Clipping Board » Medical Myths ─ The truth about healthcare is often different from what you intuitively think.
Dacun Township Health Center / Dr. Huang Jiancheng
If I told you that my three children have never used fever-reducing medicine (including fevers above 40 degrees Celsius), would you believe me? I have seen tens of thousands of patients and never given them a single fever-reducing injection. Would you believe that? You can believe it because I don’t like to reduce fevers! In fact, during the treatment of an illness, fever is the least necessary thing to address because fever is not a disease—it is a natural and healthy physiological response when the body is sick. Having a fever indicates that the immune system is functioning normally. Fever is a warning sign that something is wrong with the body, like an air raid siren going off when enemy planes approach. What we need to treat is the illness, to repel the enemy planes. Why would we try to destroy the alarm?
**Causes of Fever**
In our brain, there is a region called the hypothalamus, which is responsible for regulating body temperature and keeping it within a certain range. When this temperature-regulating center is affected by something, a fever occurs. There are many causes of fever, but the vast majority are due to infections by pathogens (including bacteria, viruses, rickettsia, fungi, etc.). After a pathogen infects the body, the immune system mobilizes white blood cells to fight the enemy and stimulates lymphocytes to produce antibodies to help eliminate the invaders. When pathogens and white blood cells battle, their remnants release something called "pyrogens," which circulate through the bloodstream to the hypothalamus and raise the body temperature, causing a fever! Therefore, fever is a healthy response of the body to disease when the immune system is functioning normally. Conversely, if the immune system is too weak, such as in some premature infants, elderly individuals, or severely ill patients, they may not even be able to develop a fever.
**Can Fever Go Too High?**
No! Most people think that a fever should be reduced immediately, otherwise, what if it gets too high and damages the brain? They often cite examples to prove this. In reality, every example is a misunderstanding! The cases they mention are usually meningitis. Meningitis is a disease where pathogens invade the brain and cause inflammation. Its main symptoms include headache, neck stiffness, vomiting, high fever, and coma. After recovery, some people may have sequelae such as epilepsy or intellectual disabilities. The general public doesn’t know about "meningitis" as a disease; they only know that the patient had a high fever and blame the fever for the damage. This is a huge misunderstanding! In fact, for a meningitis patient, no matter how high the fever is or whether fever-reducing medicine is used, the outcome is the same. Think about it: if the pathogens are damaging brain tissue, the focus should be on eliminating the pathogens. What’s the use of fever-reducing medicine? Besides, fever has a physiological limit. The temperature will stop rising at a certain point and won’t keep increasing. A persistent high fever is because the pathogens haven’t been completely eliminated. Once the pathogens are gone, the fever will naturally subside!
**Is Fever-Reducing Medicine Necessary?**
Fever is a warning sign that the body is sick. The height, pattern, and duration of the fever can provide doctors with valuable information for diagnosis and treatment. Inappropriate use of fever-reducing medicine can sometimes mask symptoms and affect diagnosis. For example, in cases of fever accompanied by abdominal pain, it is a medical consensus not to administer fever-reducing medicine (also known as antipyretics or analgesics) before a diagnosis is made. However, fever can cause significant discomfort, so whether to use fever-reducing medicine should be decided on a case-by-case basis. In non-contraindicated situations (without abdominal pain), it might be appropriate to give fever-reducing medicine if a student needs to continue attending classes. For parents who are hard to reason with, giving some fever-reducing medicine might be justifiable. If it’s during work hours, I might consider taking fever-reducing medicine, as a fever can cause flushed cheeks, palpitations, and weakness, making it hard to face patients. If I’m at home with nothing to do, I’d just drink more water and rest until the fever subsides. Children tolerate fever better than adults. Sometimes, even with a fever above 39 degrees, they can still be lively and active as if nothing is wrong.In that case, why give antipyretics?
I do not agree with giving antipyretics as soon as a fever occurs.
When I first started working at the Dacun Health Center, I noticed that the nursing staff routinely gave antipyretics after administering vaccines, which I found quite inappropriate. It easily leads people to think that they should immediately take medicine to reduce a fever. Therefore, I instructed the nursing staff to stop giving antipyretics and instead educate the public. Fever caused by vaccines (mainly the triple vaccine) usually subsides within two or three days and does not require treatment! A study from the Veterans General Hospital divided children who developed a fever after receiving the triple vaccine into two groups: one group was given antipyretics, and the other was not. The results showed that the group not given antipyretics had higher serum antibody concentrations, indicating that fever does have some benefits in driving the immune response.
Is it necessary to administer fever-reducing injections?
