu lakshanas most predominantly seen are Gourava, Tandra,
Aruchi, Alasya. In Pittaja Pandu lakshanas like Trishna, Daha and Murchha are
commonly seen. Similarly in Vataja Pandu lakshanas like Angamarda, Shiroshoola,
Parshvashoola are commonly seen.
• Kaphaja pandu being more commonly seen among the studied subjects, their
peripheral blood smear showed Microcytic Hypochromic and also Anisocytic
hypochromic RBC picture. If we get the blood picture of Microcytic Hypochromic &
Anisocytic hypochromic it can be considered as Kaphaja Pandu.
• As there were less subjects of Vataja and Pittaja Pandu in the study, their findings in
the morphological changes in RBC in peripheral blood smear are insufficient in
drawing out a proper conclusion.
• Even though in classics Vata piita and Vata kapha Pandu roga is not mentioned
separately but in this study it was found in few subjects. So we can consider these
types on the basis of presentation of Lakshanas.
Dr Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 118
SUMMARY
The loss in the normal color or discoloration of the body is called as Panduta. Along
with loss of normal color or discoloration of the skin, loss or abnormalities are seen in
the texture and luster of skin. This is more specifically observed in nails and conjunctiva.
The Pratyatma lakshana of Pandu is described as similar to the color of ketaki dhuli.
Hence a diagnostic Study entitled –“A STUDY ON THE DIAGNOSTIC VALUE OF
BLOOD PERIPHERAL SMEAR IN DOSHAJA PANDU ROGA” was undertaken for
the study to know the abnormal morphology of RBC’s in the varients of Pandu roga.
This present study was conducted on the disease Pandu roga. Hence in the first
part of dissertation detailed review of literature regarding the nirukti, paribhasha,
paryaya, bheda, nidana panchaka, sadhyasadhyata and Upadrava of Pandu roga. Along
with this detail about erythropoiesis, peripheral blood smear, staining procedure has been
mentioned.
Second part of dissertation contains the materials and methods used in the present
study, observation and results of the study, discussion on observations and results. This
part also includes conclusion of the study.
Study was completed in 50 patients having the Pratyatma lakshana along with the
Vishishta lakshana of Pandu roga. Informed consent was taken from the subjects and
peripheral blood smear was done and abnormal morphology was observed using 100X oil
immersion microscope.
Dr Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 119
The observations were done on the factors like Nidanas, Lakshanas and the
findings of peripheral blood smear were related to the types of Pandu roga.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 120
BIBLIOGRAHIC REFERENCES
1. Charaka Samhita by Agnivesha, with commentary by Chakrapani Datta, Varanasi,
Chowkhamba 2005.16th chapter 3rd shloka, p.no. 526
2. Charaka Samhita by Agnivesha, with commentary by Chakrapani Datta, Varanasi,
Chowkhamba 2005.16th chapter 3rd shloka, p.no. 522
3. Amarasimha, Amarkosha; with Ramasrani Commentary of Bhanuji Diksita, Edited With
Easy Maniprabha Hindi commentary by Haragovinda Sastry,3rd Edition, Chaukhamba
Sanskrit Sansthan, 1997, Varanasi. P-53
4. Sashtri Sadasiva Hari, Ashtanga Hrdaya with Commentaries of Arunadatta & Hemadri,
reprint Edition, 2012, Chaukhamba Sanskrit Sansthan, Varanasi, chapter 12, 1st shloka,
P.no 518.
5. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch. Su 28/10, P.no 474
6. Shastri Ambikadatta, Susruta Samhita, Dalhana Commentary, vol1, Choukambha
Sanskrit Sansthan, Edition: reprint 2010, Varanasi, chapter 24, 10th shloka, P.no 132.
7. The Atharvaveda (Sanskrit) text with English translation by Munshiram -Manoharlal
publishers Pvt. Ltd., New Delhi - 110055, India Panduroga: a medico - historical study
p.v.v. prasadBull.Ind.lnst.Hist.Med. Vol. XXX - 2000 pp 1 to 14Indian Institute of
Ilistory of Medicine (CCRAS) Osmania Medical College Buildings, Putlibowli,
Hyderabad."
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 121
8. Panduroga: a medico - historical study p.v.v. Prasad Bull.Ind.lnst.Hist.Med. Vol. XXX -
2000 pp 1 to 14Indian Institute of History of Medicine (CCRAS) Osmania Medical
College Buildings, Putlibowli, Hyderabad."
9. Raja Radhakantha Deva, shabdakalpadruma - sri varaprasadavasu; et al; Naga Publishers,
New Delhi 3rd Edition, Vol -3, Chaukhamba Sanskrit Series office, Varanasi, 3rdvol, p.no
104
10. Raja Radhakantha Deva, shabdakalpadruma - sri varaprasadavasu; et al; Naga Publishers,
New Delhi 3rd Edition, Vol -3, p. no 151
11. Raja Radhakantha Deva, shabdakalpadruma - sri varaprasadavasu; et al; Naga Publishers,
New Delhi 3rd Edition, Vol -3, p.no 104
12. Amarasimha, Amarkosha; with Ramasrani Commentary of Bhanuji Diksita, Edited With
Easy Maniprabha Hindi commentary by Haragovinda Sastry,3rd Edition, Chaukhamba
Sanskrit Sansthan, 1997, Varanasi. P-53
13. Acharya YT; ed; Charaka Samhita, Ayurveda Deepika Commentary, Chaukhamba
Krishnadas Academy, Varanasi, 2006 U.P, Chikitsa sthana- 16/1, p- 526
14. Tripathi Bramhanand, Madhava nidana, Madhukosha commentary, vol1, p.no 309,
chapter8
15. Kushwaha harishchandra, Charaka samhita, Ayurveda deepika commentary vol2, 16/1,
chaukhamba orientalia, varanasi
16. Sharma P.V, Sushruta samhita, Dalhana commentary, vol3, Chaukhambha visvabharati,
Varanasi, 44/4, p.no 448
17. Sashtri Sadasiva Hari, Ashtanga Hrdaya with Commentaries of Arunadatta & Hemadri,
reprint Edition, 2012, Chaukhamba Sanskrit Sansthan, Varanasi, 13/8, P.no 518
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 122
18. (Acharya YT; et al; Sushruta Samhita, with Dalhana’s Nibandha Sangraha and Narayana
Ramacharya Commentary, Choukhamba Krishnadas Acadamy, Varanasi, 2004. Ut 44/6,
P.no 729
19. Panduroga: a medico - historical study P.V.V. prasad" Indian Institute of Ilistory of
Medicine (CCRAS) Osmania Medical College Buildings, Putlibowli, Hyderabad.
