Ashtanga Hridayam Chikitsa stanam Chapter 16: Pandu Chikitsitam Adhyaya (Treatment of anemia)

The 16^th chapter of Chikitsasthanam of Ashtanga Hridayam is named as Pandu Chikitsitam Adhyayah. This chapter deals with the explanation of ‘treatment of anemia’.

The topics covered in this chapter include –

• Use of Kalyanaka and other Ghrtas
• Dadimadi Ghrta
• Indication for emesis and purgation
• Dosha anulomana
• Use of Ayoraja
• Vishaladi Curna
• Vasaguducyadi Kwatha
• Vyosadi Curna
• Mandura Vataka
• Tapyadi Curna
• Kutajadi Gulika
• Draksadi Leham
• Hrsva Panchamuladi Kashayam
• Dosha specific treatment principles in Pandu Roga
• Treatment principle for Pandu Roga caused by eating mud
• Vyoshadi Ghrtam
• Creating aversion to mud in Pandu Roga caused by eating mud
• Kamala Cikitsa – treatment of jaundice
• Ruddhapatha kamala
• Kumbha Kamala Cikitsa
• Halimaka Cikitsa
• Treatment of sopha in Pandu Roga

Pledge by the author (s)

अथातो पाण्डुचिकित्सितं व्याख्यास्याम: व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
अथातो पाण्डु चिकित्सितं व्याख्यास्याम:

After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘anemia’.

Use of Kalyanaka and other Ghrtas

पाण्ड्वामयी पिबेत्सर्पिरादौ कल्याणकाह्वयम् पञ्चगव्यं महातिक्तं शृतं वाऽऽरग्वधादिना ॥ १ ॥ 
The patient of panduroga (pallor disease / anemia) should drink either kalyanaka (vide chapter of uttarasthana), pancagavya ghrta (chapter 7 of uttarasthana), mahatikta ghrtaor that processed with aragvadhadi gana (chapter 15 of sutrasthana), in the beginning (of treatment).

Dadimadi Ghrta

दाडिमात्कुडवो धान्यात्कुडवार्धं पलं पलम् चित्रकाच्छृङ्गवेराच्च पिप्पल्यर्धपलं च तैः ॥ २ ॥
कल्कितैर्विंशतिपलं घृतस्य सलिलाढके ।
सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत् ॥ ३ ॥
दीपनं श्वासकासघ्नं मूढवातानुलोमनम् ।
दुःखप्रसविनीनां च वन्ध्यानां च प्रशस्यते ॥ ४ ॥

Medicated ghee prepared with decoction of one kudava (192 grams) of Punica granatum, and half kudava (96 grams) of Coriandrum sativum boiled in one adhaka (3 Litres 72 ml) of water and paste of one pala (48 g) each of Plumbago zeylanica, Zingiber officinale, half pala (24 grams) of Piper longum and twenty pala (960 grams) of– ghrita. cures disease of the heart, anaemia, abdominal tumor, hemorrhoids, disease of the spleen, pain (diseases) arising from vata and kapha; is carminative, cures dyspnea and cough, helps downward movement of inactive Vata. It is best suitedfor women who have difficult labour and the sterile women.

Indication for emesis and purgation

स्नेहितं वामयेत्तीक्ष्णैः पुनः स्निग्धं च शोधयेत् ।
पयसा मूत्रयुक्तेन बहुशः केवलेन वा ॥ ५ ॥
After giving oleation therapy, he should be administered strong emesis therapy, followed once again by oleation therapy should be administered strong purgative therapy, using fatty (oil or ghee based) purgative, added with milk and cow urine or more of milk only.

Indication for emesis and purgation

दन्तीफलरसे कोष्णे काश्मर्याञ्जलिमासुतम् ।
द्राक्षाञ्जलिं वा मृदितं तत्पिबेत्पाण्डुरोगजित् ॥ ६ ॥
मूत्रेण पिष्टां पथ्यां वा तत्सिद्धं वा फलत्रयम् ।
One anjali (48 g) of Gmelina arborea soaked in lukewarm juice (decoction) of Baliospermum montanum, or one anjali (48 g) of Vitis vinifera, squeezed in it (decoction of Baliospermum montanum) and consumed, cures anaemia; or paste Terminalia chebula macerated with cow urine; or triphala (Terminalia chebula, Terminalia bellerica, Emblica officinalis) boiled in it (cow urine) may also be consumed.

