E-ISSN:2456-3110

Case Report

Dengue Fever

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

Role of Champakadi Agad and Jwaraghna Kashaya in Dengue Fever - A Case Study

Kharjule S1*, Bhaduri T2, Vedpathak S3
DOI:10.21760/jaims.10.3.69

1* Shwetangi Kharjule, Second Year Post Graduate Scholar, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education and Research at SVSP Hospital, Kolkata, West Bengal, India.

2 Tapas Bhaduri, Reader and HOD, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education and Research at SVSP Hospital, Kolkata, West Bengal, India.

3 Swati Vedpathak, Assistant Professor, Dept of Kriya Sharir, Dr DY Patil College of Ayurved and Research Centre, Pune, Maharashtra, India.

Dengue Fever is a Mosquito transmitted viral (flavivirus) disease. 400 million cases & 22000 death occurs due to dengue fever across world yearly. In West Bengal, 67271 cases with 30 deaths occurred in 2022 which was highly noted among all the states of India. Clinical features of Dengue fever are quite similar with Dandak Jwara and Vata-Pittaj Jwara explained in our classical texts. Specifically, Dhatugat Avastha of Jwara (~Fever) was precisely mentioned in our classics. Dengue fever toxins transmitted through mosquito bite in human body was correlate with Keeta Vish (~insect toxin). Primarily aim was to minimize the symptoms of Dengue are fever, rash, arthralgia, myalgia, headache. Secondary objective was to increase in platelet count & to avoid complications like Dengue Haemorrhagic Fever. In this case study young female patient was came with symptoms - Fever for 2 days, rash all over body, Itching, headache & body pain. According to laboratory investigations thrombocytopenia was seen & her Dengue NS1 was positive. Treatment protocol was Jwarahar (~antipyretic) & Keetavishaghna (~antitoxic). Jwaraghna Kashaya (~antipyretic decoction) & Champakadi Agad was orally given to the patient. Disease progress was analysed by clinical symptoms & laboratory parameters. The combine use of medicine with Pathya Kalpna (~dietary regimen) showed significant result in minimize fever, enhancement of Platelet count. Keetavishanghna & Jwaraghna Chikitsa were alleviating the symptoms of Dengue & found to be highly effective against the progression of disease.

Keywords: Champakadi Agad, Dengue, Vector borne diseases, Keetavish, Dhatugat Jwara

Corresponding Author How to Cite this Article To Browse
Shwetangi Kharjule, Second Year Post Graduate Scholar, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education and Research at SVSP Hospital, Kolkata, West Bengal, India.
Email: 		Kharjule S, Bhaduri T, Vedpathak S, Role of Champakadi Agad and Jwaraghna Kashaya in Dengue Fever - A Case Study. J Ayu Int Med Sci. 2025;10(3):440-446.
Available From
https://jaims.in/jaims/article/view/4219/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-10 2025-02-27 2025-03-07 2025-03-17 2025-03-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 11.85

© 2025 by Kharjule S, Bhaduri T, Vedpathak S and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(3)440
Download PDFBack To ArticleIntroductionCase ReportDiscussionConclusionReferences
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

Introduction

In Ayurveda, Jwara is explained as Sarvarogagraja (~first of all the diseases) for its supremacy among all the diseases. All Aacharya vividly explained Jwara (~fever) & provide their treatment. Impact of Jwara can be seen on all Dhatus (~fundamental elements). Dhatugata Avastha (~cellular level) of Jwara[1] is mentioned in our Samhita. Site of Manifestation of Jwara is body and also our mind.[2] Clinical features of Jwara are vary according to their site, types, stages and severity. Features of Rasgata Jwara, are Bahistap (~elevated body temperature), Angamard (~myalgia and arthralgia, also known as breakbone fever) and Jrumbha (~yawning and watering of the eyes).[3] As the disease progresses, it enters the Rakta Dhatu, which exhibits features like Pidaka (~maculo-papular rash), Trishna (~thirst), Sarakta Sthivan (~haemoptysis or bleeding from any orifice), Daah (~burning sensation), Raag (~redness), Bhram (~vertigo), Mada (~intoxication), and Pralaap (~delirium).[4] Dengue fever is not directly explained in the Bruhatrayi Samhita. Still on the basis of signs and symptoms Dengue can be correlate with the Dhatugat Avastha of Jwara with Vata and Pitta Doshik predominance.[5]

