Fieber
Anhängsel
[Cummings and Ullman]
Fever and influenza
Fever is not a disease, but i t so commonly accompaning many kinds of
illnesses that we have covered it separately here. Influenza, on the other
hand, is a specific type of viral infection. We include
it in this chapter because fever often is one of the only symptoms of
the flu.
Fever can accompany almost every type of infection and occurs in other
illnesses as well. Fever may be the only apparent symptom of an illness (early
stages).
Don't be frightened by the fever itself—fever is usually a beneficial
phenomenon. Not only is it a valuable warning that an infection is taking
place, but the fever is itself part of the body's defense against the
infection.
Ancient physicians, such as Hippocrates and Celsus, considered fever a
means by which the body "cooks," separates, and eventually eliminates
the disease. In more scientific terms, the ability to increase body
temperature has come to be understood as a basic defense shared by all
organisms that can regulate their own internal temperature. Fever may help
fight infection in various ways. Simple elevation of
temperature reduces the growth of or even kills some disease-causing
organisms. More indirect effects of fever include enhancement of such innate
immune defenses as increasing the production of interferon (a
substance made by the body that inhibits viral reproduction) and
increasing white blood cell mobility and activity. Fever, indeed, is an
important positive response of the body.
Fever is defined somewhat arbitrarily as a rise in body temperature to
above 99.5°F (measured orally). Actually, normal body temperature varies from
person to person and, for each person, with time of day, activity
level, and other factors. The traditionally normal reading of 98.6°F
(37°C) is only an approximate average; your own temperature may range from a
little higher than 96°F to about 99°F when you're perfectly
healthy. Also, temperature elevations (as high as 103°F in children) can
occur after exercise or from being overdressed.
The body's regulatory mechanisms limit fevers to a maximum of 105°F to
106°F during simple acute illnesses in normal individuals.
Higher temperatures can be harmful, but unless there is something else
complicating the acute illness, a fever rarely gets so high that it threatens
health. Dehydration that results from fever can be dangerous
(children/elderly),
but it can be prevented by making certain that extra liquids are
consumed.
High fevers also sometimes cause seizures in children. Such
"febrile seizures" usually occur while the temperature is rising
rapidly, and end once it has reached its peak. They are most likely to occur in
boys between
6 - 24 months old. In children who are otherwise healthy, the seizure
tends to affect the whole body, not just one part or one side, and to last no
more than twenty minutes, usually much less. Any
deviation from this pattern may indicate an underlying neurologic disor
der. Although all children who have seizures during a fever need to
bemedically evaluated, simple febrile seizures tend to happen only once or
twice and cause no lasting ill effects. They are not uncommon and generally
do not represent a serious health problem.
What all this means is that the fever accompanying an acute illness is
not ordinarily a cause for concern. Instead of worrying about the fever, you
should pay attention to the illness responsible and try to aid the healing
efforts of the body. So long as it is not too high, the fever is best
left to continue its work as part of the body's effort to heal.
Rest and plenty of liquids (to replace the body fluid lost due to
sweating) are still important in the care of a person with a fever. It is
normal for fever to be accompanied by a diminished appetite, so don't
force-feed the
patient. Since heat is dissipated through the skin, allow for good air
circulation in the room and make certain the patient isn't heavily covered or
dressed - clothing should be the minimum necessary to prevent chilliness.
Often these steps are all that's necessary to relieve a mild fever. We
don't recommend treatment with either conventional or homeopathic medicines for
minor fevers.
Sometimes bringing the fever down is a worthwhile goal in itself - if
the temperature is 103.5°F or higher for more than an hour, if at any time it
climbs above 105°F, if the patient is a child who has had febrile
seizures, or if the fever simply has lasted long enough to be exhausting
or really uncomfortable. But remember, fever is a protective response, and you
should consider suppressing a fever only for the reasons just mentioned.
Although there is some controversy about its efficacy, sponge bathing is
recommended by many clinicians as an effective, drug-free way to bring down
fevers of mild or moderate illnesses - and should be used
immediately if the temperature rises to 106°F or if the patient becomes
delirious or has a fever-related seizure. If the patient can put up with some
discomfort, sponge bathing works more quickly than conventional
medicines. Actually, research shows that sponge bathing works best in
combination with acetaminophen given to reset the body's "thermostat"
about ½ hour before - but if you've
decided to use conventional
medicine, you probably won't need to bother with a sponge bath.
In any case, here's the technique: Just have the person sit in a basin
or tub in waist-deep, lukewarm water (don't use alcohol). Gradually lower the
water temperature by letting a little cold water run into the tub.