Dosha anulomana

स्वर्णक्षीरीत्रिवृच्छ्यामाभद्रदारुमहौषधम् ॥ ७ ॥ गोमूत्राञ्जलिना पिष्टं शृतं तेनैव वा पिबेत् ।
साधितं क्षीरमेभिर्वा पिबेद्दोषानुलोमनम् ॥ ८ ॥
Argemone Mexicana, Operculina turpethum, Ipomoea petaloides, Cedrus deodara, and Zingiber officinale macerated with one anjali (48 g) of cow urine or boiled in it should be consumed or boiled in milk should be consumed, to help downward movement of the doshas.

Use of Ayoraja

मूत्रे स्थितं वा सप्ताहं पयसाऽयोरजः पिबेत् ।
जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा ॥ ९ ॥
Iron filings soaked either in cow urine or milk for seven days shouldbe consumed. After its digestion, the person should take meals either with milk, soup of meat or sweet liquids.

Use of Ayoraja

शुद्धश्चोभयतो लिह्यात्पथ्यां मधुघृतद्रुताम्
After purification of both direction (emesis and purgation) the person should lick (powder of) Terminalia chebula along with more of honey and ghee.

Vishaladi Curna

विशालाकटुकामुस्ताकुष्ठदारुकलिङ्गकाः ॥ १० ॥
कर्षांशा द्विपिचुर्मूर्वा कर्षार्धांशा घुणप्रिया ।
पीत्वा तच्चूर्णमम्भोभिः सुखैर्लिह्यात्ततो मधु ॥ ११ ॥
पाण्डुरोगं ज्वरं दाहं कासं श्वासमरोचकम् ।
गुल्मानाहामवातांश्च रक्तपित्तं च तज्जयेत् ॥ १२ ॥

Curna (powder) of one karsa (12 grams) each of Alstonia scholaris, Picrorhiza kurroa, Cyperus rotundus, Saussurea lappa ,Berberis aristata, and Holarrhena antidysenterica,two Karsha of Vangueria Spinosa,Marsdenia tenacissima,and half karsha (6 grams) of Aconitum heterophyllum. This powder consumed with warm water followed by licking of honey cures anaemia, fever, burning sensation, cough, dyspnoea, anorexia, abdominal tumour, distention of the abdomen, rheumatism and bleeding disease.

Vasaguducyadi Kwatha

वासागुडूचीत्रिफलाकट्वीभूनिम्बनिम्बजः ।
क्वाथः क्षौद्रयुतो हन्ति पाण्डुपित्तास्रकामलाः ॥ १३ ॥
Decoction of Adhatoda vasica, Tinospora cordifolia, Terminalia chebula, Terminalia bellerica, Emblica officinalis, Picrorrhiza kurroa, Andrographis paniculata and Azadirachta indica consumed with honey cures anaemia, bleeding disease and jaundice.

Vyoshadi Churna

व्योषाग्निवेल्लत्रिफलामुस्तैस्तुल्यमयोरजः ।
चूर्णितं तक्रमध्वाज्यकोष्णाम्भोभिः प्रयोजितम् ॥ १४ ॥ कामलापाण्डुहृद्रोगकुष्ठार्शोमेहनाशनम् ।
Piper nigrum, Piper longum and Zingiber officinalis, Plumbago zeylanica, Embelia ribes, Terminalia chebula, Terminalia bellerica and Emblica officinalis,

Cyperus rotundus added with equal quantity (of all the herbs together) of iron fillings are converted into fine powder, consumed along with buttermilk, honey, ghee or warm water cures jaundice, anaemia, heart disease, skin disease, hemorrhoids, and diabetes.

Guda Nagaradi Gutika

गुडनागरमण्डूरतिलांशान् मानतः समान् ॥ १५ ॥ पिप्पलीद्विगुणान् दद्याद्गुटिकां पाण्डुरोगिणे ।
Equal quantities ofjaggery, Zingiber officinalis, iron slag and Sesamum indicum, and Piper longum double the quantity (of all the other put together) made into pills should be administered pippali – to patients of anaemia.

