Q: What do you usually do when you have a fever? At the first sign of fever, many people take aspirin, Tylenol, Advil, or Motrin.
Q: What is the result? Aspirin, acetaminophen (Tylenol), and ibuprofen (Advil and Motrin) quickly reduce a fever
Q: Why did you have a fever? Generally, fever is not itself an illness. Rather, it is your body’s response to cues that there is a bacterial or viral infection. In response to infection, your temperature set point is raised, because pathogens are more easily brought under control by the body’s defenses at higher temperatures. (Ectotherms use a similar strategy, moving to warmer areas when they have an infection!)
Q: How does reducing a fever interfere with your body’s defenses? Blocking a fever by taking aspirin or other medication may reduce your body’s ability to fight infection. A recent well-
Q: Is the lesson here about more than fever? Yes. There are other signs of infection that, as defenses rather than part of the illness itself, maybe shouldn’t be fought. For example: (1) Coughing: the use of codeine to block coughing after surgery increases the risk of pneumonia; the coughing is helpful. (2) Diarrhea: anti-
What can you conclude? Is this the dawn of Darwinian medicine? This perspective on when to treat and when not to treat symptoms is called “Darwinian medicine.” It represents a newfound appreciation for the fact that many protective responses have evolved that may be useful to the organism. Of course, suffering is not always the solution. There can be real costs to vomiting, diarrhea, coughing, fever, and other body defenses. Opting not to treat them isn’t necessarily the best solution if, for example, antibiotics can bring an infection under control easily. Either way, bringing an evolutionary perspective to medical decision making can be valuable.
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