Use a wet sponge or washcloth to bathe all exposed skin, including the
face, and get the hair wet as well. Continue for 10 - 15 minutes. Then pat-dry the largest drops of water and
allow the skin to air-dry in a
cool room, protecting the person from drafts.
When fever is too high, too uncomfortable, or has lasted too long, and
if the homeopathic medicines are not working rapidly enough, you may want to
use medication such as acetaminophen (= paracetamol), aspirin, ibuprofen
(Motrin, Advil), or naproxen (Aleve, Naprosyn). All these drugs work to
reduce fever, but keep in mind that there is good scientific evidence that they
also interfere with the body's own immune defenses. Each has its
pros and cons and should not be used with any other. In general, we
prefer acetaminophen if one of these drugs must be used. In any case, you must
be absolutely certain they are stored in a safe place so accidental poisoning
cannot occur. Seek medical advice before giving any of these medicines
to a baby younger than two.
When used correctly, acetaminophen is safe and rarely causes side
effects, and it is easier to give to children because it is available in a
liquid and in suppositories. However, overdoses can cause serious poisoning
with potentially irreversible liver damage. Be especially careful to
follow package directions when using the liquid forms of acetaminophen. The
drops meant for babies are much more concentrated than the liquid intended for
older children, which has led to poisonings when parents confused the
two forms.
Aspirin should not be given to children or teenagers because it has been
implicated in Reye's syndrome, a rare but often fatal disease covered more in
detail at the end of this chapter. Aspirin also can produce side effects
and allergic reactions in relatively low doses. Still, it's inexpensive
and time-tested, and a good choice for adults who are not allergic to it.
The newer over-the-counter drugs ibuprofen and naproxen work much like
aspirin and share its most serious side effects, although less likely to cause
ringing in the ears. Their effects last longer than acetaminophen's,
so you can take them less often - but this is a disadvantage when you're
trying to minimize your interference with the body's natural healing process.
Character of the symptoms:
• Did the symptoms seem to begin after a particular stress? For example,
from exposure to cold air or wind, loss of sleep, or overindulgence in food or
drugs?
• How recently did the fever start? Within the last 12 hours, or ear
lier than that?
• How quickly did the symptoms begin?
• Is the face flushed?
• What is the person's mental condition - is he dull or confused,
delirious, restless and anxious, irritable, or clingy and tearful?
Modalities:
• Does the person feel warm or chilly? How do external heat and cold
make him feel?
If you decide that the illness should be treated and fever is the only
obvious symptom, consult the homeopathic information in this chapter for help
with choosing the right medicine. If there are other symptoms as
well (sore throat, earache, and so on), consult the appropriate chapter
for relevant homeopathic medicines.
Generally, the ill person will recover quickly or at least after one
night's rest. If the fever isn't gone or much lower by the next morning, you'll
probably want to try another medicine.
Bell. and Acon. are the best medicines to try during the first stages of
a sudden fever. Belladonna is by far the most commonly given medicine for
people with simple fever. It's the medicine to give first unless
another is clearly indicated.
Bell.: fever includes a red flushed face, intensely hot skin, reddened
mucous membranes, and glassy eyes with dilated pupils. The skin can be so hot
that you notice the heat lingering
on your hands after you touch it. Although Belladonna patients are
mentally dull and may not fully comprehend what's going on around them, they
may well be restless and agitated. Children may even hit, bite,
tear at things, or exhibit strange behaviors such as speaking
incoherently about scary or violent hallucinations. Of course, most people who
need Bell. don't have these extreme symptoms. Still, they often do show
some nervous excitability and their senses often are more acute. As the
illness progresses, they may develop muscle twitching, which, like many of the
Belladonna symptoms, comes and goes suddenly.
Acon.: fever comes on suddenly and the patient is anxious, restless, and
fearful (begin after exposure to dry and cold air or wind). Mentally alert –
like Bell. - but frightened, and he may toss in his sleep or throw off his
covers or clothes. In the classic case, he has dry skin, dry mouth
(perhaps with unquenchable thirst for cold drinks), and a dry cough. The pupils
may be constricted.
Ferr-p.: early in the course of a fever. Symptoms develop gradually,
rather than all of a sudden as in Belladonna and Aconite. Ferr-p. also when
Belladonna seems indicated but doesn't work after 2 – 3 doses.
Nux-v. ChiLLY. Chills < uncovering (slightly moving the blankets -
can't move under the covers without setting off a wave of chilliness). Begin
after overeating, going without sleep, or using too much alcohol or
drugs of any type. The person also may have various digestive symptoms,
such as constipation or nausea, and may have a sensation of heaviness of the
head. < in the morning/in the open air. Irritability is typical.