Mandura Vataka

ताप्यं दार्व्यास्त्वचं चव्यं ग्रन्थिकं देवदारु च ॥ १६ ॥ व्योषादिनवकं चैतच्चूर्णयेद्द्विगुणं ततः ।
मण्डूरं चाञ्जननिभं सर्वतोऽष्टगुणेऽथ तत् ॥ १७ ॥ पृथग्विपक्वे गोमूत्रे वटकीकरणक्षमे ।
प्रक्षिप्य वटकान् कुर्यात्तान् खादेत्तक्रभोजनः ॥ १८ ॥
एते मण्डूरवटकाः प्राणदाः पाण्डुरोगिणाम् ।
कुष्ठान्यजरकं शोफमूरुस्तम्भमरोचकम् ॥ १९ ॥
अर्शांसि कामलां मेहान् प्लीहानं शमयन्ति च ।
Calx of Copper-Iron Pyrite, bark of Berberis aristata,Piper retrofractum,Root of Piper longum, Cedrus deodara,the nine herbs commencing with vyosa (enumerated in verse 14)are converted into the nice powder and iron slag resembling anjana (antimony sulphide) double the quantity (of the powder)are separately boiled in cow urine,eight times  the quantity of all the above mentioned herbs taken together. When it becomes suitable to prepare pills, the powder is mixed with it and rolled into pills (dried in shade) and consumed, by the patient taking buttermilk as food. These manduravatakas,are bestowers of life to patients of anaemia. They cure skin diseases, poor digestion, dropsy, stiffness of the thighs, loss of taste / appetite, haemorrhoids, jaundice, diabetes and disease of the spleen.

Tapyadi Curna

ताप्याद्रिजतुरौप्यायोमलाः पञ्चपलाः पृथक् ॥ २० ॥ चित्रकत्रिफलाव्योषविडङ्गैः पालिकैः सह ।
शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुना द्रुताः ॥ २१ ॥
पाण्डुरोगं विषं कासं यक्ष्माणं विषमं ज्वरम् ।
कुष्ठान्यजरकं मेहं शोफं श्वासमरोचकम् ॥ २२ ॥
विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च ।
Calx of Copper-Iron Pyrite, Asphaltum punjabianum, silver, and rust of ironeach five pala (240 g)
mixed with one pala (48 grams) each of citraka – Plumbago zeylanica, Terminalia chebula, Terminalia bellerica, Emblica officinalis, Piper nigrum, Piper longum and Zingiber officinale, and Embelia ribes, eight pala (384 grams) of sugar are converted into fine powder and consumed with honey. It cures anemia, poisons, cough, pulmonary tuberculosis, remittent fevers, skin diseases, loss of digestive power,diabetes,dropsy,dyspnoea, loss of taste/ appetite Especially it cures epilepsy,jaundice and heamorrhoids.

Kutajadi Gulika

कौटजत्रिफलानिम्बपटोलघननागरैः ॥ २३ ॥
भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा ।
शिलाजतुपलान्यष्टौ तावती सितशर्करा ॥ २४ ॥
त्वक्क्षीरीपिप्पलीधात्रीकर्कटाख्याः पलोन्मिताः ।
निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिजातकम् ॥ २५ ॥
मधुत्रिपलसंयुक्तान् कुर्यादक्षसमान् गुडान् ।
दाडिमाम्बुपयःपक्षिरसतोयसुरासवान् ॥ २६ ॥
तान् भक्षयित्वानुपिबेन् निरन्नो भुक्त एव वा ।
पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरम् ॥ २७ ॥
हृन्मूत्रपूतिशुक्राग्निदोषशोषगरोदरम् ।
कासासृग्दरपित्तासृक्शोफगुल्मगलामयान् ॥ २८ ॥
मेहवर्ध्मभ्रमान् हन्युः सर्वदोषहराः शिवाः ।
Seeds of Holarrhena antidysenterica,Terminalia chebula, Terminalia bellerica and Zingiber officinale,Azadirachta indica,Trichosanthes dioica,Cyperus rotundusand Zingiber officinale – each equal in quantity are boiled / soaked in water and decoction reduced (to a quarter),eight pala (384 grams) of Asphaltum punjabinum and same quantity of white sugar are soaked and macerated in the above decoction for either ten times, or double / triple of that (twenty or thirty times).Next, powder of one pala (48 grams) each of Curcuma angustifolia, Piper longum, Emblica officinalis,  Pistacia integerrima,one pala (48 grams) each of fruits and root of Solanum surattense, justifiable quantity of trijataka Cinnamomum zeylanicum, Elettaria cardamomum, Cinnamomum tamala, and three pala (144 grams) of honey are added to the above decoction,  and the solid mass made into guda (bolus, pills) of one aksa (12 g) in quantity. After consuming it (daily) the person should drink either juice of Punica granatum, payaḥ – milk, soup of meat of birds, warm water, wine or fermented infusions.  It should be consumed either without food or after food. This pill cures anaemia, skin diseases,fever,diseases of the spleen,bronchial asthma,haemorrhoids,rectal fistula, disease of the heart and of urine, foetid smell of semen, disorders of digestive fire, consumption, homicidal poisoning / chronic poison, abdominal enlargement,cough,menorrhagia,bleeding disease,dropsy,abdominal tumours,diseases of the throat,diabetes,hernia,giddiness,mitigates all the doshas and gives happiness (health).

