Review articles

By Dr. Muthiah Kannan , Dr. Sathiyarajeswaran Parameswaran , Dr. Natarajan Shanumuga Sundram
Corresponding Author Dr. Muthiah Kannan
Siddha Central Research Institute, CCRS, Dept. of AYUSH, MoH&FW, Govt. of India, , - India 600106
Submitting Author Dr. Muthiah Kannan
Other Authors Dr. Sathiyarajeswaran Parameswaran
Siddha Central Research Institute, Dept of Literary Reasearch & Documentation, Siddha Central Research Institute, Arumbakkam, Chennai - India 600106

Dr. Natarajan Shanumuga Sundram
Siddha Central Research Institute, Dept of Clinical Research, Senior Research FellownSiddha Central Research Institute, Arumbakkam, Chennai 600106 - India 600106


Anemia, Siddha, Primary care

Kannan M, Parameswaran S, Shanumuga Sundram N. Anaemia (Pandu) Primary Care in Siddha. WebmedCentral INDIAN MEDICINE 2012;3(3):WMC003172
doi: 10.9754/journal.wmc.2012.003172

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Submitted on: 20 Mar 2012 07:45:12 AM GMT
Published on: 20 Mar 2012 12:36:51 PM GMT


Adolescence in India goes hand in hand with iron-deficiency anemia, medically known as IDA (Iron deficiency Anemia), says the latest NFHS report. While 56 per cent of adolescent girls are anemic, boys too are falling prey to the disease. Around 30 per cent of adolescent boys are suffering from anemia, the report states. The National Family Health Survey (NFHS-3) conducted in 2005-06, presents the statistics that mark a growth in cases pertaining to anemia. Most of the anemic patients, especially women, suffer from mild to severe deficiency of iron. The hemoglobin count in most of the adolescent girls in India is less than the standard 12 g/deciliter, the standard accepted worldwide.

In spite of the economic growth still a good number of populations become anemic not only due to mal nutrition but also due to transformation from healthy foods to junk foods. History tracks behind anemia that the disease is named as PANDU as it affected the Pandu Maharaja, the father of Panja Pandavas. The yester generation has dictated the treatment guide lines as health foods by adding a lot of Greens, Palm jaggery, Conception of fruits and so on. Siddha system which considers food as a medicine has also given a proper treatment guide lines for anemia. This paper reviews the classification of anemia and the primary care to treat anemia.


In Siddha system of medicine all the systemic diseases have been classified under three categories.
I. Based on the vitiation of three humours.
II. Based the predominant symptoms and
III. Based on the line of treatment.
In modern medicine the Nosology which deals with the classification of diseases has grown boundless. No one can easily remember the names. But in Siddha system of medicine all the diseases the human being assailed with can be classified into 147 classifications, though the total numbers of diseases are mentioned as 4448. (Uthamarayan, 1953) ”Veluppu Noi” is one among the diseases classified based on the symptoms which literally means the Pallor, that can be exactly correlated with Modern classification of Anaemia. A detailed description of signs and the symptoms, etiological factors and their management have been found to be described in detail (Yugimuni, Annonymous.1965). This clinical entity is classified in to six, four based on vitiation of humours, one under toxic anemia and the last one Anemia due to the consumption of Ashes and the soil (Pica).


The word Paandu literally means pallor. In this clinical condition the conjunctiva, tongue, nail bud turn into pallor and it is has been named as PAANDU NOI. Syn: Velluppu Noi, Venmai Noi.


The etiological clusters, like Nutritional deficiency, hemorrhages, worm infestation and the other secondary causes like Tuberculosis, chronic sprue and the disease like piles, metarrhagia and menorrhagia are also found to be described.
• Excessive intake of Salt, sour foods, mud, ashes, toxic drugs.
• Haemorrhagic conditions like Mennorrhagia (Perumpaadu), Hypertension (Pithathikkam), Haemorroids (Moolam), Haematemesis (Kuruthivaandi).
• Worm Infestations.
• Hepatic disorders. (Murugaesa mudaliyar, 2008)

Premonitory symptoms

1. At first instance due to dietary changes, vitiated Azhal affects the colour and consistency of the blood, which will prevent the proper supply of the nutrients to the body and leads the body in to pale in colour.
2. Secondly, while walking small distance leads to dyspnoea and weakness of the lower limbs.
3. Anorexia, nausea, giddiness, blackouts, frequent fainting, palpitation and emaciation.

General symptoms

1. Weakness of the body
2. Headache
3. Palpitation
4. Blackouts
5. Giddiness
6. Fainting
7. Dyspnoea
8. Anorexia
9. Vomiting
10. Pallor and Shrinkage of the skin
11. Emaciation and shining of the body
12. Clubbing
13. Fissures, redness and softening of the tongue
14. Sore throat.