20. Acharya YT; et al; Sushruta Samhita, with Dalhana’s Nibandha Sangraha and Narayana
Ramacharya Commentary, Choukhamba Krishnadas Acadamy, Varanasi, 2004. Ut 44/4.
P.no 365
21. Pandey Jayamini, Harita Samhita, Nirmala Hindi Commentary, First Edition, 2010
Chaukhamba Vishvabharati, Varanasi, 8/1, P.No 272,
22. Tripathi bramhanand, Madhava nidana, Madhukosha commentary, Vol-1, 8/8-10, P.no
315
23. Agnivesa, Charaka Samhita, Acharya Jadavji Trikamji, Choukambha publication 2001
Varanasi, P.no 526.
24. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 423
25. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 424 16/12
26. Shashtri ambikadatt, Sushruta Samhita, vol2, Choukambha Sanskrit Sansthan, reprint
2012, Varanasi, uttaratantra, P.no 364.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 123
27. Sharma P.V, Sushruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 449.
28. Sashtri Sadasiva Hari, Ashtanga Hrdaya, Commentaries of Arunadatta & Hemadri,
reprint Edition, 2012, Chaukhamba Sanskrit Sansthan, Varanasi. 13/8, P.no 518,
29. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, 1/7, p.no 39,
30. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 424 16/12
31. Sharma P.V, Sushruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 449 , 44/5
32. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, p.no 312, 1/8.
33. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 13/4-6, Pno 518.
34. Sharma Sadashiv. k, Samprapti lakshanayo sambhandha, Ayurvediya snatakottar
shikshana Kendra, Jamnagar.
35. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 425 16/17-18
36. Sharma P.V, Sushruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/7
37. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 13/9, Pno 518.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 124
38. (Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, p.no 312, 1/4).
39. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 13/10, Pno 518
40. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, p.no 313, 1/5).
41. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 425 16/19-22
42. Sharma P.V, Susruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/8
43. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, p.no 314, 1/6.
44. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 13/11, P.no 518.
45. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
16/23-25, P.no 425.
46. Sharma P.V, Susruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/9
47. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, p.no 314, 1/6.
48. Pandey Jayamini Vaidya, Haritha Samhita,1st edition,2010, Chaukhamba Visvabharati,
Varanasi, 8/10, P. no 273.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 125
49. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
16/26, P.no 425.
50. Sharma P.V, Susruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/9.
51. Sharma P.V, Susruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/3.
52. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
P.no 425 16/7-11
53. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 13/4-6, P.no 193.
54. Tripathi Bramhanand, madhava nidana, madhukosha commentary, vol1, 1/6, p.no 314.
55. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/6-7, P.no 193
56. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/8, P.no 193
57. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/10-12, P.no 193
58. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/13, P.no 194
59. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/14, P.no 193
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 126
60. Sashtri Sadashiva Hari, Ashtanga Hrdya, Edition; Reprint, 2012, Chaukhamba Sanskrit
Sansthan, Varanasi, Ch 12/15, P.no 193
61. Rao Rama Sunder, Shreera Kriya vigyanam, 4th edition, ch 25, p no 264
62. Rao Rama Sunder, Shreera Kriya vigyanam, 4th edition, ch 26, p no 267
63. Y.T Acharya, Agnivesha Charaka Samhita, Ayurveda- Dipika Commentary, Reprint
2009, Chaukhambha Orientalia, Varanasi, ch. Chi. 15, p no 515
64. Rao Rama Sunder, Shreera Kriya vigyanam, 4th edition, ch 25, p no 273
65. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.su 24/22, pno 334.
66. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.su 24/25, p no 336
67. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.su25/24
68. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.su30, p no 490
69. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.vi 5/8, p no 631
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 127
70. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.su28, p no 474
71. Chakrapanidatta, Charaka Samhita, Ayurveda dipika Hindi commentary by Vaidya
harishchandra khushwaha, reprint edition 2012, vol2, Chaukambha Orientalia, Varanasi,
ch.vi 5/8, p no 631
72. Byadgi P.S, Ayurvediya Vikriti Vijnana & Roga Vijnana, vol2, chaukhamba
publications, New Delhi, edition:reprint, 2012, p.no 212.
73. Byadgi P.S, Ayurvediya Vikriti Vijnana & Roga Vijnana, vol2, chaukhamba
publications, New Delhi, edition:reprint, 2012, p.no 212.
74. Byadgi P.S, Ayurvediya Vikriti Vijnana & Roga Vijnana, vol2, chaukhamba
publications, New Delhi, edition:reprint, 2012, p.no 213.
75. Sharma P.V, Susruta Samhita, Dalhana Commentary, vol3, Choukambha Sanskrit
Sansthan reprint 2012, Varanasi, P.no 44/13, p no 451
76. https://en.m.wikipedia.org/wiki/red_blood_cell
77. Jain A.K, Textbook of Physiology, 3rd Edition, Reprint 2006, Avichal Publishing
Company, New Delhi.
78. Tortora. J. Gerard and derrickson. H. bryan, principles of anatomy and physiology, 12th
edition, vol 2, p no
79. Sembulingam K, Essentials of Medical physiology, 7th Edition, the health Science
publishers JAYPEE.
80. Tortora. J. Gerard and derrickson. H. bryan, principles of anatomy and physiology, 12th
edition, vol 2, p no 696.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 128
81. Tortora. J. Gerard and derrickson. H. bryan, principles of anatomy and physiology, 12th
edition, vol 2, p no 690.
82. Nayak Ramadas, Rai Sharada, Essentials in Hematology and Clinical Pathology, 2nd
Edition, JAYPEE brother medical publishers (P) ltd. New Delhi.