Drakshadi Leham / drakshavaleha

द्राक्षाप्रस्थं कणाप्रस्थं शर्करार्धतुलां तथा ॥ २९ ॥
द्विपलं मधुकं शुण्ठीं त्वक्क्षीरीं च विचूर्णितम् ।
धात्रीफलरसद्रोणे तत्क्षिप्त्वा लेहवत्पचेत् ॥ ३० ॥
शीतान् मधुप्रस्थयुताद्लिह्यात्पाणितलं ततः ।
हलीमकं पाण्डुरोगं कामलां च नियच्छति ॥ ३१ ॥
One prastha (768 grams) of Vitis vinifera, one prastha (768 grams) of Piper longum, half tula (2.4 Kg) of sugar, two pala (96 grams) of Glycyrrhiza glabra, Zingiber officinale, and Curcuma angustifolia are powdered nicely, added to one drona (12 Litre 228 ml) of juice of Emblica officinalis and cooked to make confection. After is cools, one prastha (768 grams) of honey is added, one panitala (one karsa – 12 grams) of this confection, if consumed (daily) cures advanced stage of jaundice anaemia and jaundice.

Hrisva Panchamuladi Kashayam

कनीयःपञ्चमूलाम्बु शस्यते पानभोजने ।
पाण्डूनां कामलार्तानां मृद्वीकामलकाद्रसः ॥ ३२ ॥
Decoction of kaniya (hrsva) pancamula (Shalaparni – Desomodium gangeticum, Prishniparni – Uraria picta, Brihati – Solanum indicum, Kantakari – Solanum xanthocarpum, Gokshura – Tribulus terrestris) is best for drinking and dining for patient of anaemia, and jaundice, the juice of Vitis vinifera and Emblica officinalis.

Dosha specific treatment principles in Pandu Roga

इति सामान्यतः प्रोक्तं पाण्डुरोगे भिषग्जितम् ।
विकल्प्य योज्यं विदुषा पृथग्दोषबलं प्रति ॥ ३३ ॥
 स्नेहप्रायं पवनजे तिक्तशीतं तु पैत्तिके ।
श्लैष्मिके कटुरूक्षोष्णं विमिश्रं सान्निपातिके ॥ ३४ ॥
Thus, was describedthe medicines (treatment) of anaemia. The wise physician should administer them after considering the strength of each dosha. Pandu arising from Vata should be treated with medicines which are predominant with fats. That arising from pitta with medicines predominant in bitter taste and cold potency;That arising from Kapha should be treated with medicines that are predominantly pungent, dry and hot;and that arising from the combination of all the doshas,by combination of herbs (or treatments).

Treatment principle for Pandu Roga caused by eating mud

मृदं निर्यापयेत्कायात्तीक्ष्णैः संशोधनैः पुरः ।
बलाधानानि सर्पींषि शुद्धे कोष्ठे तु योजयेत् ॥ ३५ ॥
Mud should be expelled out from the body (in anaemia caused by eating mud habitually) first, by strong purifactory therapies. When the alimentary tract becomes purified, medicated ghee recipes which bestow strength should be administered.

Vyoshadi Ghrtam

व्योषबिल्वद्विरजनीत्रिफलाद्विपुनर्नवम् ।
मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च ॥ ३६ ॥
वृश्चिकाली च भार्गी च सक्षीरैस्तैः शृतं घृतम् ।
सर्वान् प्रशमयन्त्याशु विकारान् मृत्तिकाकृतान् ॥ ३७ ॥
तद्वत्केसरयष्ट्याह्वपिप्पलीक्षीरशाद्वलैः ।
Medicated ghee prepared with decoction ofPiper nigrum, Piper longum and Zingiber officinale,Aegle marmelos,the two rajani (Turmeric – Curcuma longa and Daruharidra – Berberis aristata),Terminalia chebula, Terminalia bellerica, Emblica officinalis,the two punarnava (Shweta – white variety – Trianthema portulacastrum & Rakta – red variety – Boerhaavia diffusa),Cyperus rotundus,iron calx,Cissampelos pareira,Embelia ribes,Cedrus deodara,Boerhavia erecta,and Clerodendrum serratum added with equal quantity of milk  and quarter part of ghee. This recipe, mitigates all the disorders produced by mud quickly.  Similar is the effect of Crocus sativus, Glycyrrhiza glabra, Piper longum, milk and Cynodon dactylon.

