正宗西医这样看待发烧

三七生

翻译：寻找中医
－－－－－－－

综述

当你或者你的小孩感到不舒服的时候，也许你会做的第一件事情就是看看是否发烧了。尽管发烧本身不是病，它通常是你的身体发生了问题的一个迹象。然而发烧不一定是件坏事。事实上，发烧有可能是在帮助你的身体战胜数量众多的细菌和病毒的感染，而发烧在这个过程中起到了关键的作用。
如果你不是大人的话，一次发烧也许会让你很不舒服，但是如果温度不达到103华氏度（约为39.4摄氏度）或者以上的话，一般是没有危险的。然而，对于很小的小孩以及婴儿来说，温度只要高那么一点点，也许就意味着严重的感染。对于新生的婴儿来说，不是发烧，而是低于正常温度，也许是严重疾病的一个迹象。
因为发烧能在不同情况下发生，其他迹象和症状通常都有助于辨识原因。如果你不知道自己为何发烧，最好不要试图降低体温。这样做只会掩盖你的症状，使得更难确定病因。除此而外，有些专家认为，强行降体温事实上会干扰身体的免疫反应。这是因为引起感冒和其他肺部感染的病毒在低温下繁殖得更快。事实上，身体会通过产生低烧的方式来帮助消灭病毒。除此而外，多数发烧通常时间较短，一般几天就没事了。

迹象和症状

在体温高于正常范围的时候，发烧就产生了。正常体温应该在37摄氏度上下（上下可以稍微浮动一点）。这是为什么难以定义发烧的原因。但是一次“严重的”发烧通常可以定义为口腔或者耳部温度为102华氏度（约为38.9摄氏度），或者直肠温度103华氏度（约为39.4摄氏度）。直肠温度的读数一般大于口腔温度1华氏度左右。

根据引起发烧的原因，其他迹象和症状也许还包括：
•        发汗
•        发抖
•        头痛
•        肌肉酸疼
•        缺乏食欲
•        脱水
•        全身虚弱

很高温度的发烧（介于103华氏度（39.4摄氏度）到106华氏度（41.1摄氏度）之间）也许会引起幻觉，神智不清，亢奋甚至抽搐。

大约4%的小于5岁的小孩会发生因发烧导致的痉挛（发烧痉挛）。在小孩的温度迅速波动的时候，痉挛的症状就发生了，包括暂时失去意识以及抽搐。尽管痉挛的症状很令人焦心，多数小孩的症状不会再持续。发烧痉挛通常由小孩子的这些疾病引发，诸如红疹，病毒感染，扁桃体发炎以及皮疹。


原因

甚至在身体正常的时候，体温在一天之内也会变动——早晨低，午后和夜晚高。事实上，正常体温可以在97华氏度到99华氏度（36.1—37.2摄氏度）之内变动。尽管大多数人认为98.6华氏度（37摄氏度）是健康人的体温，你的体温也许会高出或者低于这个温度1度。
体温是由体丘下部来调节的，体丘下部在脑子的底部区域，在身体的整个系统里面担任了调温器的作用。当身体发生状况的时候，体温只是被调节得高几个点。新的体温也许是102华氏度（约为38.9摄氏度），而不是原来的97或者98华氏度（36.1，36.7摄氏度）。


发烧时发生的情况

当身体试着提高温度的时候，发烧就开始了。你会感到寒冷并通过发抖产生热量来驱赶寒冷。此时，你也许会用厚的毛毯来把自己裹起来，并把取暖电毯的温度调高。但是事实上在你的身体达到新的温度时，你很可能会感到发热。在你的体温最后开始达到正常的时候，你也许会大量地出汗，这是你的身体释放高温产生热量的方式。
发烧通常意味着你的身体对病毒或者细菌感染的抵抗反应。有时，轻度的中暑衰竭，太阳曝晒过度或者某种炎症状况（诸如暂时的动脉炎症，譬如说脑动脉炎）也许也会引发发烧。恶性肿瘤或者某些肾癌引起发烧的几率很小。
发烧也可能是一些药物的副作用引起，譬如说抗生素和用来治疗过度紧张以及抽搐的麻醉药。一些婴儿和小孩在注射免疫针之后会引起发烧，譬如说白喉，破伤风，百日咳或者肺炎疫苗。
尽管在多数情况下发烧的原因能找到，并且能够得到治疗，有时还是不可能确定发烧的原因。如果你发烧超过100.9华氏度（38.3摄氏度）持续三个星期以上，并且为你治疗的医生在经过充分的诊断之后，也不能确定病因，那么诊断结果也许会是不明病因的发烧。