83. Nayak Ramadas, Rai Sharada, Essentials in Hematology and Clinical Pathology,2nd
Edition, 42 chapter, P.no 344, JAYPEE brother medical publishers (P) ltd. New Delhi
84. Ghai CL, a textbook of practical physiology, 8th Edition, Jaypee Brothers Medical
Publishets (P) LTD, 1-6 P no 32
85. Nayak Ramadas, Rai Sharada, Essentials in Hematology and Clinical Pathology,2nd
Edition, 42 chapter, P.no 355, JAYPEE brother medical publishers(P)ltd . New Delhi
86. Bernadette F. Rodak, Jacqueline H. Carr, Clinical Hematology Atlas, 5th edition.
Chapter1
87. Nayak Ramadas, Rai Sharada, Essentials in Hematology and Clinical Pathology,2nd
Edition, 42 chapter, P.no 357, JAYPEE brother medical publishers(P)ltd . New Delhi
88. Nayak Ramadas, Rai Sharada, Essentials in Hematology and Clinical Pathology,2nd
Edition, 42 chapter, P.no 357, JAYPEE brother medical publishers(P)ltd . New Delhi
89. International Journal of Laboratory Hematology, Reporting and grading of abnormal red
blood cell morphology
90. https://www.labce.com/spg469633_guidelines_for_reporting_red_blood_cell_morpholog
y.aspx
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 129
JSS AYURVEDA MECICAL COLLEGE AND HOSPITAL, MYSURU
DEPT OF POST GRADUATE STUDIES IN ROGA NIDANA
Dissertation Title : A Study on the diagnostic value of Peripheral Blood smear
in different types of doshaja Pandu roga.
Subject No : _____________
CONSENT FORM
I ___________________________________ am exercising my free will, to participate in above
study as a subject. I confirm that the study has been explained to me adequately understood the
above study & had the opportunity to ask questions. The information given by me will be used
for Medical Research only & I will not be identified in any way in the analysis & reporting of the
Results. I hope to complete the study, but I understood that my participation is voluntary & I am
free to withdraw at any time, without giving a reason & without any medical care or legal rights
being affected. The data collected will have right of authority for the researcher for further utility
and for publications.
Queries Related to Study :
If you have any queries related to study please call the researcher
Mobile no :
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 130
Place :
Date : Signature of Subject
Signature of Researcher Signature of Guide
( Dr Shivani kaundal) ( Dr Venkatesha. S)
Signature of HOD
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 131
DEPT OF POST GRADUATE STUDIES IN ROGA NIDANA
JSS AYURVEDA MEDICAL COLLEGE AND HOSPITAL, MYSURU.
Dissertation Title:
“A STUDY ON THE DIAGNOSTIC VALUE OF BLOOD PERIPHERAL SMEAR
IN DIFFERENT TYPES OF DOSHAJA PANDU ROGA”
ANNEXURE 1- SCREENING
1. Code no. :
2. Name of the subject :
3. Gender: male (2) female (1)
4. Date of birth
5. Age (in years)
6. Address: present- postal address with phone number and email id if any:
___________________________________________________________________
SAMANYA LAKSHANA
Sl.NO LAKSHANA PRESENT
1 Twak vaivarnayata (pale color)
2 Anna dwesha (aversion to food)
3 Alpa vak (diminished speech)
4 Hatanala (loss of digestion)
5 Nidralu (oversleep)
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 132
6 Shuna akshi koota (peri orbit swellings)
7 Anga sada (malaise)
8 Sthivana (spitting)
9 Kopana (irritability)
10 Shishira dweshi (aversion to cold)
11 Sheerna loma (falling of skin hair)
12 Jwara (fever)
13 Shwasa (dyspnoea)
14 Karna kshwedi(tinnitus)
15 Bhrama (giddiness)
16 Shrama (exhaustion)
17 Hataprabha (loss of lustre)
18 Durbala (debility)
19 Pindikodwestana (pain in shank)
20 Kati,uru,padaruk(pain in waist, thigh, legs)
21 Sadana (lassitude)
22 Arohana ayasa(exertion)
NO. OF SAMANYA LAKSHANA PRESENT:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 133
ANNEXURE - 2
CASE PROFORMA
Case. No. : O. P. No.:
1. Name : I. P. No:
2. Age (in years) : 3.Sex :
4. Religion: A. Hindu ( ) B. Muslim ( )
C.Christian ( ) D. Other (Specify)
5. Occupation :
6. Marital status : A. Married B. Unmarried C. Widow D.Divorced
7. Educational Status: A. Illiterate B. Primary C. High School D. PUC/ Diploma
E. Graduate F. Post Graduate
8. Socio-Economic Status (B G Prasad classification) I / II / III/ IV / V
8.1 Total members in family :
8.2 Total monthly income in Rs :
9. Locality : A. Urban ( ) B. Rural ( )
Postal Address and Phone No:
Diagnosis:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 134
PART – A
HISTORY AND EXAMINATION
10. PradhanaVedana/Chief complaints :
Vaivarnayta: Krishna (blackish) ( ) Duration:
Aruna (reddish) ( )
Shweta (pale) ( )
11. AnubandhaVedana/Associated complaint:
12. PradhanaVedanaVrittanta/H/O Present illness:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 135
13. PoorvaVyadhiVrittanta/Past history:
14. Chikitsa Vruttanta/ Treatment history :
14.1. For present complaint: A. Taken ( ) B. Not taken ( )
14.2. For any other diseases: A. Taken ( ) B. Taking ( ) C. Not taken ( )
14.3. Treatment Course : A. Completed ( ) B. Discontinued ( )
Sl. no History Category Present Absent Duration
1 MEDICAL HISTORY 1.Hypertension
2.Diabetes mellitus
3.Hyper/hypo thyroidism
4. Recent blood donation
5.Infectious diseases
6. other
2 SURGICAL HISTORY