Dengue is a mosquito borne viral (Flavivirus – serotype 1-4) disease usually occurs worldwide.[6] The vector is mosquito Aedes aegypti & Aedes albopictus,[7] which breads in standing water, water - based air coolers & type of dumps are a good environment for the vector in large cities. Mild dengue fever causes a high fever, headache, musculoskeletal pain (breakbone fever), occasionally biphasic fever (saddleback)[6] and flu-like symptoms. The severe form of dengue fever, also called dengue haemorrhagic fever, can cause serious bleeding, a sudden drop in blood pressure (shock) and death. Although most of the cases are asymptomatic in nature but mortality rate is very high. Diagnosis usually made by clinical features and confirmed by laboratory investigation. Approx. 400million infection & 100million clinically apparent infection occurs & 22000 death occurs due to dengue fever across world annually.[8] Among the millions of dengue viruses 1–4 infections, ~500,000 cases of severe dengue occur annually, with a lethality of ~2.5%.[9] Every year during the period of July-Nov, an upsurge in the cases of dengue has been observed.

In West Bengal, 67271 cases with 30 deaths occurred in 2022 which was highly noted among all the states of India. In 2024 till October 441 cases are occurred.[10] The disease has a seasonal pattern i.e., the cases peak after monsoon and it is not uniformly distributed throughout the year. However, the states in southern and western parts of the country report perennial transmission.[11]

Description of dengue fever as Dandaka Jwara (~breakbone fever) is found in the Parishishta Adhyaya of Madhava Nidana. It has been described that a particular species of mosquito is the basic cause of spread of fever called Dandaka Jwara. This fever mostly subsides within a week; however, it is more dangerous for the children and old people.[12]

In Ashtang Ayurved there is one Anga (~branch) of Ayurveda was explained, known as Danshtra (Agad Tantra ~ Toxicology) in Samhitas.[13] Under this section we found different references related to bite and treatment of Sarpa (~Snake), Keeta (~Insects), Luta (~Spider), Mushak (~Rat & rodents). Aacharya Vagbhat explained one magical formulation i.e., Champakadi Agad in Keetalutadivishpratishedhiyaadhya.[14] Pathogens transmitted in Dengue fever can be correlate with Visha i.e., Keetavisha. In present case study we used Champakadi Agad, to alleviate the impact of these toxins and to see the efficacy of Agad (~antidote) against vector borne diseases. Jwaraghna Kashay is also show magical result in the management of pyrexia.

Case Report

Patient Information:

A 22 years old female patient came to the Kayachikitsa outpatient department on (21/09/24) with High grade fever (103.8°F), severe headache, generalised weakness, rashes over extremities, chest & back with intense itching, 2 episodes of vomiting. The complaints started with a mild fever, nausea, abdominal pain, reddish rash over both hands increased gradually in size since previous 2 days. The patient took 2-3 paracetamol tablet for fever, but fever not subsided & intermittently occurred with associated complaints. There was blood investigation reports, reveals her Dengue NS1 positive & also marked thrombocytopenia [Figure. 1: a & b]. There was no history of any major illness, allergy towards any allergen & surgical intervention.


J Ayu Int Med Sci 2025;10(3)441
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

jaims_4219_01.jpg
Figure 1: Rash before & after treatment

Clinical Findings:

There was high grade fever (103.8°), with reddish rash over chest, back & both extremities with itching [Figure 2a]. Rash was macular in nature without active bleeding spot. Torniquet test was positive.

Abdominal tenderness in upper quadrants present but hepato- splenomegaly was not noted. This case was diagnosed as Rasa-Raktagat Jwara with Keetavishaktata.