Creating aversion to mud in Pandu Roga caused by eating mud

मृद्द्वेषणाय तल्लौल्ये वितरेद्भावितां मृदम् ॥ ३८ ॥
वेल्लाग्निनिम्बप्रसवैः पाठया मूर्वयाऽऽथवा ।
For creating aversion to mud in those who are addicted to it; the mud should be soaked and macerated in the (juice or decoction) of Embelia ribes, Plumbago zeylanica, tender leaves of Azadiracta indica Cissampelos pareira or Marsdenia tenacissima. The dosha predominant by eating different kinds of mud should be recognised and medication/ treatment appropriate to it should be administered.

Kamala Cikitsa: Treatment of jaundice

कामलायां तुपित्तघ्नं पाण्डुरोगाविरोधियत्।
For jaundice treatments which mitigate pitta and which are not against anaemia should be administered.

पथ्याशतरसे पथ्यावृन्तार्धशतकल्कितः ॥ ४० ॥
प्रस्थः सिद्धो घृताद्गुल्मकामलापाण्डुरोगनुत् ।
Medicated ghee prepared with decoction of one hundred by number of Terminalia chebula, paste of half hundred of rind of pathya fruit – Terminalia chebula and one prastha (768 grams) of ghee cures abdominal tumour, jaundice and anemia.

आरग्वधं रसेनेक्षोर्विदार्यामलकस्य वा ॥ ४१ ॥
सत्र्यूषणं बिल्वमात्रं पाययेत्कामलापहम्
Cassia fistula mixed with Piper nigrum, Piper longum and Zingiber officinale, with juice of Saccharum officinarum, should be consumed either Pueraria tuberosa or Emblica officinalis, consumed in the dose of the size of fruit of Aegle marmelos for the cure of jaundice.

पिबेन्निकुम्भकल्कं वा द्विगुडं शीतवारिणा ॥ ४२ ॥
कुम्भस्य चूर्णं सक्षौद्रं त्रैफलेन रसेन वा ।
Paste of Baliospermum montanum, mixed with two parts of jaggery should be consumed along with cold water. Or powder of Baliospermum montanum along with honey or decoction of Terminalia chebula, Terminalia bellerica and Emblica officinalis.

त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम् ॥ ४३ ॥
प्रातः प्रातर्मधुयुतं कामलार्ताय योजयेत् ।
Either the decoction ofTerminalia chebula, Terminalia bellerica, Emblica officinalis, Tinospora cordifolia, Berberis aristate or Azadirachta indica should be administered mixed with honey in the morning daily for the person suffering from jaundice.

निशागैरिकधात्रीभिः कामलापहमञ्जनम् ॥ ४४ ॥
Collyrium applied to the eyes with Curcuma longa, Ferrum haematite and Emblica officinalis, cures jaundice.

Ruddhapatha kamala

तिलपिष्टनिभं यस्तु कामलावान् सृजेन्मलम् ।
कफरुद्धपथं तस्य पित्तं कफहरैर्जयेत् ॥ ४५ ॥
The patient of kamala who eliminates feces resembling the paste Sesamum indicum, the path of pitta being blocked by kapha. Pitta should be won over by treatment which mitigate kapha.