It is classified as 6 types A. Based on Humoral pathology - 4 types
1. Vali Paandu – Haemolytic anaemia
2. Azhal Paandu – Megaloblastic anaemia
3. Iyya Paandu – Pernicious anaemia
4. Mukkutra Paandu – Sickle celled anaemia B. Based on Toxaemia - 1 type 1. Nanju Paandu – Thalassemia Apart from these 5 types it is found to be described the other classification MANNUN PAANDU which is caused by consumption of ashes, mud and so on. This can be correlated with iron deficiency anaemia. (Kuppusamy mudaliyar, 2007)

Vali paandu:

The main symptoms are
• Anorexia
• Stomach ache
• Thirst
• Blackish discolouration of blood vessels
• Redness of eye
• Constipation
• Pallor
• Anasarca

Azhal paandu:

The main symptoms are
• Yellowish discolouration of body
• Pallor of tongue, hand and foot
• Eye vision diminished
• Thirst
• Dyspnoea
• Giddiness

Iya paandu:

The main symptoms are
• Whitish colouration of body
• Pylo erection
• Cough with expectoration
• Syncope
• Low back ache

Mukkutra paandu:

The main symptoms are
• Dyspnoea
• Bronchial asthma
• Frequent micturition
• Sneezing
• Anasarca

Nanju paandu:

It is defined due to consumption of toxic materials. The following symptoms are manifested this may be easily correlated with toxic anaemia. Haemolytic anaemia, Thalasemia can be grouped under this classification.
• Excessive thirst
• Vomiting
• Hic cough
• Cough
• Anasarca

Mannun paandu:

Consumption of Mud, ashes induces worm infestations which in turn leads anaemia and pallor. The main symptoms are
• Flatulence
• Indigestion
• Vomiting
• Diarrhoea Treatment: The treatment of Anaemia involves three phases.

First phase

It is a preparatory phase. In this phase purgation is generally given to normalise the vitiated Vali humour. It also helps to eliminate worms and other accumulated toxins of the body. Generally, the following medicines are prescribed. Therapy
1 1. Vitis vinifera - Thiraatchai
2. Phoenix dactylifera - Pereichu
3. Rosa borboniana - Rosa poo
4. Operculina turpethum - Sivathai Equal quantity of all the ingredients are boiled in water and reduced to 1/8 and administered at bedtime to cleansing the GIT and detoxify the body. Therapy
2 1. Sesbania grandiflora - Agathi 10 -15 gms of leaves are boiled with 250 ml of water and reduced to 1/8th that is 30 ml and administered with palm jaggery before bedtime. This will be useful in cleaning the GIT tract and also to expel the worms Therapy
3 1. Tinospora cordifolia - Seenthil
2. Feronia limonia - Narivila
3. Mollugo cerviana - Parpadagam
4. Cassia acutifolia - Perungalli
5. Operculina turpethum - Sivathai Equal quantity of the above ingredients is taken and ddecoction is prepared using sufficient quantity of Epsom salt. This will be useful in cleaning the GI tract and hepato-biliary system by inducing purgation.

Second phase

This phase includes the medicines the dosage, vehicles, adjuvants, durations and diet prescription. Siddhar’s intuitions are so high that, the prescription given by them containing herbs, herbo minerals, metallic compounds which are rich in micro and macro nutrients such as calcium, Vit C, zinc and iron. The modern way of treating anaemia goes in par with their intuitions. Siddhar’s have used iron, ferrous sulphate, magnetite, iron rust predominantly. They have been selected, purified and processed to get the medicine which later evolved as traditional standard operating procedures. The form of iron present in the end product is in the ferrous state which enhances in pharmacokinetics and logistics. The following drugs are generally prescribed in treatment of the Anaemia with suitable vehicle (Anupanam) and Adjuvants (Tunai marunthu).

Third phase

This is the phase followed immediately after the treatment in which prescription is made to change the life style i.e. Iyama, Niyama (daily course), seasonal conducts and diet to prevent the recurrence.


1. Annonymous. (2005). Yugi Vaithya Chinthamani - 800, 2nd edition.pp 167-169, Chennai: Dept of Indian Medicine and Homeopathy,Govt of Tamilnadu.
2. Kuppusamy mudaliyar, K. (2007). Siddha Maruthuvam 7th edition. pp 345-352,Chennai: Dept of Indian systems of Medicine and Homeopathy, Govt of Tamilnadu.
3. Murugaesa Mudaliyar, C. (2008). Siddha Materia Medica Part I 2nd edition pp 229-231. Chennai: Dept of Indian Systems of Medicine and Homeopathy, Govt of Tamilnadu.
4. Thiagarajan, R. (1981). Siddha Materia Medica part II 3rd Edition. pp 394-397 Chennai: Dept of Indian systems of Medicine and Homeopathy, Govt of Tamilnadu.
5. Uthamarayan, C. (1953). Siddha Maruthuvanga Churukkam.pp 285. Chennai: Govt Press, Tamilnadu

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1 review posted so far

gud wrk on anemia
Posted by Dr. Thiagarajan Saminadane on 20 Mar 2012 09:59:34 AM GMT

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