Fever
Traditionally Categorization of Fevers has been complicated and involved. In general, Humoral Systems will divide Fever into Humoral types.
TCM has a advanced system of the development of a pathogen from Exterior to Interior of the Body. This is dealt with in detail in our page on Shang Han Lun.
The primary classifications of Fever in the West are:
- Acute Fever–acute Fever as seen in Cold, Influenza
- Burning (High) Fever–as seen in High Fever which occurs with more severe infections
- Fever from Excess Bile–Fever associated with excess Heat in the Body, excess Liver Heat in particular
- Intermittent Fever–Fever that comes and goes as in Malarial Fevers
- Chronic Fever–persistent, on going Fever
- Hectic Fever–Fever with Yin deficiency and Wasting, often a low-grade Fever with Night Sweats; as seen in Tuberculosis
Fever may also come from any of the organs. For example, Lung Heat Fveer associated with Pneumonia, Stomach Heat Fever associated with Gastroenteritis, Liver Fever associated with acute Hepatitis etc.
Treatment
Treatment of Fever in its acute stage is by Diaphoretics, medicines that promote sweat, and are viewed as clearing the surface of the body in TCM. That is, the the superficial layer of skin and mucosa that is first penetrated by invading pathogens.
Treatment of ongoing Fever or High Fever uses Cold medicines to clear the excess Heat. Mineral medicines like Tabasheer and Pearl are useful in High Fever. If there is an excess nature (ie. a strong person with Fever), Purging and Bloodletting are indicated.
Chronic Fever and Hectic Fever, as well as Fever in a weak individual, require simultaneous use of tonic medicines to strengthen the deficiency. Qi tonics which boost immunity (such as Astragalus, Elecampane, Withania or Licorice) can be used with medicines to clear Heat. Yin tonics are added in Hectic Fever where excessive or long-term Heat has damaged the Yin (Fluids) of the body, resulting in wasting with weakness.
Its interesting to note that many of the herbs traditionally used for Fever have either Anti-bacterial, Anti-viral or Anti-pyretic effects. Some also have immune-stimulating effects.
Diet & Regimen
1. ‘Feed a Cold, Starve a Fever” is an old addage. Fasting during an acute Fever is often the best medicine as it allows the body to focus on fighting the pathogen, and prevents a build-up of unhealthy Humors in the blood. Conversely, eating inappropriately can readily exacerbate a Fever or lead to complications.
2. “Water is the best medicine for Fever”. Drinking sufficient water is essential during a Fever, and drinking water alone has long been regarded as sufficient treatment in acute Fever (along with fasting). Water helps cool the body, reduce Fever, and prevent the burning of Humors. Water can be enhanced with the addition of a little Vinegar. Water taken as an infusion with appropriate cooling medicines can also enhance the febrifuge activity of water.
3. Sweating has long been indicated in Acute Fever. Various diaphoretic formulas are used in all systems to treat acute Fevers. Drinking copious amounts of hot infusions of herbs such as Elder flower, Peppermint, or Feverfew followed by going to bed and rugging up to induce a sweat can be very effective. Sweating is contraindicated if the body is dry or Yin deficient, or in cases of marked deficiency.
4. Bloodletting has also long been used for Fever caused by excess or Heat of the Blood. In old practice, one of the three arm veins was opened and several ounces were drained. TCM has several points used for Fever which require only pricking to remove a drop or 2 of Blood. This includes the top of the ear (Ear Apex), or pricking the tips of all fingers and thumbs.
5. Purging is sometimes indicated in Fever, especially with excess and constipation. Purging is generally not used in acute Fevers with sweating. TCM states that purging can lead a superficial pathogen down deeper into the body. However, even TCM has formulas containing purging medicines used for acute Fever, these generally indicated in acute Fever with Internal Heat (or excess).
Other Formula
| Troches for Burning Fever, Henbane seed Lettuce seed Poppy seed equal parts Form Troches with Lettuce juice Dose: 1–2 drams with cold water |
Chronic Fever
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Western Tradition |
Chinese Classification |
Hectic Fever, Yin-Deficient Fever
Hectic Fever is a Fever where the Blood, Fluids, Tissues or Organs are being affected by the Heat of Fever. Typically, there is chronic Low Grade Fever, Night sweats, Tidal or afternoon Fevers, heat of the soles and palms. It is equivalent to the Yin-Deficient Fever of TCM, where the Yin (Tissues and Organs, body substance) is being damaged by Heat. Ayurveda likewise has the concept of the 7 Tissues of the Body being burned by the Heat of Fever, Fever of Blood and Chyle being more superficial, progressing eventually to Fever of the Sperm and Essence.