3 CHILDHOOD HISTORY 1.Vaccination
2.Other
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 136
14.4. Details of Drugs taken & Taking :
Morbidity Name Dose Duration
DM
HTN
Other
15. Kula Vrittanta/Family history:
Sl. no H/O Diseases Mother (A) Sister (B) Father (C) Brother (D) Other (E)
1 Living Status
2 DM
3 HTN
4 Obesity
5 Anemia
7 Other
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 137
16. VayaktikaVrittanta/ Personal history :
16.1 Ahara : A. Vegetarian ( ) B. Mixed diet( )
16.2 Appetite : A. Increased ( ) B. Reduced ( ) C. Not altered ( )
16.3 Nidra :
Sl. No Duration (hrs)(a) Nature of sleep Cause for disturbance (d)
Sound (b) Disturbed (c)
A Ratri /Night
B Diva/Day sleep
16.4 Mala (Bowel) and 16.5 Mutra (Micturation)
Sl. No Bowel (4) Micturation (5) Duration
A Frequency a) Increased ( )
b) Not altered ( )
c) Reduced ( )
a) Increased ( )
b) Not altered ( )
c) Reduced ( )
B Urgency a) Under control ( )
b) Not under control ( )
a) Under control ( )
b) Not under control ( )
C Colour a) Normal ( )
b) Altered ( )
a) Normal ( )
b) Altered ( )
D Consistency a) Hard ( )
b) Soft ( )
a) Transparent ( )
b) Turbid ( )
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 138
16.6 Vyasana:
Sl. No Vyasana Status Details
Present (A) Absent (B)
1 Tea
2 Coffee
3 Alcohol
4 Smoking
5 Other
17. VyavasayaVrittanta/ Occupational History :
17.1. Type of Employment : Sedentary (A) Moderate (B) Heavy (C)
17.2. Nature of Work : Physical (A) Mental(B)
17.3. Time of Work : Day (A) Night (B) Day & Night (C)
17.4. Duration of Work : _____________hrs/day ___________ hrs/night
c) Loose ( ) c) Thick ( )
E Odour a) Altered ( )
b) Not alterd ( )
a) Altered ( )
b) Not alterd ( )
F Other
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 139
18. Artava, Garbini and SutikaVrittanta :
18.1. Age at menarche :
18.2. MC : A. Nature of cycles : Regular (a) / Irregular (b)
B. Time gap between the cycles :
18.3. MF : A. Duration of flow :
B. Quantity : Heavy (a) / Scanty (b) / Moderate (c)
C. Clots : Present ( ) / Absent ( )
D. Odour : Present ( ) / Absent ( )
18.4. White discharge : Present ( ) / Absent ( )
18.5. Itching in vulva : Present ( ) / Absent ( )
18.6.Obstetric History: A. Gravida ( ) B. Para( ) C. Abortion( ) D. Dead( ) E. Living( )
Rogi Pareeksha
19. SamanyaPareeksha/ General examination :
1. Consciousness : A. Present ( ) B. Absent ( )
2. Built/ Akriti : A. Poorly built ( ) B. Well built ( ) C.Over built ( )
3. Nourishment / : A. Malnourished B. Well nourished C. Over nourished
Upachaya
4. Pallor : A. Present ( ) B. Absent ( )
5. Icterus : A. Present ( ) B. Absent ( )
6. Cyanosis : A. Present ( ) B. Absent ( )
7. Clubbing : A. Present ( ) B. Absent ( )
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 140
8. Edema : A. Present ( ) B. Absent ( )
9. Lymph adenopathy : A. Present ( ) B. Absent ( )
10. Height : ______ cms. (_________ft)
11. Weight : _______ kgs
12. BP / Raktachapa : ________ mm of Hg
13. Pulse : ______ / min
14. Respiratory rate : ______ /min
15. Temperature : ____0 F
20. SYSTEMIC EXAMINATION
1. Cardio vascular system
2. Respiratory system
3. Digestive system
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 141
4. Musculoskeletal system
5. Nervous system:
21. ASHTA STHANA PAREEKSHA
Sl. no Astasthana Pareeksha lakshanas Present
1 Nadi A. Teekshna
B. Madhyama
C. Manda
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 142
2 Mutra A. Pandu
B. Rakta
C. Phenayukta
3 Mala A. Ruksha
B. Peeta
C. Shweta
4 Jihwa A. Cold, rough and cracked (brown or black)
B. Reddish and blackish
C. Whitish and sticky
D. Blackish, Kantaka (thorny) and dry
5 Shabda A. Hoarse and rough
B. Sphuta vaktra (cracked)
C. Guru (heavy)
6 Sparsha A. Cold and rough
B. Hot and moist
C. Wet and cold
7 Druk A. Sunken, dry and reddish brown
B. red or yellow
C. wet & watery
8 Akruti A. Krusha
B. Madhyama
C. Sthoola
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 143
21. Dashavidhapareeksha
Sl.
No
Dashavidha
pareeksha
Gross idea Specific findings Present
1 Prakruthi A.Eka a) Vata
b) Pitta
c) Kapha
B.Dwandwa d) Vatapitta
e) Vatakapha
f) Pittakapha
C.Tridoshaja g) Vatapittakapha
2 Vikruthi A.Hetu
a) Shaareerika
b) Manasika
B.Dosha c) Vata
d) Pitta
e) Kapha
C.Dushya f) Rasa
g) Rakta
h) Mamsa
i) Asthi
j) Majja
k) Shukra
D.Prakruti a) Yeka
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 144
b) Dwandwa
c) Tridosha
E.Desha (srotus) a) Prana
b) Udaka
c) Anna
d) Rasa
e) Rakta
f) Mamsa
g) Asthi
h) Majja
i) Shukra
j) Mutra
k) Pureesha
l) Sweda
m) Arthava
n) Manovaha
F.Kala a) Chaya
b) Prakopa
c) Prasara
d) Sthanasamraya
e) Vyakta
f) Bheda
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 145
G.Bala a) Pravara
b) Madhyama
c) Avara
3 Sara A. Twak Sara:
Snigdha(Unctous), Slakshana(Smooth),
Mrudu(Soft Skin &Hair), Sukshama (Fine Hair),
Gambhira(Deep Rooted Hair), Sukumara
Loma(Tender Hair), Prabha(Lusturous Skin)
B. Rakta Sara
Red Colored Eyes, Hair, Ears, Face, Tongue,
Nose, Lips, Soles Of Hand And Feet, Nails,
Forehead.
C. Mamsa Sara:
Shankha ,Lalata ,Krikatika, Akshi, Ganda ,Hanu,
Griva, Pani , Pada, Sandhi( Heavy, Compact,
Beautiful, Handsome)
D. Meda Sara
Unctous In Varna, Swara, Netra, Kesha, Loma,
Nakha, Danta, Oshta, Mutra, Puresha.
