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=== Etiology, features, and consequences of ''atikrisha'' (emaciation) ===

=== Etiology, features, and consequences of ''atikrisha'' (emaciation) ===

The etiological factors for ''atikrisha'' may be divided into two groups - excessive expenditure of calories and fewer intakes of calories. Either of these conditions leads to under-nutrition which ultimately results in ''atikrisha''. In the pathogenesis of ''krishata'', ''vayu'' plays an important role. Most of the etiological factors observed in the case of ''krisha'' and ''atikrisha'' provoke ''vata'' vitiation. Thus, vitiated ''vata'' may be considered the most important factor in the pathogenesis of ''krisha''. In ''sthaulya'' there is excessive formation and under-utilization (due to sedentary habit) of the ''rasa dhatu''. On the other hand, in ''krishata'' there is less formation of ''rasa'' due to diseases or due to undernourishment. Further, Charak and Sushruta both have categorized ''krishata'' as a ''rasa pradoshaja vyadhi'' (C.Su.28:10, Su.Su.15:37,24:8). In this way, ''rasa dhatu dushti'' mainly in the form of ''kshaya'' is found in extremely lean or emaciated people. The other ''dhatu'' involved in the pathogenesis of obesity as well as ''atikrisha'' is ''meda'' since it is mentioned that ''medokshaya'' (or the deficiency of ''meda'') cause ''krisanga'' (A.H.Su.11:18)<ref>Munshi, V.D. (translator) (1952). Ashtang Hridaya,Sastum Sahityavardhak Mudranalaya, Ahmedabad, India, p. 135, Sutrasthana-24/5, 11/18. </ref>.  

The etiological factors for ''atikrisha'' may be divided into two groups - excessive expenditure of calories and fewer intakes of calories. Either of these conditions leads to under-nutrition which ultimately results in ''atikrisha''. In the pathogenesis of ''krishata'', ''vayu'' plays an important role. Most of the etiological factors observed in the case of ''krisha'' and ''atikrisha'' provoke ''vata'' vitiation. Thus, vitiated ''vata'' may be considered the most important factor in the pathogenesis of ''krisha''. In ''sthaulya'' there is excessive formation and under-utilization (due to sedentary habit) of the ''rasa dhatu''. On the other hand, in ''krishata'' there is less formation of ''rasa'' due to diseases or due to undernourishment. Further, Charak and Sushruta both have categorized ''krishata'' as a ''rasa pradoshaja vyadhi''. [Cha.Sa.[[Sutra Sthana]]28/10], [Su.Sa.Sutra Sthana 15/37]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>,[Su.Sa.Sutra Sthana 24/8]<ref name=Susruta/> In this way, ''rasa dhatu dushti'' mainly in the form of ''kshaya'' is found in extremely lean or emaciated people. The other ''dhatu'' involved in the pathogenesis of obesity as well as ''atikrisha'' is ''meda'' since it is mentioned that ''medokshaya'' (or the deficiency of ''meda'') cause ''krisanga''. [A.H.Sutra Sthana 11/18]<ref>Munshi, V.D. (translator) (1952). Ashtang Hridaya,Sastum Sahityavardhak Mudranalaya, Ahmedabad, India, p. 135, Sutrasthana-24/5, 11/18. </ref>   

In biomedical terms, emaciation is the outcome of loss of the fatty contents or loss of adipose tissue component of subcutaneous fat, which is lying beneath the outer covering of the body<ref>Gray D.S., Fujioka K. (1991). "Use of relative weight and Body Mass Index for the determination of adiposity". J Clin Epidemiol, 44 (6): 545–50. </ref>. It is also known as extreme weight loss, leanness, or thinness. In general term, it is also known as wasting, which is caused by hampered nutritional requirement at the tissue level and excessive starvation. Wasting or leanness is an important symptom of improper nourishment, which is commonly seen in various clinical conditions such as poverty, a variety of gastrointestinal disorders, various eating disorders, prolonged fever, malignant diseases, endocrine disorders, chronic infections, autoimmune disorders as well as parasitic infections. The malnourished person faced a lot of problems related to cardiovascular, integumentary and urogenital systems. Disturbances in blood circulation, serum electrolyte, and serum protein are commonly observed in emaciated person. Such type individuals are more to suffer from infections due to deranged immune power and swelling in general<ref>"Emaciation". Medical-Dictionary.TheFreeDictionary.com. Retrieved February 19, 2014. </ref>.   

In biomedical terms, emaciation is the outcome of loss of the fatty contents or loss of adipose tissue component of subcutaneous fat, which is lying beneath the outer covering of the body<ref>Gray D.S., Fujioka K. (1991). "Use of relative weight and Body Mass Index for the determination of adiposity". J Clin Epidemiol, 44 (6): 545–50. </ref>. It is also known as extreme weight loss, leanness, or thinness. In general term, it is also known as wasting, which is caused by hampered nutritional requirement at the tissue level and excessive starvation. Wasting or leanness is an important symptom of improper nourishment, which is commonly seen in various clinical conditions such as poverty, a variety of gastrointestinal disorders, various eating disorders, prolonged fever, malignant diseases, endocrine disorders, chronic infections, autoimmune disorders as well as parasitic infections. The malnourished person faced a lot of problems related to cardiovascular, integumentary and urogenital systems. Disturbances in blood circulation, serum electrolyte, and serum protein are commonly observed in emaciated person. Such type individuals are more to suffer from infections due to deranged immune power and swelling in general<ref>"Emaciation". Medical-Dictionary.TheFreeDictionary.com. Retrieved February 19, 2014. </ref>.