General Examination:

1. General Assessment of illness: Moderate
2. BP: 80/60mmhg
3. Mental state patient was conscious, alert, oriented and anxious
4. Intelligence: Good  
5. Respiration Rate:15/min
6. Build & state of nutrition: Medium
7. Weight: 45kg
8. Pulse: 118bpm   
9. Body temperature: 103.4F

Ashtavidha Pariksha:

1. Nadi: Vata Pitta
2. Mutra: Pit Varna, 5-6times/day
3. Mala: Vibandha
4. Jivha: Ishat Saam
5. Shabda: Ksheena
6. Sparsha: Ushna
7. Drik: Prakrit
8. Akriti: Madhyam

jaims_4219_02.jpg
Figure 2: Temperature chart

Therapeutic Intervention:

The Jwaraghna (~antipyretic), Tarpak (~Hydrating), Vishaghna (~Detoxifying), Raktashodhak (~Blood purifying), medicines were prescribed in the management of this case. Ingredients of Jwaraghna Kashaya [14] are Draksha, Madhuk, Madhu, etc., having Madhur (~sweet)- Tikta (~bitter) Rasa (~taste), Sheeta Virya, Madhur Vipaki which are Vata-Pitta Shamak in nature.

This medicine (Figure. 3) administered in the form of Chruna Kalpana (~powder form) - 4gm twice a day with lukewarm water before food intake. Champakadi Agad [15] was used, having Keetavishaghna properties. This Agad given to the patient 1.5gm twice a day with normal water after meal. Along with both medicine special attention was given towards Pathya - Apathya (Table. 1). For the maintenance of hydration Dhanyak + Jeera Him Kalpana used in Muhurmuhu (frequently) Kaal.


J Ayu Int Med Sci 2025;10(3)442
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

All diet given to the patient was Agnideepak (~Improve digestion), Arochakghna (Taste enhancer) & having nutritious quality.

jaims_4219_03.jpg
Figure 3: Medicine

Pathya:

Table 1: Pathya (Diet regimen)

DateBreakfastLunchEvening SnacksDinnerMuhurmuhu
  22/09/241 Bowel PomegranateMudga Peya 200ml15 Manuka (Black)Mudga Peya 200mlDhanyak + Jirak Him- 20ml
23/09/24Mudga Peya 200mlTandul Peya 200mlPapaya1 Bowel PomegranateMudga Peya 200mlDhanyak + Jirak Him- 20ml, 10 Pieces of Manuka (Black).
24/09/24Mudga Peya 200ml, 2 pieces DatesTandul Peya – 300ml1 Rajgira Ladu, PapayaMudga Peya 200mlDhanyak + Jirak Him- 20ml, 10 Pieces of Manuka (Black).
25/09/24Mudga Yush 300ml, Papaya1 bowel Oats1 Bowel Pomegranate, 2-3 DatesMudga Peya 300mlDhanyak + Jirak Him- 20ml 10 Pieces of Manuka (Black).
26/09/24Tandul Peya-300ml1 bowel Oatskiwi, DatesMudga Yush- 300ml, 10 soaked Manuka, at bedtimeDhanyak + Jirak Him- 20ml.
27/09/24Mudga Yush-300ml, kiwi juiceKhichadiPapaya, Rajgira LaduKhichadi, 15 soaked Manuka, at bedtimeDhanyak + Jirak Him- 20ml.
28/09/24Oats, Papaya,KhichadiPomegranate, DatesKhichadi, 20 soaked Manuka, at bedtimeDhanyak + Jirak Him- 20ml.

Apathya:

1. Shital Jal
2. Spicy & oily food
3. Fast food
4. Unhygienic food
5. Use of air condition
6. Avoid to go in unhygienic places
7. Heavy food intake.

Follow-Up and Outcome

Patient got relief with help of this medicines. No further complication seen in this case. Temperature chart, Torniquet test with other clinical symptoms (Table 2) & blood investigation (Table 3) was used for assessment of this case. Patient was monitored daily & blood investigation was done after 2 -2 days.

