When we are threatened with toxic or infectious agents our bodies can muster a fearsome fightback. At a local level this is inflammation; when the threat is on a wider level, eg the bloodstream, the result is a fever,
Inflammation clssically was seen to move through 4 stages after the initial injury or intrusion, named from the ancient Greek observations. Rubor or redness marks the increased flow of blood into the area. This brings in more neurophils and other white blood cells (see Part 1). Calor refers to the heat that is generated by this increased blood flow. Tumor is the swelling that follows the blood congestion and Dolor is the pain the accompanies the release of histamine and other ‘cytokines’ that are engaged in the battle to deal with the threat. All these ‘acute’ stages are signs of a healthy response and if the measures are effective the inflammation subsides. However if the intrusion overwhelms or resists these defences the inflammation persists and becomes ‘chronic’.
Chronic inflammation often is called by a word ending in ‘itis’: cystitis, bronchitis, gastritic, arthritis, hepatitis and so on. However we now know that a great many diseases and longterm conditions are really a form of chronic inflammation. These include some surprises: heart and cardiovascular disease, diabetes, depression, chronic fatigue syndrome, bipolar disorder, dementias, all autoimmune diseases (see Part 4) and chronic inflammation can be a major feature in cancer.
The usual approach to a chronic inflammatory condition is to use anti-inflammatories like steroids or NSAIDs (eg ibuprofen). These suppress the inflammation but do not remove the cause. Another option (that can also be used alongside anti-inflammatories, is to find ways of diminishing the threat. This will be the focus of these posts and courses. As we go through each form of chronic inflammation we will be suggesting the most effective approaches we know to respond the body’s call for help in fending off trouble.
Fever is a similar a call to action involving the body as a whole. Infectious organisms unwittingly provoke our inner thermostat to increase our temperature. When the thermostat setting is higher than the actual body temperature we feel cold. At this point we wrap up, take a hot bath and drinks, and shiver (muscle contractions produce heat). A body temperature a a few degrees above normal leads to a very much increased neutrophil and other defensive activities. If all goes well and these fired up defenders get rif of the pathogen then the thermostat is allowed to set down: the fever ‘breaks’. When the thermostat is lower than the body temperature we feel hot: we throw off our bedclothes, and splash with and drink cold water.
Fever management involves learning that when we feel cold our body temperature is rising and whne we feel hot it is lowering. Additional measures may be needed more when we still feel cold. Handling a fever does call for many precautions and safeguards and will feature in detail in a another edition of this gazette.