E. Asthi Sara: Parshini(Heels), Gulfa(Ankle),Janu(Knees),
Trik(Forearms), Chibuka(Chin), Shira(Head),
Parva Shtoola(Joints), Sthoola Asthi, Nakha,
Danta
F. Majja Sara: Mridu Anga(Softness Of Organs), Balavanta(
Strength0, Snigdha Varna(Unctous Complexion &
Voice), Sthoola Dhrigha Vrut And Sandhi( Big,
Wide Joints)
G. Shukra Sara: Soumya(Gentle), Snigdha(Unctous),
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 146
Vritsara(Round),Mahasphik(Large Buttocks),
3A In total sara of person a) Pravara (>4)
b) Madhyama (3-5)
c) Avara (<3)
4 Samhanana A. Symmetry &
demarcation of
bones
a) Strong
b) Moderate
c) Weak
B. Development of
joints
a) Strong
b) Moderate
c) Weak
C. Compactness of
muscles
a) Strong
b) Moderate
c) Weak
D. Built a) Strong
b) Moderate
c) Weak
d) Strength a) Strong
b) Moderate
c) Weak
4A In total samhanana of person a) Pravara (>3)
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 147
b) Madhyama (2-3)
c) Avara (<2)
5. Pramana a) Pravara
b) Madhyama
c) Avara
6 Satva a) Pravara
b) Madhyama
c) Avara
7 Satmya A. Dravya satmya a) Gritha
b) Ksheera
c) Taila
d) Mamsa rasa
B. Rasa satmya a) Madhura
b) Amla
c) Lavana
d) Katu
e) Tikta
f) Kashaya
C. Veerya satmya a) Ushna
b) Sheeta
D. Guna satmya a) Shuksha
b) Drava
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 148
c) Snigdha
d) Rooksha
E. Other Others
8
Ahara shakti
A. Abhyavarana
shakti
a) Pravara
b) Madhyama
c) Avara
B. Jarana shakti a) Pravara
b) Madhyama
c) Avara
9
Vyayama
shakti
Karmashakti a) Pravara
b) Madhyama
c) Avara
10 Vaya A. Bala a) Kumara
b) Youvana
B. Madhyama a) Madhyama
C. Vrudhdha b) Vrudhdha
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 149
ANNEXURE-3
NIDANAS
AHARA JANYA NIDANA’S :
Sl No. Nidana No(0) Yes(1)
1 KSHARA
2 LAVANA
3 KATU
4 KASHAYA
5 ATI TIKSHNA
6 ATI USHNA
7 VIRUDDHA
8 VIDAGDHA
9 ASATMAYA
10 NISHAPAVA
11 MASHA
12 TILA TAILA
13 MADHYA
14 AMLA
15 MRITTIKA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 150
BHAKSHANA
VIHARA JANYA NIDANA’S:
Sl
No.
Nidana No(0) Yes(1) Duration
1 DIVASWAPNA
2 VYAYAMA
3 MAITHUNA
4 PANCHAKARMA
VAISHMYA
5 RUTU VAISHMYA
6 NIDRA NASHA
7 SHRAMA
8 VEGA VIDHARANA
MANASIKA NIDANA’S:
Sl No. Nidana No(0) Yes (1)
1 BHAYA
2 CHINTA
3 KRODHA
4 MANASTAPA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 151
5 SHOKA
VISHISHTA LAKSHANA:
(1) VATAJA PANDU:
Sl.NO LAKSHANA PRESENT(1) ABSENT(0)
1 ANGAMARDA
2 TODA
3 KAMPA
4 KRISHNA, RUKSHA, ARUNA SIRA
5 NAKHA VIN MUTRA NETRA
6 SHOPHA
7 ANAAHA
8 AASYA VAIRASYA
9 VARCHA SOSHA
10 PARSHVA SHOOLA
11 SHIRO RUJA
12 BALAKSHAYA
13 RUJA
14 BHRAMA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 152
NO. OF VATAJA PANDU LAKSHANA PRESENT:
(2) PITTAJA PANDU LAKSHANA:
SL.NO LAKSHANA PRESENT(1) ABSENT(0)
1 PEETA/ HARITA VARNA
2 JWARA
3 DAHA
4 TRISHNA
5 MURCHHA
6 PEETA MUTRA, VIN, NAKHA
7 PEETA SIRA
8 SWEDA
9 SHEETA ICCHA
10 DOURGANDHYA
11 KATU ASYA
12 VARCHA BHEDA
13 AMLA UDGARA
14 VIDAHA
15 VIDAGDHA ANNA
16 DOURBALYA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 153
17 TAMA
NO.OF PITTAJA LAKSHANA PRESENT:
(3) KAPHAJA PANDU:
SL.NO LAKSHANA PRESENT(1) ABSENT(0)
1 GOURAVA
2 TANDRA
3 CHARDI
4 SHVETAABHASA
5 PRASEKA
6 LOMAHARSHA
7 SADA
8 MURCHHA
9 BHRAMA
10 KLAMA
11 SHWASA
12 KASA
13 AALASYA
14 ARUCHI
15 VAK SWARA GRAHA
16 SHUKLA MUTRA AKSHI VARCHAS
17 KATU RUKSHA USHNA KAMTA
18 SHVAYTHU
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 154
19 MADHURA ASYA
20 SWARA KSHAYA
NO. OF KAPHAJA PANDU LAKSHANA PRESENT:
(4) SANNIPATAJA PANDU:
SL.NO LAKSHANA PRESENT(1) ABSENT(0)
1 TANDRA
2 AALASYA
3 SHWAYATHU
4 VAMATHU
5 KASA
5 HRILLASA
6 SHOSHA
7 NETRA PARUSHA
8 JWARA
9 KSHUDHA
10 MOHA
11 TRISHNA
12 KLAMA
NO. OF SANNIPATAJA LAKSHANA PRESENT:
TYPE OF PANDU ROGA PRESENT:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 155
VATAJA (1)___ PITTAJA(2)___ KAPHAJA(3)___ SANNIPATAJA(4)___
VATA PITTA (5)__VATA KAPHA (6)___
FINDINGS OF BLOOD PERIFERAL SMEAR:
SIZE OF RBC’S: GRADING: 0- Absent, 1- Few (10-50 cells), 2- Moderate (51-100 cells),
3- Many (>100cells)
Normocytic
Microcytosis
Macrocytosis
Anisocytosis
CROMASIA: Normochromic
Hypochromic
Absence of central pallor
SHAPEOF RBC’S: GRADING: 1-Few (1-2 cells), 2-Moderate (3-5 cells), 3-Many (>5 cells)
Poikilocytes
Sickle shape
Spherocytes
Ovalocytes
Burr cells
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 156
Target cells
Spur cells
Roulex formation
Schistocytes
Dacrocytes
Signature of Researcher Signature of Guide
Dr SHIVANI KAUNDAL Dr. VENKATESHA .S
Signature of HOD
Dr VENKATESHA. S
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 157
DEPT OF ROGA NIDANA
JSS AYURVEDA MEDICAL COLLEGE, MYSURU
PRAKRITI ASSESSMENT
1. Name of the Subject: ___________________________________________
Assessment
of Prakriti:
S.No.
