An Integrative Review of Karshya in Children

Karshya is a classical Ayurvedic condition characterized by emaciation, leanness, and undernourishment, and is an important disorder described in Kaumarbhritya. In Karshya, there is progressive depletion of body tissues (Dhatu Kshaya), particularly Rasa Dhatu and Mamsa Dhatu, leading to loss of body weight, reduced strength, poor immunity, and delayed growth. The etiological factors responsible for Karshya include Alpashana (insufficient food intake), Vishamashana (irregular eating habits), consumption of nutritionally poor food, chronic infections, worm infestations, and psychological stress. Children are especially vulnerable due to their immature digestive capacity (Mridu Agni) and incompletely developed tissues (Asampurna Dhatu Avastha). Karshya closely correlates with modern paediatric malnutrition, particularly protein-energy malnutrition (PEM). PEM includes clinical conditions such as underweight, wasting, and stunting, resulting from inadequate intake of calories and proteins. Common manifestations include weight loss, muscle wasting, developmental delay, recurrent infections, irritability, and reduced immunity. Management of Karshya in Ayurveda involves Nidana Parivarjana (elimination of causative factors), Deepana-Pachana (improving digestion), and Brimhana Chikitsa (nutritive therapy). Easily digestible and calorie-rich foods, along with Rasayana and Balya herbs, are recommended to promote growth and immunity. Modern treatment includes nutritional rehabilitation, micronutrient supplementation, treatment of infections, and counselling on appropriate feeding practices. Thus, Karshya provides a comprehensive Ayurvedic understanding of paediatric undernutrition. Integrating Ayurvedic principles with modern nutritional strategies offers a holistic and effective approach for the prevention and management of childhood malnutrition.