The principle is "avoid injections if possible, and avoid medication if possible." "Fever-reducing injections" have long been banned in advanced countries! Perhaps because people in our country are too fond of injections, the Department of Health has not yet explicitly prohibited them. Many private practitioners also continue to use them without hesitation! However, from a purely medical and educational standpoint, fever-reducing injections should be avoided as much as possible! Apart from the various complications that injections may cause, consider how many anxious parents bring their children to the clinic in the middle of the night for a fever that they could have managed themselves. How many fever patients or their family members actively request an injection after seeing a doctor? This may be a matter of opinion, and perhaps some doctors treat their own family members the same way! However, I still firmly believe that one of the benefits of being a doctor's child is getting fewer injections than others!
Should you see a doctor for a fever?
I recommend that patients with a fever see a doctor as soon as possible to allow the doctor to diagnose and treat the illness. After receiving medication, unless there are significant symptoms other than the fever, you should confidently finish the prescribed medication and avoid repeatedly seeking medical attention just because of the fever! Many parents, upon finding that their child's fever persists or returns after taking the medication, think that the doctor's prescription is ineffective and rush to the emergency room in the middle of the night, even consulting several doctors in a row. This is truly unnecessary! Remember, we are treating the illness, not the fever! Fever caused by an illness naturally fluctuates, whether or not antipyretics are used. Once the acute phase passes, the fever will subside!
How to care for a feverish patient?
As mentioned earlier, my three children have never used antipyretics, so how did I care for them? Simply put, try to make the patient as comfortable as possible! For example, ensure good ventilation in the room, encourage drinking plenty of water to replenish lost fluids, avoid overdressing and keep clothing comfortable, use warm water in winter and tap water in summer for wiping, and use ice pillows to cool the head and face. These are all good methods to help the patient. I often tell young mothers, "An excellent mother should learn to manage her child's fever without using antipyretics."
Conclusion
Fever is not an illness; it is a symptom caused by an illness! The purpose of seeing a doctor is to treat the illness, not the fever. The use of antipyretics is merely to make the patient more comfortable. To alleviate the public's distress over "seeing a doctor for a fever," health authorities should educate the public on the correct approach to and management of fever. When I see patients, whether to prescribe antipyretics is often left to the patient's discretion. I have found that many young mothers can accept the concept of not using antipyretics, thereby reducing the number of times they bring their children to see a doctor. I believe that administering injections solely to reduce fever should be avoided. As the public's medical knowledge improves, unless the doctor believes that antipyretics will benefit the patient's health (which is rare), the decision to prescribe antipyretics should be made by the patient or their family.
Myths about Reducing Fever
If I told you that my three children have never used fever-reducing medicine (including fevers above 40 degrees Celsius), would you believe me? I have seen tens of thousands of patients and never given them a single fever-reducing injection. Would you believe that? You can believe it because I don’t like to reduce fevers! In fact, during the treatment of an illness, fever is the least necessary thing to address because fever is not a disease—it is a natural and healthy physiological response when the body is sick. Having a fever indicates that the immune system is functioning normally. Fever is a warning sign that something is wrong with the body, like an air raid siren going off when enemy planes approach. What we need to treat is the illness, to repel the enemy planes. Why would we try to destroy the alarm?
**Causes of Fever**
In our brain, there is a region called the hypothalamus, which is responsible for regulating body temperature and keeping it within a certain range. When this temperature-regulating center is affected by something, a fever occurs. There are many causes of fever, but the vast majority are due to infections by pathogens (including bacteria, viruses, rickettsia, fungi, etc.). After a pathogen infects the body, the immune system mobilizes white blood cells to fight the enemy and stimulates lymphocytes to produce antibodies to help eliminate the invaders. When pathogens and white blood cells battle, their remnants release something called "pyrogens," which circulate through the bloodstream to the hypothalamus and raise the body temperature, causing a fever! Therefore, fever is a healthy response of the body to disease when the immune system is functioning normally. Conversely, if the immune system is too weak, such as in some premature infants, elderly individuals, or severely ill patients, they may not even be able to develop a fever.
**Can Fever Go Too High?**
No! Most people think that a fever should be reduced immediately, otherwise, what if it gets too high and damages the brain? They often cite examples to prove this. In reality, every example is a misunderstanding! The cases they mention are usually meningitis. Meningitis is a disease where pathogens invade the brain and cause inflammation. Its main symptoms include headache, neck stiffness, vomiting, high fever, and coma. After recovery, some people may have sequelae such as epilepsy or intellectual disabilities. The general public doesn’t know about "meningitis" as a disease; they only know that the patient had a high fever and blame the fever for the damage. This is a huge misunderstanding! In fact, for a meningitis patient, no matter how high the fever is or whether fever-reducing medicine is used, the outcome is the same. Think about it: if the pathogens are damaging brain tissue, the focus should be on eliminating the pathogens. What’s the use of fever-reducing medicine? Besides, fever has a physiological limit. The temperature will stop rising at a certain point and won’t keep increasing. A persistent high fever is because the pathogens haven’t been completely eliminated. Once the pathogens are gone, the fever will naturally subside!