FEATURES VATA (V) PITTA
(P)
KAPHA(K) V P K
1 Body Structure Short, thin,
weak
Medium,
fleshy,
plump
Well built,
complete,
strong
2 Body Weight Low, hard to
gain,
easy to loose
Moderate,
good
muscles
Heavy, obese,
easy to gain
3 Joints Protruding,
creaking,
unsteady
Loose,
moderately
hidden
Strong, well
knit, compact,
well hidden
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 158
4 Movements Unsteady,
habit of
waving arms
& Legs
Fast Slow, steady
5 Shoulders Thin, small Medium Broad, strong
6 Chest Narrow Normal Deep
7 Arms Short Medium Long
8 Hands Small, dry,
cold,
rough
Medium,
warm,
pink
Large, thick,
moist, cool
9 Legs Small, hard Medium,
small
Round, firm
10 Feet Dry, rough,
cracks
Medium,
soft, pink
Large, soft
11 Nose Thin, small,
crooked
Medium Wide
12 Eyes Large or small,
darting around
unsteadily
Average,
thin,
reddened
easily,
piercing
Wide, white,
moist, steady
13 White of the
eye
Dirty Yellowish Milky white
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 159
14 Nails Thin, hard,
brittle
Soft, pink,
rubbery
Strong,
smooth, pale,
thick
15 Lips Dry, cracked Thin Thick
16 Neck Long, thin Medium Thick
17 Teeth Irregular in
size,
crooked,
pigmented
Medium,
even with
cavities
Even, large,
white
18 Gums Receding,
brown
Bleeding,
red
Pink, good
19 Tongue Coated with
grayish
pink film
Coated
with
yellowish
green film
Coated with
white film
20 Forehead Small Medium
with lines
Large
21 Head Small Medium Large
22 Strength Low, gets tired
fast
Moderate Good
23 Appetite and
digestion
Variable,
needs frequent
meals
Strong,
enjoys
food,
Constant,
emotional
eaters
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 160
irritable if
meals are
missed
24 Bowel
movements
Dry, hard,
constipated
Soft, oily,
loose
Heavy, slow,
thick
25 Urine Scanty,
colorless,
often difficult
Profuse,
yellow or
red, often
burning
Moderate.
white or
milky
26 Body
temperature
Low, cold
palms and feet
Above
normal,
hot
palms,
feet, face,
forehead
Normal, palms
and
feet are
slightly cold
27 Physical
activity
Quick, erratic,
restless
Motivated,
purposeful,
goal
oriented
Slow, steady,
methodical
28 Voice Low, weak,
hoarse, cracks
Medium,
clear
Deep, pleasant
29 Speech Quick,
talkative
Argumenta
tive, likes
Slow,
deliberate
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 161
debate,
convincing
30 Immunity Variable, low Moderate,
subject to
infections
Strong
31 Sleep pattern Light, tends
towards
insomnia
Moderate
but sound
Heavy,
difficult to
wake up,
sleeps easily
32 Quality of pulse Faint,
wavering
Moderate,
jumping
Slow and
graceful
33 Pulse rate 80 - 100 beats
per minute
70 - 80
beats per
minute
60 - 70 beats
per
minute
34 Speed of work Fast, in a hurry Medium,
fast
Steady, slow
35 Sweating Little, odorless Profuse,
strong
smell
Moderate,
pleasant
smell
36 Complexion Dull, brown,
tans
without
Flushed,
pigmented,
fair,
White, pale,
tans
evenly with
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 162
sunburn sunburns
easily
little
sunburn
37 Skin condition Dry, rough,
cracked with
freckles and/or
acne
Warm,
moist, pink
White, moist,
cool,
soft
38 Hair texture Coarse, dry,
wavy
Fine, light
colours,
early
greying or
balding
Abundant,
oily,
lustrous
39 Hair color Dark brown to
black
Light
blonde,
red, light
brown
Medium
blonde,
medium to
dark
brown
40 Scalp hair Thin, curly,
short
Light,
straight
Thick, black,
long
41 Eye lashes Inconspicuous Medium Thick, dark
42 Eye brows Thin, small Medium Thick, dark
43 Body hair Sparse Sparse, on
the chest
Hairy
44 Consumption of Not fixed Comparati Comparatively
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 163
food and drinks vely more less
45 Snacks Likes crunchy
snacks
Likes cold
drinks and
snacks
Sweets and
creamy
snacks
46 Food
preferences
Hot and Wet Cold and
warm
Hot and dry
47 Climate
preferences
Likes sunny
weather
Likes cool
weather
Likes warmth,
suffers in the
cold
48 Habits Likes
travelling, fun,
entertainment
Likes
physical
sports,
politics,
activities
Water sports,
gardening,
business
49 Grasping
power
Sometimes
grasps
quickly
Quick to
grasp, very
sharp
Grasps late but
understands
best
50 Emotional state Anxious,
nervous,
creative
Angry,
irritable,
jealous
Attached,
sentimental,
depressed
51 Memory Quick but poor
in the long
term
Clear Slow, good in
the
long term
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 164
52 Finance
management
Spends freely Tends to
budget
Saves, spends
emotionally
53 When
threatened
Fearful.
anxious
Angry,
irritable,
fights
Indifferent,
withdraws
54 Tackling
problems
Worrying
constantly,
cannot take
one stable
decision
Takes firm
decision
quickly
Can take the
right
and firm
decision
but takes time
55 Cannot tolerate Cold Heat,
anger,
physical or
mental
exertion,
hunger,
thirst,
physical
urges
Can tolerate
cold,
heat, anger,
exertion,
physical
urges, hunger
or
thirst
56 Nature of
dreams
Flying,
Moving,
Strong Winds,
Nightmares
Colorful ,
passionate,
fire,
lightning,
Romantic,
uneventful,
few
dreams, water,
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 165
conflicts gardens,
faintly
colored
57 Thought
process
Questions,
theorizes
Judgmenta
l, artistic
Stable, logical
TOTAL NO. OF FEATURES V = P= K=
Vata-Pittaja (1) Vata-Kaphaja (2) Pitta-Kaphaja (3)
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 166
Fig 1: showing Erythropoesis
Fig 2: showing RBC structure
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 167
Fig. 3: Different steps in the preparation of peripheral blood smear
And appearance of well made smear
Fig 4: showing a well made smear having Head, body and tail
Fig 5: Showing microcytic hypochromic picture of RBC
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 168
Fig 6: Showing Anisocytic hypochromic picture of RBC.
Fig 7: Showing target cells
Fig 8: Showing Burr cells
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 169
ARTICLE PUBLISHED IN ANVESHANA AYURVEDA MEDICAL
JOURNAL VOL3, ISSUE 4.
