Fever must be considered a friend and not a disease.
Fever is the first alarming sign to indicate any problem in our body from external or internal factors. It is the symptom of the body’s reaction to fight against any disease. Fever mostly points to an underlying illness. In most of the cases, it is often untreated or maltreated. In both the cases, their importance in reflecting the disease is missed.
Fever is a defence mechanism which creates circumstances that are not favourable for virus or bacteria to thrive, or it kills them directly. If you are going to get rid of the fever without taking steps against the underlying disease, then you are giving way for the disease force to progress. Later you have will have to strain yourself more to eliminate the disease.
We must become aware that suppressing this symptom alone does not mean healing the patient. Also, while suppressing, the patient may feel better at first, but sooner or later, he/she the disease will return, reinforced. Although fever helps the body to fight infections by stimulating the natural defence mechanisms, fever can cause complications and even lead to death. Medicos fashionably often call it as PUO (Pyrexia of Unknown Origin) when the causative factor is uncertain after all investigations.
Normal body temperature – Body temperature is measured in Fahrenheit or Celsius (centigrade). Fahrenheit is commonly used in our country and Celsius is common in western countries. Our normal body temperature is 98.4°F or 37°C when measured orally. This may vary up to 0.5°F (0.2°C) when measured in the armpit (in case of children) or rectum.
This temperature may vary within a sharp range throughout the day due to atmospheric changes, our coverings, tissue metabolism, etc. It is somewhat less in the mornings and slightly higher in the evening. The regulatory system of the body is controlled by the hypothalamus (like a thermostat) by a nervous feedback mechanism. If the body temperature becomes very high, it makes vasodilatation (dilatation of blood vessels), sweating and decreases the temperature of the body. If the body temperature becomes very low, it produces vasoconstriction and protects the internal temperature.
Pyrogens in blood, which come from external substances such as bacteria, viruses, toxins and internal malignant or benign tumours, are the precursor of high temperature. Our skin, as one of the good barometers, also controls and regulates the water content and heat with perspiration. If humidity of the atmosphere permits, it works well. If all regulatory mechanism fail or the disease super wins, the temperature shoots up to more than 104°F, which endangers life.
Fever means the elevation of body temperature above the normal level (i.e. 98.4°F or 37°C). It is mostly associated with cold, cough, throat pain, ear pain, abdominal pain, nausea, vomiting, diarrhoea, urinary complaints, etc.
- Due to infection (bacteria, virus and fungus) – for example: flu, cold, chickenpox, herpes, tonsillitis, laryngitis, pharngitis, pneumonia, endocarditis, tuberculosis, meningitis, vasculitis, breast abscess, rheumatic fever, vasculitis, pyelonephritis, cystitis, boils, appendicitis, pancreatitis, prostatitis, orchitis, otitis, etc.
- Due to infestation (parasites/worms) – for example: malaria, filariasis, amoebiasis, trichinosis, etc
- Due to drugs – for example: sulpha drugs, penicillin, overdose of any drug.
- Due to tissue necrosis – for example: myocardial infarction (heart attack), liver cirrhosis, injury, malignancy, etc.
- Sudden or gradual increase in temperature
- Body pain
- Aching joints
- Shivers (rigor)
- Rashes which may burn and itch
- Sore eyes
- Coating of tongue
- Loss of taste
- Signs of dehydration – Thirsty and dryness of body, tongue and skin
- Seizure or convulsions (often seen in children with high temperature)
- Continuous high fever more than three days
- Blabbering or confusion or delirium
- Stiff neck
- Difficulty in breathing
- Diarrhoea or repeated vomiting
- Swollen glands
Acute – Sudden onset of temperature and has a short course
Chronic – Slow, progressive and recurrent in nature; some people, even after recovering from typhoid, function as carriers and suffer from it periodically.
Recurrent – Fever recurring often due to improper treatment.
Continuous fever – The temperature is continuous and variation is not more than 1°C and never touches normal in a whole day.
Remittent – The temperature variation is more than 2°C and never touches the normal level in a whole day.
Intermittent – The fever is on and off and is only for a few hours and for the remaining period, the temperature will be normal. Also, intermittent fever has been further classified as.
Quatidian – which occurs daily
- Tertian – which occurs on alternate days, for example – malaria fever
- Quartan – when there is a gap of two days between two episodes
Non-contagious – The fever does not spread from one to another, for example, fever due to connective tissues, heart problems, malignancy, trauma, fear, metabolic disorder like gout, milk fever, etc.
Effects and complications – High fever often aggravates the already existing complaints. The process also increases tissue catabolism and dehydration which precipitates the disease with delirium, convulsions (due to cerebral oedema or circulatory shock) and finally leads to death.
For untreated or maltreated fever due to:
Respiratory infections – Pleural stitches occur as complication
Typhoid – Perforation of intestine occurs as a complication
Pneumonia – Necrosis of lung occurs as a complication
Rheumatic fever – valvular heart disorders occur as complication
Examination – will provide all information.