Treatment of these types of Fever requires clearing Heat while simultaneously nourishing Yin and replenishing body Fluids.
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Western Tradition |
Chinese Classification |
Fever, Complex
Complex Fever has several factors involved. From the Humoral viewpoint, Bile and Phlegm mixed with Pituitous or Burnt Humors may be classed as Complex. It can also apply to Chronic Fever with mixed symptoms. Pills of Agrimony and Pills of Rhubarb were commonly used for chronic, obstinate and complex Fever.
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Western Tradition |
Chinese Classification |
Spotted or Eruptive Fevers
Spotted Fever is any of the infectious diseases that appear with Spots or rashes. The classic examples are Measles Mumps, Chickpox and Small Pox.
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Western Tradition |
Chinese Classification |
Fever from the Humors
Fevers of the Humors are Fever caused by the Humors.
1. BILE FEVER: Violent attacks, high temperature, diarrhea, sweating, feeling of heat, vomiting, bad smell from the mouth or throat, bitter taste, fainting, dullness of mind, thirst, yellowness of stool, stool and eyes
2. WIND FEVER: Shivering, irregular temperature, dry throat, insomnia, roughness and dryness of the whole body, moving pain, colic, flatulence; pain in the head, heart, or all over the body; Ayurveda says Fever from Wind will begin with pain in the Head, gradually affecting the whole body.
3. PHLEGM FEVER: moisture of the whole body, low temperature, lethargy, sweet taste, pale stool, clear urine, vomiting, stiff limbs, indigestion of food, excess sleep; Ayurveda says Fever due to excess Phlegm will begin with pain in the thighs, which gradually affects the whole body.
4. BLOOD FEVER: high fever, red macular rash, bleeding, maybe delirious
5. MIXED FEVER: combination of symptoms from above.
| Fever from Bile | Fever from Wind |
| Fumitory | 1. Ginger powder with Ghee (Ayurveda) |
| Chicory | Clove |
| Camphor | Calamus |
| White Sandalwood | Ginger |
| Yellow Myrobalan | Tabasheer |
| Rhubarb | Compound Fever |
| Rose juice | Confection of Dates |
| Manna | Decoction of Agrimony |
| Whey | Syrupus Diarhodon |
| The Bitter Decoction | Troches of Rose (Mesue) |
| Syrup of Fumitory | Troches of Agrimony |
| Syrup of Hops | Great Death-defying Pills (Maha Mrutyunjaya Rasa) |
| Syrup of Violet | Bile & Phlegm |
| Syrup of Sorrel juice | Syrup of Damask Roses |
| Electuary of Prunes (Diaprunis lenitiva) (Nicholas) | Fever from obstructed Bile and Phlegm that is difficult to eradicate |
| Chronic Fever from Bile | Wormwood |
| Asarum | Fumitory |
| Hops | Hops |
| Syrup of Hops | Rhubarb |
| Troches of Agrimony | Whey |
| Fever from Phlegm | Byzantine Syrup – Simple & Compound (Mesue) |
| 1. Ginger powder with Honey (Ayurveda) | Fever from Blood |
| Ginger | Syrup of Hops |
| Long Pepper | |
| Decoction of Stoechas | |
| Syrup of Stoechas | |
| Troches of Diarrhodon |
Periodic and Intermittent Fever
Periodic and Intermittent Fevers are Fevers that come and go. Classically, their categorisation was quite complex but were generally divided into 2, 3 and 4 day Fevers meaning the Fever came back every 2, 3 or 4 days. These are usually Malarial Fevers. Treatment depends on the individual. In acute stages with strong Heat, cooling medicines are used; in chronic cases with deficiency, strengthening medicines must be combined.
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Western Tradition |
TCM Classification |
Fever of the Organs
A Fever can be said to come from an organ when that organ is overheated and causes Fever. In reality, we are usually referring to an Infection or Inflammation of that Organ. In all cases there will be a rapid pulse, red tongue and yellow coating.