PANDU ROGA: SAMANYA SAMPRAPTI AND IT’S AMSHAMSHA
KALPANA
Shivani kaundal* Venkatesha.S**
*P.G Scholar, Dept of PG studies in Roga nidana, JSS Ayurveda Medical College and Hospital,
Mysuru, Karnataka.
**Reader and HOD, Dept of PG studies in Roga nidana, JSS Ayurveda Medical College and
Hospital, Mysuru, Karnataka.
ABSTRACT
Pandu roga has been regarded as a Pitta pradhana vyadhi in which along with other
features there is Pandu vaivarnayata i.e development of whitish yellow discoloration all over the
body. The Pratyatma lakshana of Pandu is described as similar to the color of ketaki dhuli. It
exhibits symptoms like Panduta, Dourbalyata, Arohana ayasa, Bhrama etc. Most important
factor in the pathogenesis of Pandu roga is Mandagni. This paper is an attempt to understand the
Nidana, Samanya samprati with Amshamsha kalpana along with and Samanya lakshana of
Pandu roga with its vitiated Dosha associated with Vridhi and Kshaya of its Guna.
KEYWORDS: Pandu roga, Samanya samprapti, Vikalp samprapti, Amshamsha kalpana.
INTRODUCTION:
The loss in the normal color or discoloration of the body is called as Panduta. Along with loss of
normal color or discoloration of the skin, loss or abnormalities are seen in the texture and luster
of skin. Pandu roga has been regarded as a Pitta pradhana vyadhi1 in which along with other
features there is Pandu vaivarnayata i.e development of whitish yellow discoloration all over the
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 170
body. This is more specifically observed in nails and conjunctiva. The Pratyatma lakshana2 of
Pandu is described as similar to the color of ketaki dhuli.
“Rogaaha sarvepi mande agnow”- as said by Vagbhata, Mandagni is also the major factor in the
pathogenesis of Pandu. The resultant effect of Mandagni is Rasadushti and Rasa is the
Pradhana dhatu involved in Pandu roga. So, Acharya Charaka as well as Sushruta have
included Pandu roga in Rasa pradoshaja vyadhi.3,4
Pareeksha is an integral part of clinical medicine. Pareeksha, as said in classics includes both
roga as well as Rogi pareeksha. The latter one is utilized in examining a patient whereas the
former one is used in understanding a disease. Roga pareeksha includes Nidana panchaka.
Samprapti is the key factor to understand the disease in detail and along with other component of
nidana panchaka, it aids in planning proper treatment.
Vikalpa samprapti is a type of Samprapti that deals regarding Amshamsha kalpana which
literally means “knowing in-depth”. It helps in understanding the disease by means of dissecting
it i.e the Dosha that is responsible for the production of the disease is understood not as a Dosha
as a whole but by determining the Vikriti in its guna and karma. Agni is given high credentials in
Ayurveda and Agni vikriti in terms of Mandagni is a major contributing factor in production of
many diseases and one such disease is Pandu roga.
AIM:
To study the Samanya samprapti of Pandu roga, mentioned in Ayurvedic samhitas and to
understand the Vikalpa samprapti and Amshamsha kalpana in detail.
STUDY MATERIAL:
Pandu roga is studied with different lexicon present in central library, all the Brihataryee and
Laghutrayee, various journals and internet source.
NIDANA5,6:
AAHAARAJA NIDANA:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 171
• Kshara, Amla, Katu, Lavana dravyas aggravate Pitta.
• The regular intake of Amla rasa vitiates Pitta and Kapha dosha.
• Viruddha ahara leads to vitiation of “Tridoshas”.
• Tila is Pittakara & Ushna veerya and in turn increases Pitta.
• Diwaswapna vitiates tridosha and depresses the function of Jataraagni and Dhaatwagni.
• Ati Teekshna Ahara causes Daaha as it is of Agni bhoota predominance.
• Madya does Pitta vitiation.
VIHAARAJA NIDANA:
• Diwaswapna , Ratri jagarana , Ati vyayama, Ati vyavaya, Adhika Shrama ,Vegadharana,
Rutu vaishamya. Among these, Diwaswapna causes Pandu by vitiation of Tridosha and
Ratrijagarana by Vata prakopa and Ati vyavaya causes Tridosha prakopa.
MANASIKA NIDANA:
The Manasika nidanas also plays a major role in the causation of Pandu such as Kama,
Krodha ,Bhaya ,Chinta ,Shoka. Where Kama, Shoka and Bhaya vitiate Vata dosha ,
krodha vitiates Pitta dosha, and Chinta vitiates Vata & Kapha and produce Vataja, Pittaja
and Kaphaja predominant Panduroga.
PRATIKARMA VAISHAMYA:
Pandu roga can also be caused due to improper usage of especially Snehatiyoga,
Amatisara samgraha, Dushta rakta nigraha in raktarsha, Vega vidharana in Vamana
karma.
NIDANAARTHAKA ROGA:
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 172
Pandu is a disease itself and occurs as a symptom also in many of the diseases. Some of
them are as follows:
Raktarsha7, Krimi8, Punaraavartaka jwara9, Pleehodara10, Sira vyadhana11, Raktapitta12,
Raktarbuda13 which directly or indirectly vitiate Vata, Pitta and Kapha singly or in
combination.
POORVAROOPA.14,15,16
CHARAKA
(Ch. chi. 16)
SUSHRUTA
(Su. ut. 44)
VAGBHATA
(Ah.ni 13)
Hridaya
spandanadhikya
Twaksphotana
Hridaya spandana
Roukshyam
Steevana
Mootra peetata
Swedoabhava
Gaatra saada
Rookshata
Shrama
Mrid Bhakshaneccha Alpa vanhita
Prekshana koota
shotha
Swedoabhava
Avipaka
Aruchi
Vitpeetata
SAMPRAPTI17:
NIDANA SEVANA
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 173
PIITA PRADHANA TRIDOSHA PRAKOPA
AGNI VIKRITI
HRUDAYA KHA VAIGUNYA
RASA DUSHTI
PIITA + DUSHITA RASA
Circulates through DASHA DHAMANIS VYAN VAYU
ASHRAY in TWAK & MAMSA
Vitiates RAKTA, KAPHA, VATA, TWAK, MAMSA etc
Produces HARITA, HARIDRA, PANDU varna.
