FEVERAn evil or a boon…

Dr. Shelly Arora

Medical Officer (Homoeopathy)

Dte. Of AYUSH

Govt. of NCT of Delhi

Body Temperature

The body temperature refers to the temperature of the

viscera and tissues of the body.

It is kept within the normal level by maintaining a balance

between the heat gain and heat loss, which is regulated

by hypothalamus.

The normal body temperature varies from 36.6ºC – 37.2ºC

(98-99ºF).

There is normally a diurnal variation of 1ºC.

What is Fever

Body temperature above the usual range of

normal i.e. 36.6 – 37.2ºC (98-99ºF).

It is caused by an elevation in thermo-regulatory

set-point i.e. due to a disturbance of heat

regulation, the thermostatic mechanism

controlling heat gain and loss is set at a level

higher than normal.

Result of increase in

temperature regulatory set-point

The body attempts to counteract the newly-

perceived hyperthermia and reach the new thermo-

regulatory set-point by:

Increase in muscle tone

Increase in heart rate

A feeling of cold, resulting in greater heat

production

Body’s effort to conserve heat

Shivering

Classification of Fever

GRDE CELSIUS FAHRENHEIT

Normal temperature 36.6-37.2 98-99

Low Grade 37.2-37.8 99-100

Moderate 37.8-39.4 100-103

High Grade 39.4-40.5 103-105

Hyperpyrexia >40.5 >106

Hyperpyrexia is a medical emergency because it approaches the upper limit

compatible with human life.

Causes of Fever

Fever is caused by an abnormality in Body’s

Temperature regulation, which results from:

An abnormality in the brain itself.

Toxic substances that affect the temperature

regulating centre.

Some Causes of Fever are:

Infections: bacterial, viral, rickettsial, fungal, parasitic

etc

Neoplasms

Vascular: acute MI, pulmonary embolism

Immunological: Sarcoidosis, IBD, RA, Drug disease

Tissue destruction eg. Hemolysis, surgery

Metabolic: Gout

Heat Stroke, radiation sickness etc.

Unexplained - PUO

Fever is not a Disease

Fever is not itself a disease but the body’s response

to a disease.

It is considered as one of the body’s immune

mechanism to attempt a neutralization of a

perceived threat inside the body, be it bacterial or

viral.

Various Studies

Various studies suggest:

The patient recovers more rapidly from infections or

critical illness due to fever.

There is reduced mortality in bacterial infections

when fever is present.

Fever was found beneficial in some diseases like cancer,

neurosyphillis etc. Fever was often induced in these

diseases by injection of milk protein or BCG vaccine.

Usefulness of Fever

It has been suggested that fevers may be useful to some extent since:

They allow the body to reach high temperature, where some

pathogens with strict temperature preferences can be hindered.

Fever aids in Host defence by-

Increased proliferation of WBCs, which help fight off the harmful

pathogens and microbes that invade the body.

Enhanced Leukocyte phagocytosis

Endotoxin efects decreased

Increased proliferation of T-cells

Enhanced activity of interferon

Treatment

Both aggressive treatment of fever and too little

fever control can be detrimental.

This depends on the clinical situation. Therefore,

careful assessment is needed.

Treatment

With the exception of very high temperature, treatment

to reduce fever is often not necessary.

It is rare for an untreated fever to exceed 40.6 C (105 F).

Damage to Brain generally doe not occur until

temperatures reach 42 C (107.6 F).

Most people recover without specific medical treatment.

Fever is an important sign of an illness in the body. It

should be used to govern the medical treatment and

guage its effectiveness.

Management

Even when treatment is not indicated, general measures

should be taken in a case of fever:

Keep patients adequately hydrated as dehydration

produced by a mild fever can be more dangerous than the

fever itself.

Facilitate Heat-loss by-

Wet clothes, usually applied to forehead, bathing body

in tepid water.

Perspiration

Homoeopathic perspective

“Treat the Patient, not the Disease”

According to Samuel Hahnemann (in Organon of Healing Art)

all kinds of Fevers should be treated in the same manner as

any other disease.

Homoeopathic Prescribing in Fever

A medicine should never be prescribed simply to control

Fever. Rather, a similimum has to be found according to the

totality of the case.

The patient should be observed carefully, taking note of

all the changes in the health of the body and mind since

the current illness (fever).

The totality of the symptoms should be perceived,

embracing the more striking, singular, uncommon and

peculiar (characteristic) signs and symptoms of the case

of disease; and the most similar remedy found.

The Fever – its name / type is just one of the symptoms

and is of the least value in selection of the remedy, being

the general (common) symptom.

Homoeopathic Prescribing in Fever

Our Materia Medicas and Repertories are full of symptoms

associated with Fever, which characterize the case of

fever - indicating the type, sensations associated, time,

modalities, concomitants etc.

Hahnemann has given special instructions in his Organon

of Healing Art regarding the treatment of intermittent

fevers (§ 321-244).

Various stalwarts have written books with instructions on

treatment of fevers:

Intermittent Fever by H.C.Allen

Repertory to the Symptoms of Intermittent Fever by

W.A.Allen

Bibliography Guyton, Arthur C. Textbook of Medical Physiology, Eighth edition

Mehta,P.J. Practical Medicine for Students and Practitioners, Thitteenth edition, 1998

Hutchinson’s Clinical Methods, Twentieth edition

Hahnemann, Samuel. Organon of Medicine, translated from the fifth edition with an appendix by R.E.Dudgeon;with additions and alterations as per sixth edition translated by William Boericke

Khan L.M., Pleasure of Prescribing

en.wikipedia.org/wiki/fever

wikidoc.org/index.php/Fever_usefulness_of_fever

www.webmd.com/first-aid/fevers-causes-symptoms-treatments

www.ncbi.nlm.nih.gov/pubmed