Examination of pulse – You can judge the temperature with the help of pulse itself. Normal pulse rate is 72-84 per minute. For every degree of rise in temperature, 10 pulses will be more. If this relationship is not there, we must be more careful with the disease:
- Slow pulse rate is noticed in typhoid and cardiac disorder
- High pulse rate is seen in septic conditions
Examination of cardiac rate and sounds must be done to rule out cardiac disorders.
Examination of ear, nose and throat should be done since complaints often start here. Also examination of the patient thoroughly for eruptions, boils, injury, swelling of glands, joints and skin is a must, to rule out other causes.
The character of the fever also sometimes indicates the disease:
Evening rise of temperature indicates tuberculosis infection
Gradual increase of fever (step ladder type) indicates typhoid infection
Fever with rigor indicates septic fever such as urinary tract infection, puerperal fever, etc.
Fever with nervous involvement indicates poliomyelitis
Fever with rheumatic complaints indicates rheumatic fever or rheumatoid arthritis
Fever with loose stools indicates gastritis, food poisoning, etc.
Routine blood and urine investigation often helps to diagnose the patient. Additionally, peripheral smear can be done to diagnose malaria and filaria when the fever is high. Mantoux test and sputum for AFB can be done to diagnose tuberculosis infection. Blood culture and widal test can be done to diagnose typhoid after three days. Bile salts and bile pigments can be done to diagnose jaundice.Ultrasound scan, CT and MRI can be done to diagnose inner diseases like cancer and tumours
Bed rest in a well-ventilated, cool room until the fever subsides
Sponge bath with lukewarm water
Extra fluids to compensate for dehydration (water, juices, vegetable soups, etc.)
A light diet without oil
Extra cover with warm blankets when shivering
Coffee, soft drinks and tea
Mental work even at home
General treatment To start any treatment, a detailed case history, examination and lab investigations are necessary. In general, everyone treats fever by anti-pyretic drugs like Paracetamol, Crocin, Aspirin, etc. These drugs act as anti-inflammatory and make us sweat profuse and reduce the temperature. Since we are losing body fluids, we will become tired. So, it is safe to return to school or work after the temperature has become normal for 24 hours.
No one needs an antibiotic treatment unless the situation requires it. Antibiotic resistance is common in these days. Due to often usage, diseases also become more potent and resistant. Due to this, antibiotic doses are increasing, creating more complications by adding stress to the diseased body. Also, most of the time, fever is caused by virus (common cold). But everyone takes antibiotic treatment in spite of their ineffectiveness against viral infections.
In Homeopathy, we treat the patients (symptoms of the patients) and not the disease. So, in Homeopathy, diagnosis with lab investigations and causative factor (bacteria or virus) are not important since the medicines are not going to act against the disease or kill the bacteria or virus directly. The resistance is sought to be improved by giving no chance for recurrence due to re-infection of the same bacteria or virus. So, a lot of patients being diagnosed only as ‘PUO’ after routine lab investigations can be easily treated in Homeopathy, by increasing the immune mechanism. But no one can deny the importance of diagnosis and laboratory investigations for the assessment of prognosis and to monitor the improvement.
In the light of concept ‘Similars’, Homeopathy is the most popular alternative medicine. Homeopathic remedies make the patient more comfortable during treatment by supporting the healing process and stimulating the immune response. Every patient has his/her own pattern of falling ill and will experience a different set of symptoms even for the same illness as per diagnosis.
In Homoeopathy, medicines are usually selected with the mode of onset and character of the disease, exciting cause, thirst, sweat, shivering, mental restlessness, characteristic symptoms of the patient, appetite, sleep and stool habit, etc. A well-selected remedy quickly supports the body mechanism and clears the complaints at the earliest.
Cure and comfort feeling (well-being sensation) can be felt only by the patient and cannot be examined or diagnosed by a doctor or lab findings. While taking anti-pyretic drugs, there won’t be a comfort feeling even after the fever subsides. But everyone can feel the well-being sensation while being treated by Homeopathy medicines even when there is fever as healing begins by the natural defence mechanism. In Homeopathy, the patient’s appetite and thirst improve to energise the body for getting better, i.e. Homeopathy treats the patient in all ways, always.
Some of the common medicines often used for fever are Aconite, Apis-mel, Ars alb, Baptisia, Belladonna, Bryonia, Eupatorium Per, Ferrum phos, Gelsemium, Rhus tox, Pulsatilla, Pyrogen.
To cure, one should have disease knowledge, drug knowledge and applicable knowledge of drugs on diseases. Disease knowledge includes study of symptoms and diagnosis of the patient with clinical findings and investigations. Drug knowledge includes study of drugs. Applicable knowledge comes only with experience which cannot be taught. So, an experienced, qualified doctor is absolutely necessary to treat fever.
(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)