Puls.: often used when there are clear symptoms of a cold or ear
infection, you can give it when fever is the only symptom. Characteristic
mental and general symptoms of this medicine are evident: weepy/clingy/craving
affection.
Their moods are changeable. They may be irritable, whiny not angry or
strong. Intolerant of external heat/feel much worse when warmly covered or in
warm rooms. Begin after the patient has eaten too much rich or fatty
food, and tend to get worse at night. Classically, the Pulsatilla
patient isn't thirsty, even with a fever.
INFLUENZA
Though illnesses such as colds, digestive upsets, and other maladies are
often called "the flu," technically influenza is an acute infection
of the respiratory tract associated with a particular group of viruses.
Practically
speaking, the diagnosis is influenza if acute respiratory symptoms like
runny nose or cough are accompanied by marked fever, general weakness, and
muscular aching. The person with the flu looks and feels more
ill than he would with just a common cold.
Though uncomfortable, influenza ordinarily lasts only 3 - 5 days in most
healthy people. However, the severity of the illness varies from person to
person and from year to year. Even the milder strains can lead
to life-threatening disease among young children, the elderly, and those
debilitated by chronic illnesses - because severe bacterial infections such as
pneumonia can develop when the system is weakened by
the flu virus (ear and sinus infections also may occur). Also, the flu
viruses mutate rapidly, and some strains have been much more virulent than
others.
Home treatment for people with influenza is the same as for those with
fevers and colds. Avoid aspirin, especially when treating children under
nineteen, as its use is associated with Reye's syndrome, as
discussed in more detail at the end of this chapter. Antibiotics are
unnecessary and actually can be harmful; they should be avoided unless a
secondary bacterial infection has developed.
CASETAKING QUESTIONS FOR INFLUENZA
Character of the symptoms:
• Which are the more bothersome symptoms—tiredness, a heavy feeling, or
aches and pains? (If fever is a predominant symptom, see the previous section;
if there is significant runny nose or cough
• Is there a headache, and if so, where is it located and what sort of
pain does it cause?
• Does the person have chills?
• Is the person restless, or does she prefer to lie still?
Modalities:
• How does moving about affect the pains?
• How do heat and cold affect the body aches, and do they make the
person feel better or worse in general?
HOMEOPATHIC MEDICINES
One of the great success stories of homeopathic medicine concerns its
superb treatment of epidemic influenza during the 1917—18 flu season. Records
maintained by government medical officers at the time show
that proportionally, far fewer patients treated homeopathically died
from the flu or its complications than those who received conventional medical
treatment.
Among appropriate flu medicines covered in other chapters are Acon.
Bell. Ars. Puls. Nux-v.
In many ways, the symptoms of Gels. represent the classic picture of
flu—this is the medicine to give if you can't find a better fit.
Gels.: Mainly feels tired, weak, heavy, and sick. Generally wants to be
left alone, not because they're especially irritable, but simply because it's
too much work to interact with people. They don't
feel restless, and although motion isn't painful, the patient just lies
still because she's so weak. The eyelids look heavy and droopy, and the face
may appear dull and lacking in expression. A Gels. flu is characterized by
chills, which often run up and down the back. Typically, there is little
thirst in spite of the fever. The nose may be runny and the throat may burn.
Headaches are common, usually in the back of the head and extending
to the top or forehead. More striking symptoms, however, are general
weakness and tiredness.
Bry.: irritable with aversion to company, and physical aggravation from
motion. If either or both of these are present, give Bry.
Compare: Gels. with Bry. Bry. doesn't want to
be disturbed and is truly irritable. May snap when asked questions or refuse to
answer them altogether. May be preoccupied with worries about business/ordinary
affairs.
< Motion; > when lying still. Likely to
have generalized muscle and joint aches that are definitely more painful from
motion. Lies still because it hurts to move, not just because he's too tired
(headache < with motion
(walking, or even from moving the eyes/light
touch, eating, stooping, and talking also may make headaches worse, while
applying firm pressure and lying still may relieve them). < in warm rooms
and > in the cool air.
They may have an intense thirst for cold
drinks. A dry, hacking, often painful cough may accompany the flu symptoms.
Constipation.
Rhus-t.: restless. Muscles stiff and achy if the patient lies still for
any length of time. Paradoxically, her pain feels most severe when trying to
move after a period of rest, but it improves as soon as she moves about
and limbers up. She may be unable to sleep, because it's so
uncomfortable keeping still. Chilly and feel < in cold, wet weather,
improving in warmth and with applied heat. Exposure to damp weather or
overexertion may have
brought on the illness. Thirsty, sometimes only for sips of water at a
time, and may sweat profusely. Mentally, she may be anxious, apprehensive,
irritable, or depressed. Dry mouth and lips, dry sore throat, and hoarseness
often
accompany the general symptoms.
