Bull. Ind. Inst. Hist. Med. Vol. XXI pp. 99 to 104

TREATMENT OF ANAEMIA WITH SPECIAL REFERENCETO IRON IN ANCIENT INDIAN MEDICINE AYURVEDA

A HISTORICAL PERSPECTIVE

K. SWAYAM PRAKASAM*

ABSTRACT

The two main texts of Ayurveda viz. Charaka Samhita andSushruta Samhita. which were said to be written around 1500 B.C. mentionedthe use of iron. Iron powder pocessed along with herbs like Amalaki (Emb/icaofficina/is), a rich source of ascorbic acid, is indicated in Pandu (anaemia).Vagbhata, a 4th Cent. A.D. author of Ashtangahridaya considered iron as thebest among drugs used for Pandu (anaemia). Use of iron in modern medicinefor anaem.a dates beck \0 18th and19th centuries.

INTRODUCTION:

Human being is thriving to getrelief from diseases since time imme-morial. Human beings in ancienttimes were also troubled with manydiseases with which we are sufferingnow-a-days. In those days alsoscientists struggled hard to findsolutions for various medical problemswith available facilities. By studyingancient medical literature, one canperceive the problems of ancientpeople and solutions adopted by thosepeople. Ayurveda is one such ancientmedical science, which is still in pra-ctice in India and which can givesuch information. Purpose of present

paper is to mention the descriptionand treatment of anaemia mentionedin Ayurveda so as to study the ancientprescriptions for this disease withspecial reference to iron preparations.

Caraka Sarnhita and SusrutaSarnhita are the two main depositoriesof Ayurveda. The former deals mainlywith medicine and the latter withsurgery. Atreya and Dhanvantary aretwo main teachers of Ayurveda whosedisciples wrote the texts of AyurvedaViz. Aqnivesa Samhita and SusrutaSamhita (Samhita means collection}.They are said to be lived as early as1500 B.C. These two texts werethoroughly edited and systematized.

* Lecturer, S. V. Ayurvedic College, TIRUPATI - 517 501, A.P. (India)

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Caraka edited Aqnivesa Sarilhitaafter whose name it became CarakaSamhita , Susruta Sarnhita remainedto be called with the same name.Exact date of Caraka is disputed.Historians put him between 600 B.C.to 100 A.D. (Ray 1965). Susrut aSarnhita is edited by Nagarjuna andCandrata, who are said to be lived inthird to fourth centuries A.D. (Ray etal 1980) and 10th century A.D.(Sarma, 1975) respectively. Exactdate of the oldest existing manus-cripts of both these Sarnhitas are notknown. Caraka Sarnhita and SusrutaSarnhita described preventive andcurative aspects of diseases. Etiolo-gical factors, prodromol symptoms,symptoms, prognosis and treatmentof various diseases have been explai-ned in both the texts Anaemia isone among such diseases whichneeds special attention.

TREATMENT OF ANAEMIA INCARAKA SA~lHIT.\ :

General picture of anaemia men-tioned in Caraka Sarnhita is, deficiencyof blood, fat, ojas, looseness of bodyparts and abnormality of complexion(Sarma. 1983). Principles of treat-ment of anaemia explained in CarakaSarnhita are:

'The patient of anaemia afterunction should be subjected tostrong emesis and purgation.After evacuation he should bemanaged with wholesome diet

Bull. Ind. Inst. Hist. Med. Vol. XXI

such as old rice, barley and wheatwith soups of green gram, pigeon,pea and lentils or meat soup ofwild animals and birds. Medica-ment should be administered tothem according to dosa and asspeicfic to the disorder. (~arma,1983, p. 276).

Various medicated ghees are prescri-bed for anaemia in Caraka Sarnhita.Interesting thing is prescription ofiron preparation for anaemia. Onesuch prescription reads as follows(Sarma, 1983, p, 279).

Powder of Trikatu (fruits of Piperlongum, Piper nigrum, rhizome ofZingiber officina/e), Triphala(fruits of Terminalia che bule,Terminelte belerice, Embticeotticinetis ), Musta, (Cyperusrotundus }, Vidanqa (fruits ofEmbelia ribess , Citr aka (root ofPlumbago zey/anica) all in equalparts are mixed with nine parts ofiron powder. This (Navavasa)powder formulated by Krsnatrevais taken with honey and ghee,alleviates anaemia, heart disease,skin diseases, piles, and jaundice.Swarnarnaksika (copper iron pyrite

processed) and Mandura are alsoindicated in anaemia. Mandura meansiron pieces collected from placeswhere iron is melted, and variousinstruments were prepared by black-smith. These iron particles exposedto atmosphere more than 100 years

Treatment of Anaemia-Swayam Prekesem

should be collected and used fortherapeutic purposes. Iron becomesrusted and converted completely intoiron oxide (Fe~03) due to exposureto atmosphere for a long time, andthis is purified and used in Ayurveda.Among other important herbal prepa-rations, Dhatr i avaleha and Ohatrva-ri-t a, the two drugs mainly preparedout of fruit juice of .~malaki (Emblicaofficina/is) are indicated in anaemia.

The process in which iron is usedfor therapeutic purposes is mentionedin Caraka Samhita elsewhere (Samra,1983 p. 22).

The paper like pieces of sharp ironfour fingers long and thin likesesamum seeds should be heatedtill they are red hot. Then theyshould be dipped in decoction oftriphala, cow urine, alkali preparedout of iuqudi (Bsterutes aegy-ptiece (Linn.) Delile) and Pala~a(Buteo manosperma (Lam.)Kuntze), Lavana (Salt). Whenthey are transformed like collyriumthey should be powdered finely.This powder mixed with honey andjuice of amalaki fruits (Emb/ica

ottrcinsliss should be made intoa linctus which should be kept ina ghee pitcher and stored for ayear in granary of barley, stirringit from all sides every month.After the end of year it should betaken mixed with honey and ghee.

