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Fever

Susan R. Johnson MD, FAAP

The anthroposophical approach to fever is different then what I was taught during my residency. In anthroposophical medicine, a fever is seen as good because it actually strengthens the child's immune system and helps a child get further into their physical body. Once it is determined that the child does not have a serious illness like strep throat, pneumonia or meningitis, then one supports the fever process in the child. (For a febrile child less than 2 years of age, it is important to see a physician or nurse practitioner first to ensure that the child doesn't have these illnesses). Instead of letting a child "cool off" by running around barefoot in a t-shirt, I learned that it was important to encourage rest in a peaceful environment (without television and radio) and to keep the child's whole body warm during a fever. It is recommended that children be dressed in natural fibers with 3 layers on the top and 2 layers on the bottom, in addition to wool socks. The goal is to keep the warmth distributed throughout the body so that the child's forehead, hands, feet, and abdomen are the same temperature.

It is also important to give children lots of warm fluids (like linden tea, warm water with lemon juice, or warmed diluted fruit juices) and avoid anything cold (like popsicles). Somehow, if part of the body is cold then the body tries to compensate by

generating more heat, and this can cause the temperature to rise faster and higher. A rapid rise in temperature, especially in the first 24 hours of an illness, is linked to febrile seizures. It is important to avoid eating proteins (eggs, meat, milk etc) and fats when one has a fever. These foods are harder to digest, and proteins actually generate heat when they are metabolized and therefore, can cause the fever to go higher. Vegetable broth, rice, applesauce, bananas, and toast are carbohydrates and are easier foods to digest. Sugary foods, chocolate, and caffeinated drinks make children more irritable and are a stress to their metabolism.

As a parent, one of my first exposures to anthroposophical medicine was when my child had a cold and a fever of 104. He didn't have a sore throat, cough, or any difficulty breathing and his lungs were clear to auscultation. He also didn't have any vomiting, or a stiff neck, so there weren't any signs of meningitis. It was late at night, and I was up in the mountains and at least 30 minutes away from any hospital or urgent care. Well, my son started having auditory hallucinations with his fever. I gave him a lukewarm bath. The bath worked temporarily (for 5-10 minutes), but he would get chilled and shiver and then the fever rose higher than ever. After two more tepid baths which didn't work, I then called a friend who was an anthroposophical physician. I was told to feel my sons feet. If they were warm (and not cold) then I could apply a "Lemon Wrap". If the feet were cold I would need to warm them first using blankets or a covered hot water bottle before applying the lemon wrap.

Now, to make a lemon wrap you take a lemon, squeeze it into a pan and add 1/2 to

1 cup of water and heat it to almost boiling. I was then instructed to soak a pair of my cotton socks in this hot lemon juice (reportedly tepid or warm lemon juice also works), wring the socks out well, and put the hot socks on both of my child's feet (pulling the socks up over his calves). I then placed a pair of my wool socks over the cotton socks so his feet and legs would not get chilled and covered him with a blanket. All I could think of while doing this was the headlines in the morning newspaper- "Son dies of a febrile seizure while mother, who is a pediatrician, applies lemon juice to his calves".

Well, the headlines didn't turn out like that. My son's fever immediatedly came down to 102 and the hallucinations stopped, all in 10 minutes. I left the lemon wrap on his legs for a total of 20 minutes and then removed it. Lemon wraps are usually only needed when a child is restless and uncomfortable with a fever greater than 102 degrees. Usually one would apply no more than three lemon wraps in a 24 hour period while carefully observing the child for any signs of a more serious illness. A lemon wrap does not cause a large drop in temperature but rather it works by pulling the inflammation away from the head.

The rest of the night my son remained comfortable and only had a low grade fever of 99 to 100 degrees. The fever continued to subside on its own until it returned to normal by the next afternoon. I couldn't believe I had actually managed his fever without Tylenol. He seemed much more comfortable. He didn't have the alternating periods of chills and sweats. In addition, the fever brought to him a developmental burst. His personality had softened. He was kinder and gentler to other children, and he could do things at school, like coloring and painting, with a much greater ease. I had also grown closer to him because I really was there with him during his illness.

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© Susan R. Johnson, M.D., F.A.A.P.
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