Table 2: Follow-up & Outcomes

Clinical
Features		22/09/2423/09/2424/09/2425/09
/24		26/09
/24		27/09
/24		28/09
/24
Fever spike (°F)103.4101.299.9----
Blood pressure
(mm/hg)		85/6692/67104/70107/75110/78113/80114/78
Pulse Rate113bpm109bpm100bpm87bpm84bpm79bpm83bpm
Rash (Macular)Over chest, back & both limbs.Present on chest & hands, Diminished on legs & backSmall patch over hands, diminished on back, disappeared from legs & chestDisappeared
Torniquet testPositivePositive-----
Vomiting episode1------
Abdominal pain [16]4320000
ItchingIntense PresentPresentOn & off----
Active Bleeding spot-------

Table 3: Lab. findings

DateHaemoglobinTLC CountPlatelet count
21/09/2411.7gm/dl4300mil/cmm0.44lac/cmm
23/09/2412.7gm/dl7900mil/cmm1.16lac/cmm
29/09/2411.8gm/dl4600mil/cmm4.09lac/cmm

J Ayu Int Med Sci 2025;10(3)443
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

Discussion

The etiological factor for dengue fever is virus (Gad/Visha) that transmitted through mosquito bite (Keeta Dansha). When viruses entered in human body shows feature like high grade fever, anorexia, rash along with arthralgia & myalgia (Breakbone Fever). According to sign & symptoms it was diagnosed as Rasgata & Raktagat Jwara. The Langhan (~fasting & detoxification), Deepan (~enhancing digestive fire), Pachan (~digestion) are main treatment protocol followed in Jwara Chikitsa. Pathya Kalpna used in this patient was Peya, Yush, Him are Laghu (~light) in nature with Deepan – Pachan qualities. Jwaraghna Kashaya[14] has Draksha (Vitis vinifera L.), Madhuk (Madhuca longifolia L.), Madhuk (Glycyrrhiza glabra L.), Lodhra (Symplocos recemosa Roxb.), Kashmarya (Gmelina arborea), Sariva (Hemidesmus indicus R. Br.), Musta (Cyprus rotundus), Aamalak (Emblica officinalis G.), Hribber (Pavonia odorata W.), Padmakesar (Nelumbo nucifera G.), Padmak (Prunus cerasoides W.), Mrunal (Nymphaea stellata), Chandan (Santalum album L.), Ushir (Vetiveria zizanioides L.), Nilotpal (Nymphaea stellata Wild.), Parushak (Grewia asiatica L.) having properties of Vata-Pittashamak. These are Laghu in nature, easily penetrate in Srotasa (~ channels) and helps to clear channels. Due Madhur (~sweet), Tikta (~bitter) rasa alleviate Pitta and Vata Dosh. Champakadi Agad is rarely used formulation, mentioned in Ashtang Hruday in the reference of Keetavisha Chikitsa.[15] This Agad contains Haridra (Curcuma longa L.), Daruharidra (Barberis aristate Dc.), Patang (Caesalpinia sappan L.), Manjishtha (Rubia cordifolia L.), Tagar (Valeriana wallichii DC), Kesar (Crocus sativus L.). All ingredients of this Agad possess properties of Raktaprasadak (~Blood purifier), Raktastambhak (~Helps in anticoagulation) & Vishaghna (~Antitoxic). In modern science in spite of high technology there is no specific treatment for the complete cure of Dengue fever. They follow symptomatic treatment with prophylactic management.

Conclusion

Vatapittaghna Jwaraghna Kashay & Champakadi Agad helps to correct fluid loss, cures loss of appetite, generalised weakness along with Rashes in this patient.

On basis of results of this study it may be concluded that addition of Champakadi Agad to Jwaraghna Kashay was significantly effective against Dengue Fever. And there were no further complications seen. So, this type of medication is very effective in management of vector borne diseases mainly dengue along with Chicken guinea, Malaria. Although, all ingredients of these formulation are easily available, cost effective and having no/fewer side effects so can be easy to use in management of various diseases according to their pathogenesis.

jaims_4219_04.jpg

jaims_4219_05.jpg


J Ayu Int Med Sci 2025;10(3)444
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

jaims_4219_06.jpg

jaims_4219_07.jpg

References

1. Kushavaha HS, editor. Charaka Samhita of Agnivesha. Chikitsa Sthan; Part 2 Chikitsa Sthan, Ch. 3 Ver. 75–83. Varanasi: Chaukhambha Orientalia; 2022. p. 86 [Crossref][PubMed][Google Scholar]

2. Kushavaha HS, editor. Charaka Samhita of Agnivesha. Chikitsa Sthan; Part 2 Chikitsa Sthan, Ch. 3 Ver. 30. Varanasi: Chaukhambha Orientalia; 2022. p. 74 [Crossref][PubMed][Google Scholar]