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TREATMENT OF ANAEMIA INSU~RUTA SA\IHIT.\ :

Principles of treatment of anaemiamentioned in Susruta Samhita (Sastri,1974) are almost same as those ofCaraka Samhita. ~usruta mentionedfruit juice of amalaki (Emblicaofficinalis) and he mentioned ironpowder along with Trikatu, Vidanqapowder and turmeric or Triphalapowder, Su-ruta mentioned the useof Mal.1flClra.

Vaqbhat a. a 4th century A.D.author of A~tailga Hrdaya (Paradkar,1982), credited iron as the bestamong drugs used for anaemia. Inthis way the important text ofAyurveda mentioned the use of ironin anaemia.

Later development in the use ofiron is iron bhasma. Process of ironbhasma is fully established by 13thcent. A. D. which is compiled basingon earlier works. Chemically ironbhasma is Fez03.

BRIEF HISTORY OF USE OF IRONIN MODERN MEDICINE:

In the sixteenth century A.D. thecausative role of iron deficiency inthe then prevalent green sickness orchlorosis of adolescent women beganto be recognized. Sydenham isproperly credited with identifying ironas a specific remedy to take the placeof bleeding and purgings. In 1713,

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Lemary and Geoffry provided moredirectevidence that iron was presentin blood (ash). In 1832, the Frenchphysician Pierre Blaud wrote that themalady chlorosis arises from a faultyformation of blood as a result ofwhich the blood is an imperfect fluidor the colouring matter is so defectivethat is no longer suitable for stimula-ting the organism and maintainingthe regular exercise of its functions.He reported a rapid cure of 30 patientsgiven a mixture of equal parts offerrous sulphate and potassiumcarbonate. The treatment of anaemiawith iron followed the principlesenunciated by Sydenham and Blaud.In twentieth century various aspectsof iron metabolism were observed.(Basing on Goodman & Gillman,1980) .

DISCUSSION AND CONCLUSION:

More than 2000 years ago iron isindicated in anaemia in Ayurveda.Even in the absence of facilities alsoAyurvedic Scientists established theclinical use of iron for anaemia.Constant observation of patients ofvarious diseases might have led themto this finding. One such clue is, inthe prodromal symptoms of haemeor-hagic disorders, iron smell ismentioned. Probably this observationmight have prompted the use of ironin anaemia. Role of stomach andliver in the production of blood iswell established in Susruta Sarnhita

Bull. Ind. Inst. Hist. Med. Vol. XXI

and AHanga Hrdaya (Dwarakanath,1959), even though the presence ofiron in blood is not mentioned in thebooks. Along with iron preparations,juice of Amalaki or Triph ala. in whichAmalaki is present.. is extensivelyindicated in anaemia. Amalaki isrich source of ascorbic acid. Ascorbicacid is known to increase the absorp-tion of iron. In this way Arnalakifacilitates absorption of iron whetherdietary or supplementary. Pharma-ceutically also amalaki is an importantdrug.

In the preparation of iron Amalakijuice or Triphala is extensivelymentioned. Triphala facilitates con-version of iron into iron oxide. Inthis way by adding Triphala duringpreparation and as an adjuvant withiron Ayurvedists achieved optimumuse of iron particularly in anaemia.Mawliira, the iron which is convertedinto iron oxide by constant exposureto atmosphere because of its presencein earth for years, is also indicated inanaemia. Turmeric is other importantherb indicated in anaemia. This maywork on liver and helps in anaemia.Role of liquorice (Yastlmadhu ) needsfurther clarification.

In this way use of iron powderwhich is processed with Triphala. arich source of ascorbic acid, is wellestablished in Ayurveda more than2000 years ago.

Treatment of Anaemia-Swayam Prakasam 103

REFERENCES

1. Dwarakanath, C. Introduction to Kayachikitsa, Bombay, popular BookDepot, 1959.

2. Gilman, A. G., Goodman, L. S. Gilman, A. (Ed.) Goodman and Gilman'sThe Pharmacological basis of therapeutics. New York, Macmillanpublishing Co. Onc., 1980.

3. Kulkarni, A.D. (Hindi Trans.) Sri Va/dyapathi Simhagupta Sunu Vagbhata-charya Virachitah "Rsser ct.ie Samuchchayah." New Delhi, MeharchandLachmandas, 1982.

4. Paradk ar, Harishastri (Ed.) , Ashtangahridaya (A Compendium of theAvurvedic System) composed of Vaghbata with the commentariesSarvangasundara of Arunadatta and Ayurvedarasayana of Hemedri.Varanasi, Chowkhamba Sanskrit Series Office, 1982.

5. Ray, Priyaranjandas and Gupta Hirendranath. Caraka Samhita: AScientific Synopsis, New Delhi. National Institute of Sciences of India, 1965.

6. Ray, P., Gupta, H., Roy, M. Sushruta Samhita (A scientific synopsis)New Delhi, Indian National Science Academy, 1980.

7. Sharma, P.V. Ayurveda Ka Vaignanika itihasa. Varanasi, ChaukhambaOrientalia, 1975.

8. Sharma, P.V. (Eng. Trans.) Caraka Sarilhita Agnivesa's treatise refined endannotated by Cbereke and redacted by Drdhabala. Varanasi, ChaukhambhaOrientalia, 1983

9. Shastri, A. (Hindi Trans.) Sushruta Samhita of Maharshi Sushruta.Chaukhambha Sanskrit Sansthan, Varanasi, 1974.

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