Ep-per.: Severe aching and pain that feels as though it comes from deep
inside the bones. Bruised soreness all over the body, and the bones (back),
feel as though they would break. Symptoms that confirm the
choice of this medicine—but that aren't necessarily present—include a
sudden nasal discharge with sneezing and redness in the eyes preceding the
onset of the body aches. Chills (morning between 7 - 9 h.
Typically they have great thirst for ice-cold drinks, but liquids may
cause digestive disorders. A dry, hacking cough that shakes the body also is
characteristic.
Osc.:
‡ Folgendes hat anthroposofische Einschlüße ‡
Frei nach: Philip
Incao, M.D. medical practioner in
Q. Pediatrician Daniel Alexander, MD (
A: This question raises an important point. The answer requires us to
look at the process of acute inflammatory illness more closely. Every feverish
illness proceeds in a rhythmical course with alternating cycles in which fever
takes hold of us, then lets go, takes hold, lets go, etc. This is a primal
biological process of contraction and expansion, like in-breathing and
out-breathing.
As fever takes hold, a child contracts and concentrates her forces
inward. She usually loses interest in play, food and drink and wants to curl up
under the covers. As the body temperature rises,
the child perceives its surroundings growing colder relative to its
warming body and she starts to feel chilled or even shiver.
As the "Father of Western Medicine" Hippocrates rightly
understood, this inward concentration of heat into the depths of the body
betokens a cooking, digesting and ripening process which he named pepsis in
Greek. During this phase of inner contraction and cooking the child may be
slightly dehydrated yet instinctively refuses to drink or eat, because her
bodily energy is fully concentrated and engaged in the inner work of digesting
of the illness. If a child is induced to eat or drink during this phase of the
illness, she often vomits.
When the fever peaks or breaks and starts to come down, this signals the
expansion and relaxation phase of the illness process. The child feels warm,
may sweat and then, having perked up somewhat and thrown off the blankets, may
announce that she's thirsty and hungry, and may need to go to the bathroom.
This is the out-breathing phase, in which the waste products of the previous
cooking-digesting phase are eliminated through sweating and mucus discharge as
well as through the usual channels of bladder and bowels.
Hippocrates called this phase of the illness the catharsis, meaning the
active throwing off and release of poisons from the body. Having detoxified
somewhat, the child now feels better and may want to play and become active.
Often however, the catharsis is merely a hiatus and not the end of the illness.
After some hours the fever starts to rise again as the child, feeling unwell,
draws her energy inward for the work of further digesting the illness.
The inner work of digesting an inflammatory illness is much easier for a
child if its stomach and colon are relatively empty of food. A child will often
have vomiting and/or diarrhea at the very beginning of an illness, and these
will often abbreviate the illness or even prevent it altogether.
The various complications of an inflammatory illness, including
dehydration, usually result from the incomplete digestion and/or the inadequate
catharsis of the illness, causing the child to become "toxic."
Anti-inflammatory drugs [acetaminophen (Tylenol)/ibuprofen/aspirin work]
by interrupting the cooking-digesting phase of the inflammatory process, thus
lowering the fever prematurely before the body is ready and ripe for a
cleansing catharsis. This explains why such anti-inflammatory, fever
suppressing drugs may increase the risk of toxic complications in an
inflammatory illness. Reye's syndrome from aspirin and the invasive bacterial
complications reported two years ago in New Zealand after ibuprofen treatment
of children with chicken pox are examples. I would argue that dehydration is
not caused by the fever itself, but by the inner toxicity which results when
fever is unable to do its job.
In 30 years of treating children's feverish, inflammatory illnesses in
the home, I have never recommended fever suppressants like Tylenol for fevers
below 106 degrees and I have never seen dehydration as a problem, Nor have I
ever seen dehydration result from judicious bowel cleansing with suppositories
or Milk of Magnesia in toddlers and children.
To be sure, infants are vulnerable to dehydration, especially with
repeated vomiting and diarrhea. I do not recommend Milk of Magnesia for infants
under one year old. Using a glycerin suppository in a healthy feverish infant
who hasn't had a bowel movement in the past 8 hours has always proved helpful
in making the infant more comfortable and less restless, in my experience, and
I believe it also helps the infant in getting over the illness. When infants
under six months old become ill for any reason, I always recommend checking
with your doctor.
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