PANDU ROGA
Though Tridosha are vitiated in Pandu roga, Pitta plays dominating role in its
Samprapti. Nidanas (aaharaja as well as vihaaraja, mainly pitta prakopakara) does pitta dosha
vikriti. Since Pachaka pitta is situated in the grahani,the vitiated Pitta affects the Agni. The
Dravata in this Vidhagdha pitta reduces its Teekshnata. Hence this agni cannot digest the
aahaara which is consumed , thereby leading to Vidagdha bhava of Annarasa.
This Annarasa is taken by Vyan vayu to Hrudaya and transforms it into Rasa datu. The Vihaara
like Ativyayama, ativyavya etc causes vitiation of Vyan vayu. This vitiated Vyan vayu along with
Pitta and Dushita Rasa dhatu circulates throughout the body through the Dasha dhamani that
emerges from the Hrudaya.
Finally, Rasa dhatu lodges in Twak and Mamsa, then by vitiating the kapha, Vata, Rakta, Twak
and Mamsa it produces Pandu, Haridra, Harita varna. And out of these Pandu varna is seen
predominantly.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 174
VIKALP SAMPRAPTI18 & AMSHAMSHA KALPANA19:
Vikalpa samprapti is a type of Samprapti deals regarding Amshamsha kalpana which
literally means “knowing something part by part”. It helps in understanding the disease by means
of dissecting it i.e the Dosha which is responsible for the production of the disease is understood
not as a Dosha as a whole but by determining the Vikriti in its guna and karma. To point out a
lakshana or a vyadhi which is arising from a particular disease causing dosha is assessed by
Vikalp samprapti. In the classification of samprapti there is mentioning of Vikalp samprapti.
Where there will be some involvement of every dosha.
List of Samanya lakshana20 and their Dosha and Guna prakopa21:
1. KARNAKSHWEDA Vata vriddhi Chala guna
2. HRUDYA SPANDANA Vyana vata, sadhaka pitta Chala ,sara guna
3. DOURBALYA Vata vriddhi Sukshma, chala guna
4. ANGASADA Vata vriddhi Sukshma guna
5. SHRAMA Vata vriddhi Sukshma guna
6. BHRAMA Vata ,pitta vridhi ,kapha
kshya
Chala, sara ,sthira guna
7. GATRASHOOLA vata vriddhi Sheeta guna
8. SHWASA Vata kshaya Chala, sukshma guna
9. GOURAVA Kapha vridhi Guru guna
10. ARUCHI Kapha vridhi Guru guna
11. SHOONA AKSHI KOOTA Kapha vridhi Guru guna
12. HATAPRABHA Pitta kshaya Ushna, Drava guna
13. KRODHA Pitta vridhi Ushna ,teekshna
14. SHISHIRA DWESHI Vata- kapha vridhi Sheeta guna
15. NIDRALU Kapha vridhi Guru guna
16. HARIDRA, HARITA VARNA Piita vridhi Drava guna
17. ALPA VAKTVUM Vata kshaya Shukshma guna
18. AAROHANA AYASA Vata kshaya Laghu, sukshma guna
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 175
19. SHTHIVANA Kapha vridhi ,ama Guru, sheeta ,pichilla guna
20. PINDIKODWESHTANA Vata kshaya Sukshma guna
21. JWARA Pitta vridhi Ushna guna
22. HRIDRAVA Vata –pitta vridhi Sara, chala guna
CONCLUSION:
1 Pandu roga is one of the prevalent disease in Indian subcontinent
2 It is a Rasadusti janya vyadhi.
2. It is a disease predominantly characterized by pathological variation in skin color and named
after different discolorations of the body mainly Pandu varna.
3. Being a Pitta pradhana vyadhi, Agni plays a prime role in its Samprapti.
4. Although Pandu is a tridoshaja vyadhi, Pitta is a aarambhaka dosha for the manifestation of
disease.
5. When we look at the vyadhi, it is observed that mainly Rasavaha strotas gets affected in it,
leading to further vitiation of Raktavaha strotas. So it can be concluded that both the strotas gets
vitiate in Pandu roga.
6.By thorough examination of lakshana in a disease we can assess Gunatah, Karmatah,
Dravyatah Vriddhi or Kshaya of that particular Dosha and hence we can plan the treatment
accordingly.
BIBLIOGRAPHY:
1) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba Oriental,
Varanasi 2007, p- 526.
2) Radhakantdev Raja, Shabdakalpadruma, vol 3, Nag publishers, Delhi 2002, p-104.
3) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba Oriental,
Varanasi 2007, p-179.
4) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997 Varanasi, p-116.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 176
5) Acharya YT, ed; Charaka Samhita Ayurveda dipika commentary, Choukambha oriental,
Varanasi ,2007 P- 526.
6) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997 Varanasi, p- 730.
7) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba
Oriental, `Varanasi 2007, p-503
8) Tripathi bramhanand, Madhavanidana, Madhukosha commentary, Choukhamba
Surbharati publication, Varanasi, p-307.
9) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba Oriental,
Varanasi 2007, p-427
10) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997, Varanasi, p-297.
11) kunte moreshwar anna, Ashtangahridayam, Hemadri teeka, choukhamba Sanskrit
samsthan, Varanasi, p-
12) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997, Varanasi, p-735
13) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997, Varanasi, p-
14) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba
Oriental, Varanasi, 2007, p-527.
15) Acharya YT, Susruta Samhita Nibandhasangraha commentary, Choukambha Sanskrit
Sansthan 1997 Varanasi, p-
16) Kunte Moreshwar Anna, Ashtangahridayam, Hemadri teeka, Choukhamba Sanskrit
Samsthan, Varanasi, p-
17) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Choukhamba
Oriental, Varanasi, 2007, p-527.
18) Murthy Himasagar Chandra, Madhav nidana, Madhukosha commentary, choukhamba
oriental, 2006, p-28.
Dr. Shivani Kaundal 2018
A STUDY ON THE DIAGNOSTIC VALUE OF PERIPHERAL BLOOD SMEAR IN
DIFFERENT TYPES OF DOSHAJA PANDU ROGA Page 177
19) Murthy Himasagar Chandra, Madhav nidana, Madhukosha commentary, choukhamba
oriental,2006, p-28.
20) Acharya YT, ed; Charaka samhita Ayurveda dipika commentary, Chaukhamba Oriental,
Varanasi 2007, p-527.
21)Sharma sadashiv.k ,Samprapti lakshanayoho sambhandha, Ayurveda sanatakottara
shikshana Kendra, Jamnagar. p-69-72.