Dr . Manjeet Kaur

Karshya

A balanced diet is essential to prevent undernutrition (karshya). By ensuring an adequate intake of all the necessary nutrients, it helps maintain a healthy body and reduces the risk of both undernutrition and overnutrition. Undernutrition leads to weaken immunity and susceptibility to diseases increases. Proper digestive fire is needed for nutrient absorption so that good quality of Rasa dhatu( plasma) is formed.karshya is frequently associated with poor digestive fire. As a result Malnutrition occurs.

Thus karshya and physical, mental, immune health are interconnected to each other. karshya is a condition in Ayurveda characterized by excessive thinness . It is seen as a result of malnutrition and imbalance within the body, impacting both physical and mental health.

Karshya impacts not only small children but also affects the majority of the adult population.
According to Ayurveda karshya is Vata Pradhan Apatarpanjanya Vyadhi resulting from reduced food intake .

Acharya Charak and Shushrut as classified it as Raspradoshaja Vyadhi . In Ayurveda Karshya is a disease as well as a cause, pre-monitory symptom and could be complication of some diseases.

Archarya Dalhan explains that Agni ( Jathragni) Converts food (Ana) into Nutrition (Ahaar Ras) . If the digestive fire (Mandhagni) is low, it doesn’t metabolise food properly, resulting in malnutrition.

Etiological Factors:

Eating food with a dry nature (Lagu Ahaar), occasional fasting, or consuming food in very small quantities can lead to the vitiation of Vata dosha. Moreover, sometimes Karshya is also caused by over therapeutic cleansing (Sanshodhan karma), excessive consumption of astringent foods (Khasaya Ras Pradhan), suppression of natural urges such as thirst and hunger, late-night sleep habits, application of dry powders on the body, hereditary factors, advancing age, chronic illnesses, excessive physical and mental exertion, and excessive bathing. Additionally, weight loss can occur due to the depletion of muscle mass and body fat.

Pathogenesis of karshya

Dosha Imbalance
Karshya is primarily associated with an imbalance of Vata dosha. When Vata is aggravated, it disrupts the body’s ability to properly digest and assimilate nutrients, leading to emaciation.

Weak Digestive Fire
Weak digestive fire is main reason in the development of Karshya. When Agni is impaired, even a nutritious diet cannot be properly digested and utilized by the body, leading to malnutrition.

Importance of Dhatus (Body Tissues)
In Ayurveda, the body’s is built from seven tissues (dhatus). Karshya affects the nourishment and strength of these dhatus, particularly Rasa (plasma) and Mamsa (muscle)

Common Symptoms:

Archarya Charak says a person who is lean cannot tolerate excessive physical activities . He even cannot tolerate thirst , hunger, high potency medicine even climatic changes. His buttocks, abdomen, neck and his other body parts look emaciated, wrinkled. Prominent veins are visible on the skin, thin , dry and rough skin covers the body, and the skeleton and joints appear swollen.

Complications:

Spleenomegaly, Dry Cough, Breathing Difficulty,piles, Intestinal disorders, Tuberculosis , Pain in body can occur.

Ayurvedic treatment :

Diet and Nutrition

Recommended Foods Warm, nourishing, and easily digestible foods such as ghee, milk, rice, and soups,egg mango , Badam, kaaju, pistachio, Raisins, Manuka, Walnut, Kharjur.

Do’s – sweet (Madura) and unctuous (Snigdha) food items. Newly harvested Rice, mutton Soup, milk, curd, ghee, sugarcane juice, cereals, and wheat. pleasant environment, proper sleep, comfortable bed, stress-free practice like meditation, be with friends who make you happy.

Foods to Avoid: Cold, dry, and light foods that can aggravate Vata.
Don’t – Bitter (katu) , Pungent (Tikt), Astringent (Kashaya), Rough (Ruksha), Yav, Masoor, Moringa, Kodrav, Fasting,

According to Acharya Charak Lagu Santarpan ( Light Nutritional ) food is the line of treatment.

1. Avoid all the factors mentioned above that causes emaciation / leanness .
2. If needed, health care provider should perform therapeutic cleansing (Sanshodhan).
3. Give a Strength-giving (Balya) and Nutritive (Bruhana) diet.
4. Light easily digestible diet.

Therapeutic cleansing (Sanshodhan):

1. External and Internal oleation (snehnan). Massage body with Bala taila, and Mahanarayan taila . Internally take Bala Ghrita Mixed with food or Milk to balance vata.
2. Enema therapy (Basti): Anuvaasan basti.
3. Nutritional enema (Bruhana basti).
4. Nutritive Nasya (Bruhana Nasya) .
5. Herbal Remidies :

Take herbs that are nourishing and rejuvenating like Shatavari, Ashwagandha, Shaal Mishri, Safed Mishri, Varahikadh, Amalaki Churna, Pravaal Panchamrut, Museli, Shaalparni as Rasayana( Nourishing and Rejuvenating) and Vaajikaran.
Asav : Draksha Aasav ; Ashwagandha Arishta .

You can also use Ayurvedic formulations of gold as per doctor’s advice.

Lifestyle Modifications

Consistency : Maintain a regular eating schedule and avoid skipping meals..

Mindfulness: Eat in a calm, relaxed environment, chewing food thoroughly.

Hydration: Stay hydrated with warm water and herbal teas throughout the day.

Self-massage (Abhyanga) with warm oils.Gentle exercises to improve circulation and muscle tone.

Meditation helps to relax mind.

Breathing exercises like Pranayama. Anulom Vilom (Alternate Nostril Breathing

These guidelines help balance the Vata dosha, promote healthy weight gain, and ensure overall well-being for lean individuals.

Combining karshya with medical treatment can offer a holistic approach for managing malnutrition. According to Ayurveda vata dosha, Rasa and mamsa dhatu and weak digestive fire are responsible for pathophysiology of karshya while in modern perspective deficiency of essential vitamins and minerals are responsible for malnutrition. Coelic disease, Crohn’s disease and Anorexia Nervosa can lead to malnutrition.

Ayurveda diagnosis karshya with physical signs and symptoms ,weak pulse; while morden medicine it is diagnosed with the help of blood test and imaging studies.

Ayurveda recommends food ,herbs and detoxification while medical terms they recommend nutritional supplement, protein powder, high calorie balancing diet.

Karshya is a complex condition that requires a comprehensive approach for effective management. By addressing dietary habits, lifestyle, mental well-being, and incorporating Ayurvedic treatments, it is possible to restore balance and; improve overall health. Always seek guidance from a qualified Ayurvedic practitioner for personalized care.

Sample Daily Meal Plan:

Breakfast:- Warm oatmeal cooked with milk, topped with ghee, chopped nuts, and sweetner honey.

Mid-Morning Snack :- A ripe banana/any fruit or a handful of soaked almonds/ kaju.

Lunch:- Khichdi (a mixture of rice and mung dal) with cooked vegetables, seasoned with cumin, coriander, and turmeric (optional)with a spoon of ghee while eating.- A side of yogurt or buttermilk seasoned with rock salt, roasted cumin powder, powder black pepper.

Afternoon Snack :- A warm glass of milk with a pinch of cardamom or a piece of fruit like mango or papaya.

Dinner :- A bowl of vegetable soup with sweet potatoes, carrots, and leafy greens.- A serving of basmati rice or quinoa.

Before Bed :- A warm glass of milk with a pinch of nutmeg and a teaspoon of ghee .

reference:Karshya-A Critical Review on Nutritional Deficiency as per Ayurveda