Sunday, December 9, 2012

To a hammer, everything is a nail - to a thermometer everything is fever: but was penicillin fever BAD ??

Fever is closely associated with virtually any and every kind of illness - but does it make the disease worse or is it one of its cures ?

After the introduction of clinical thermometers in the 1870s, this fundamental question became moot.

Doctors and nurses took up this new hammer with great enthusiasm and soon saw nails everywhere.

They couldn't actually do much for most illnesses but now the carefully kept temperature chart's hills and valleys allowed them to semi-accurately predict that the patient was going to get better or go downhill.

A few doctors actually tried to raise a fever for a therapeutic purpose ,with mixed results, but most felt honour-bound to keep it down at normal at all costs.

Any drug they introduced into a patient that raised their temperature, even if only a few degrees for a few hours, made most medical staff recoil in horror.

But did it actually harm the patient ?

No one knew and no one cared to find out.

Few asked if a bacteria infection or a foreign protein (introduced accidentally along with a pneumonia serum for example) was the instigator of a temperature change, why then was fever itself always created by the body ?

Created for its own reasons - perhaps even its own good reasons.

The claim that any "non-store-bought" penicillin (rather like mom's home-made bread) was potentially lethal, was all down to reports that a sometimes a patient's temperature went up a few degrees for a hour or so, after an injection with hospital-made penicillin.

(And very often with store-bought industrial penicillin as well, in point of fact !)

This sort of minor side effect was not uncommon with many drugs and penicillin patients could in fact count themselves lucky.

There is no drug without side effects - never has been, never will be.

These side effects - often far more lethal than a short sharp temp rise - must always be judged as to their absolute danger and frequency.

And then also weighed, relatively speaking, against the alternative choices - which could be the untreated condition rapidly sliding into death.

Fever was just an excuse

"Penicillin Fever" was just an excuse, an excuse for hundreds of thousands of doctors world-wide between 1928 to 1943 to explain away why they choose not to inject un-refined hospital-made penicillin into their dying patients.

But I rather doubt that the doctor St Luke and his boss will buy that sort of excuse....

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