रूक्षशीतगुरुस्वादुव्यायामबलनिग्रहैः ।
कफसम्मूर्छितो वायुर्यदा पित्तं बहिः क्षिपेत् ॥ ४६ ॥
हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः ।
भवेत्साटोपविष्टम्भो गुरुणा हृदयेन च ॥ ४७ ॥
दौर्बल्याल्पाग्निपार्श्वार्तिहिध्माश्वासारुचिज्वरैः ।
क्रमेणाल्पेऽनुषज्येत पित्ते शाखासमाश्रिते ॥ ४८ ॥
रसैस्तं रूक्षकट्वम्लैः शिखितित्तिरिदक्षजैः ।
शुष्कमूलकजैर्यूषैः कुलत्थोत्थैश्च भोजयेत् ॥ ४९ ॥
भृशाम्लतीक्ष्णकटुकलवणोष्णं च शस्यते ।
सबीजपूरकरसं लिह्याद्व्योषं तथाऽऽशयम् ॥ ५० ॥
स्वं पित्तमेति तेनास्य शकृदप्यनुरज्यते ।
वायुश्च याति प्रशमं सहाटोपाद्युपद्रवैः ॥ ५१ ॥
निवृत्तोपद्रवस्यास्य कार्यः कामलिको विधिः ।
By indulgence in foods which are dry, cold,not easily digestible,and sweet,excess of exercises,restraining (controlling by great effect) the strong (animals etc.) vata getting aggravated in association with kapha,expels the pitta outside (of its seat) then the person develops the colour of turmeric in the eyes,urine and skin, the feces turn white,gurgling noise in the abdomen, no movement of feces,feeling of heaviness in the region of the heart,debility,poor digestive power,pain in the flanks,hiccup,dysnoea,loss of taste,and fever accompany. When the pitta gets localised in the sakhas (dhatus/ tissues), the patient should be gradually allowed to take meals in small quantities along with either soup of meat of peacock, black partridge or fowl/ cock mixed with dry (non-fatty), pungent, sour things; or with soup of dried Raphanus sativus or of Dolichos biflorus.  Soup being made intensely sour, penetrating deep, pungent, salt and hot in properties is ideal; powder of Piper longum, Piper nigrum and Zingiber officinale should be licked with the juice of Citrus medica, by this treatment when the pitta gets back into its own seat, the feces regain its normal colour, vata becomes subsided along with gurgling noise and other complications (secondary affections). After the relief from all these complications, treatments prescribed for jaundice should be administered.

Kumbha Kamala Chikitsa

गोमूत्रेण पिबेत्कुम्भकामलायां शिलाजतु ॥ ५२ ॥
मासं माक्षिकधातुं वा किट्टं वाऽथ हिरण्यजम् ।
In kumbha kamala (advanced stage of jaundice) either shilajatu (asphaltum), makshika dhatu (chalcopyrite) or hiranyaja kitta (waste product obtained during melting of gold/ silver) should be mixed with cows urine and consumed daily for one month.

Halimaka Chikitsa

गुडूचीस्वरसक्षीरसाधितेन हलीमकी ॥ ५३ ॥
महिषीहविषा स्निग्धः पिबेद्धात्रीरसेन तु ।
त्रिवृतां तद्विरिक्तोऽद्यात्स्वादु पित्तानिलापहम् ॥ ५४ ॥ द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च ।
यापनान् क्षीरवस्तींश्च शीलयेत्सानुवासनान् ॥ ५५ ॥
मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये ।
कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम् ॥ ५६ ॥
पयसा च प्रयुञ्जीत यथादोषं यथाबलम् ।
The patient of halimakashould be administered oleation therapy, using buffalo gheeboiled with juice of Tinospora cordifolia and milk,then consume (the powder of) Operculina turpethumalong with Emblica officinalis. After purgationshe should consume meals which issweetand mitigating pitta and vata.Then either draksavalehadescribed earlier (verses 29-31)or ghee prepared withsweet herbs should be consumed Ksira basti (enema with milk etc.) which are yapana in action (chapter 14 of kalpasiddhi sthana)should be adopted along with anuvasana (oil enema). Mrdvikarista (Draksharishta) and such other recipes should be consumed.To increase the digestive fire,Abhayalehadescribed in the treatment of cough, chapter 3 of cikitsasthana)Piper longum, Glycyrrhiza glabra and Sida cordifolia, boiled in milkshould be consumedappropriate to the (aggravated) dosha and strength (of the person).

Treatment of sopha in Pandu Roga

पाण्डुरोगेषु कुशलः शोफोक्तं च क्रियाक्रमम् ॥ ५७ ॥
The intelligent physician should adopt the methods of treatments described for dropsy (vide next chapter) also in anaemia

इति श्री वैद्यपति सिंहगुप्तसूनु
श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने पाण्डुचिकित्सितं नाम षोडशोऽध्याय: ॥ १६ ॥

Thus ends the chapter panduroga cikitsta – the sixteenth in cikitsita sthana of Astangahrdaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.