Integrating Ayurvedic Agni Modulation and Modern Appetite Pathways: Karvyadi Syrup in Paediatric Arocaka Cases

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Karvyadi syrup rapidly restored appetite and weight gain in three Paediatric Arocaka cases (Ayurveda's
selective anorexia equivalent) from Balrog OPD, targeting Jatharagni weakness, dosha blockage at Jihva-
Hridaya taste centres, and neuroinflammatory hypothalamic suppression of hunger signaling. Arocaka
represents profound food aversion despite intact taste perception, caused by dosha Sanchaya impairing
Jatharagni (gastric fire) at tongue-heart axis receptors. This parallels modern neuroinflammation where
cytokines (IL-1β, TNF-α, IL-6) suppress NPY/AgRP hunger neurons, over activate POMC satiety pathways,
and disrupt ghrelin-dopamine reward circuits. Three children aged 4-9 years with 15-day to 4-month
anorexia histories received age-weight adjusted Karvyadi syrup (5-10 ml TDS pre-meals ×5 days with warm
water). The polyherbal formulation featured Deepana herbs (Kaarvi, Jeerak), Sroto shodhana (Maricha),
Grahi-Balya (Dadima, Draksha), Medohara (Vrukshamla), Yogavahi carriers (Madhu, Guda), and Anulomana
(Sauvarchala). All patients showed uniform rapid response: Day 3 marked spontaneous food requests; Day
5 demonstrated weight gains of 0.1-0.21 kg with complete fatigue resolution and appetite restoration. No
adverse effects occurred. Karvyadi syrup potently interrupts Arocaka pathogenesis through multi-pronged
action: Deepana-Pachana clears Ama-Sanchaya, Maricha removes Margavarana at taste centres, Dadima-
Draksha restore Agni-dhatu Poshana, while Vrukshamla addresses associated metabolic stagnation. This
synergizes classical dosha correction with putative anti-inflammatory modulation of ghrelin-responsive
hypothalamic circuits and cytokine-mediated appetite suppression. The formulation's rapid efficacy (72
hours to behavioral response) suggests potent Jihva-Hridaya de-blockage and Jatharagni reactivation.
Recommend randomized controlled trials incorporating serial ghrelin/IL-6 biomarkers, appetite visual
analog scales, hypothalamic functional imaging, and RoB2.0 assessment for dosha-specific validation across
larger Paediatric cohorts with varying anorexia etiologies.