**Is Fever-Reducing Medicine Necessary?**
Fever is a warning sign that the body is sick. The height, pattern, and duration of the fever can provide doctors with valuable information for diagnosis and treatment. Inappropriate use of fever-reducing medicine can sometimes mask symptoms and affect diagnosis. For example, in cases of fever accompanied by abdominal pain, it is a medical consensus not to administer fever-reducing medicine (also known as antipyretics or analgesics) before a diagnosis is made. However, fever can cause significant discomfort, so whether to use fever-reducing medicine should be decided on a case-by-case basis. In non-contraindicated situations (without abdominal pain), it might be appropriate to give fever-reducing medicine if a student needs to continue attending classes. For parents who are hard to reason with, giving some fever-reducing medicine might be justifiable. If it’s during work hours, I might consider taking fever-reducing medicine, as a fever can cause flushed cheeks, palpitations, and weakness, making it hard to face patients. If I’m at home with nothing to do, I’d just drink more water and rest until the fever subsides. Children tolerate fever better than adults. Sometimes, even with a fever above 39 degrees, they can still be lively and active as if nothing is wrong.In that case, why give antipyretics?
I do not agree with giving antipyretics as soon as a fever occurs.
When I first started working at the Dacun Health Center, I noticed that the nursing staff routinely gave antipyretics after administering vaccines, which I found quite inappropriate. It easily leads people to think that they should immediately take medicine to reduce a fever. Therefore, I instructed the nursing staff to stop giving antipyretics and instead educate the public. Fever caused by vaccines (mainly the triple vaccine) usually subsides within two or three days and does not require treatment! A study from the Veterans General Hospital divided children who developed a fever after receiving the triple vaccine into two groups: one group was given antipyretics, and the other was not. The results showed that the group not given antipyretics had higher serum antibody concentrations, indicating that fever does have some benefits in driving the immune response.
Is it necessary to administer fever-reducing injections?
The principle is "avoid injections if possible, and avoid medication if possible." "Fever-reducing injections" have long been banned in advanced countries! Perhaps because people in our country are too fond of injections, the Department of Health has not yet explicitly prohibited them. Many private practitioners also continue to use them without hesitation! However, from a purely medical and educational standpoint, fever-reducing injections should be avoided as much as possible! Apart from the various complications that injections may cause, consider how many anxious parents bring their children to the clinic in the middle of the night for a fever that they could have managed themselves. How many fever patients or their family members actively request an injection after seeing a doctor? This may be a matter of opinion, and perhaps some doctors treat their own family members the same way! However, I still firmly believe that one of the benefits of being a doctor's child is getting fewer injections than others!
Should you see a doctor for a fever?
I recommend that patients with a fever see a doctor as soon as possible to allow the doctor to diagnose and treat the illness. After receiving medication, unless there are significant symptoms other than the fever, you should confidently finish the prescribed medication and avoid repeatedly seeking medical attention just because of the fever! Many parents, upon finding that their child's fever persists or returns after taking the medication, think that the doctor's prescription is ineffective and rush to the emergency room in the middle of the night, even consulting several doctors in a row. This is truly unnecessary! Remember, we are treating the illness, not the fever! Fever caused by an illness naturally fluctuates, whether or not antipyretics are used. Once the acute phase passes, the fever will subside!
How to care for a feverish patient?
As mentioned earlier, my three children have never used antipyretics, so how did I care for them? Simply put, try to make the patient as comfortable as possible! For example, ensure good ventilation in the room, encourage drinking plenty of water to replenish lost fluids, avoid overdressing and keep clothing comfortable, use warm water in winter and tap water in summer for wiping, and use ice pillows to cool the head and face. These are all good methods to help the patient. I often tell young mothers, "An excellent mother should learn to manage her child's fever without using antipyretics."
Conclusion
Fever is not an illness; it is a symptom caused by an illness! The purpose of seeing a doctor is to treat the illness, not the fever. The use of antipyretics is merely to make the patient more comfortable. To alleviate the public's distress over "seeing a doctor for a fever," health authorities should educate the public on the correct approach to and management of fever. When I see patients, whether to prescribe antipyretics is often left to the patient's discretion. I have found that many young mothers can accept the concept of not using antipyretics, thereby reducing the number of times they bring their children to see a doctor. I believe that administering injections solely to reduce fever should be avoided. As the public's medical knowledge improves, unless the doctor believes that antipyretics will benefit the patient's health (which is rare), the decision to prescribe antipyretics should be made by the patient or their family.