3. Kushavaha HS, editor. Charaka Samhita of Agnivesha. Chikitsa Sthan; Part 2 Chikitsa Sthan, Ch. 3 Ver. 76. Varanasi: Chaukhambha Orientalia; 2022. p. 86 [Crossref][PubMed][Google Scholar]

4. Kushavaha HS, editor. Charaka Samhita of Agnivesha. Chikitsa Sthan; Part 2 Chikitsa Sthan, Ch. 3 Ver. 77. Varanasi: Chaukhambha Orientalia; 2022. p. 86 [Crossref][PubMed][Google Scholar]

5. Acharya YT, editor. Ayurveda Dipika of Chakrapani Dutta on Charaka Samhita of Agnivesha. Chikitsa Sthan; Ch. 3, Jwara Chikitsa, Ver. 76. Varanasi: Chaukhambha Orientalia; 2023. p. 405 [Crossref][PubMed][Google Scholar]

6. Kaye ET, Kaye KM. Harrison’s Principles of Internal Medicine. 21st ed. Vol 1. Part II, Ch. 19, Fever and Rash, Table 19-1. 2022. p. 135 [Crossref][PubMed][Google Scholar]

7. Kuhn JH, Crozier I. Harrison’s Principles of Internal Medicine. 21st ed. Vol 1. Part V, Ch. 209, Arthropod-borne and Rodent-borne viral infection, Table 209-1. 2022. p. 1626 [Crossref][PubMed][Google Scholar]

8. Dockrell DH, Sundar S, Angus BJ. Davidson’s Principles & Practices of Medicine. 23rd ed. Ch. 11, Viral Infection—Dengue. 2018. p. 243 [Crossref][PubMed][Google Scholar]

9. Kuhn JH, Crozier I. Harrison’s Principles of Internal Medicine. 21st ed. Vol 1. Part V, Ch. 209, Arthropod-borne and Rodent-borne viral infection. 2022. p. 1644 [Crossref][PubMed][Google Scholar]

10. National Centre for Vector Borne Diseases Control. Dengue Situation in India [Internet]. Updated on January 17, 2025 [cited 2025 May 18]. Available from: https://ncvbdc. mohfw.gov.in/index4.php?lang=1&level=0&linkid=431&lid=3715 [Crossref][PubMed][Google Scholar]

11. National Notifiable Diseases Surveillance System (NNDSS). guidelines. for investigations. . [Crossref][PubMed][Google Scholar]


J Ayu Int Med Sci 2025;10(3)445
Shwetangi K et al. Role of Champakadi Agad and Jwaraghna Kashaya

12. Ayurvedic Perspective of Dengue Fever [Internet]. National Health Portal. Available from: http://www. nhp. gov.in/ayurvedic-perspective-of-dengue-fever-mtl [Crossref][PubMed][Google Scholar]

13. Paradakara HSS, editor. Sarvang Sundari of Hemadri on Ashtanga Hruday of Acharya Vagbhat. Sutrasthan, Ch. 1, Ver. 5. Varanasi: Chaukhambha Surbharati Prakashan; 2025. p. 5 [Crossref][PubMed][Google Scholar]

14. Paradakara HSS, editor. Ashtanga Hruday of Acharya Vagbhat. Chikitsa Sthan, Ch. 1, Jwara Chikitsa, Ver. 55–58. Varanasi: Chaukhambha Surbharati Prakashan; 2025. p. 554 [Crossref][PubMed][Google Scholar]

15. Paradakara HSS, editor. Ashtanga Hruday of Acharya Vagbhat. Uttarsthan, Ch. 37, Keetalutadivishpratishedhaadhyay, Ver. 71. Varanasi: Chaukhambha Surbharati Prakashan; 2025. p. 919 [Crossref][PubMed][Google Scholar]

16. Scott J, Huskisson EC. Visual analogue scale: Graphic representation of pain. Pain. 1976;2(2):175-184. [Crossref][PubMed][Google Scholar]

Disclaimer / Publisher's Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of Journals and/or the editor(s). Journals and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.


J Ayu Int Med Sci 2025;10(3)446