何时寻求医治

发烧本身也许不是引起担忧的原因——或者说看医生的原因。然而在如下情况下，你应该为你的宝宝，小孩或者你自己寻求医治。

婴儿

相较于大人，对于婴儿以及小孩来说，不明原因的发烧是寻求医治的主要原因。如果你的婴儿：

•        小于2个月并且直肠温度大于或等于100.4华氏度（38摄氏度），即便你的宝宝没有其他生病的迹象或者症状，为安全起见还是要叫医生。

•        大于2个月并且直肠温度大于或者等于102华氏度（38.9摄氏度）

•        新生儿并且温度低于正常体温——直肠温度低于95华氏度（35摄氏度）

•        发烧并且不明原因的亢奋，譬如在你给宝宝换尿片的时候或者挪动宝宝的时候，宝宝嘶声裂肺地哭。一些婴儿也许正发烧并显得昏昏欲睡毫无生气。对于婴儿以及小于两岁的小孩来说，这些也许是脑膜炎的迹象——包裹脑子以及脊髓的膜质和液质的感染以及炎症。如果你担心宝宝也许得了脑膜炎，立刻寻求医治。不要等到第二天早晨才去看医生——脑膜炎是一种急症。


小孩

尽管高温也许会引起家长很大的担忧，其实小孩通常较能忍受发烧。然而，最好是根据你的小孩的行为，而不是根据任何测得的温度来指导你。如果你的小孩发烧了，但是他还是比较活泼并且喝水很多，还想玩耍，也许你就不必担忧。
如果你的小孩很倦怠或者很急躁，并一再呕吐，头很痛或者肚子痛，或者有其他使得他很不舒服的症状，请联络你的儿科医生。如果你的小孩被留在一辆非常热的车子里面呆了很久，并且发烧的话，请立即寻求医治。
如果一个小于两岁的小孩持续发烧超过一天，或者一个大于或等于两岁的小孩持续发烧超过三天的话，请联络医生。
除非医生建议，否则如果发烧低于101华氏度（38.3摄氏度）的话，不要采用任何药物治疗。


成人

发烧时寻求医治如果：

•        体温超过104华氏度（40摄氏度）

•        发烧超过三天

此外，如果在发烧时伴随有以下迹象以及症状的话，请寻求医治：

•        严重的头痛

•        喉咙肿得很厉害

•        异常皮疹

•        眼睛对亮光的异常过敏

•        歪脖并且在头前倾时感到痛

•        意识错乱

•        持续呕吐

•        呼吸困难并且胸痛

•        极端倦怠或者亢奋

•        腹痛或者小便痛

•        其他不明原因的症状


诊断

根据其他症状并且在常规检查完之后，医生一般会诊断出发烧的原因。有时需要其他的测试来确定诊断结果。例如，如果医生怀疑肺炎的话，也许会在常规检查之后，让你来一个胸透。在其他情况下，也许会让你进行血液检查或者尿检来看是否有感染的迹象。
如果你发烧温度不高持续三周，但没有其他症状，医生也许会建议你做些检测来帮助发现病因。这些检查也许包括血液检查以及胸透。


并发症

在小于5岁的小孩中，很小一部分会因为体温迅速波动而引发痉挛。尽管小孩的状况会使父母担忧，多数痉挛不会有进一步的影响。
如果痉挛发生的话，让小孩侧躺。将任何扎人的东西从小孩身边拿走，解松小孩的衣物并且保护好你的小孩不要受到外物伤害。不要尝试把任何东西放在小孩的嘴巴里面来阻止小孩的痉挛。尽管大多数痉挛自动会停下来，如果痉挛超过10分钟的话，赶紧寻求医治。
如果可能的话，对痉挛的时间进行计时。因为痉挛很令人焦心，所以痉挛的时间通常显得比实际时间要长。也要注意小孩身体哪一部分先开始颤抖。这个有助于医生明白痉挛的原因。应该尽快让医生来给小孩治疗。


治疗

医治取决于发烧病因。医生很可能会对细菌感染开一些抗生素药，譬如肺炎或者喉部链锁状球菌感染。对于肠胃型流感（肠胃炎）和单核细胞增多症这些病毒感染来说，最好的治疗方法通常是休息以及大量饮水。
医生也许会建议你服用一些非处方药，譬如退热净( 一种替代阿司匹林的解热镇痛药，羟苯基乙酰胺)或者布洛芬(抗炎、镇痛药)来降高温。成人也许还会服用阿斯匹林(解热镇痛药)。但是不要给小孩服用阿司匹林。如果服用的话，也许会引发一种很少见但是潜在致命的神经紊乱症——雷氏综合症！


预防

最好的防止发烧的方法是尽量不要和有传染性的病源接触。最有效也是最简单的方法之一就是——勤洗手。
教育小孩勤洗手，尤其在饭前和便后以及在拥挤的公共场所或者和宠物呆过之后。告诉他们怎么样仔细洗手，要用香皂洗每只手的前边和后边，并用流动的水将手完全冲洗干净。在你没有香皂和水的时候，身上要带上洗手用的小毛巾。如果可能的话，教育你的小孩不要用手去摸鼻子，嘴巴或者眼睛——这些是病毒感染传播最主要的途径。

三七生

这是从美国最负盛名的MAYO CLINIC所出。

首先，跟中医一样，他们也认为发烧是人体排毒的表现。

对成人，如果没有别的什么特别不适的症状，烧到40度（104F），你可以挺三天，还不退烧，再找医生。

理论上来讲，小孩可以烧到更高，但是大人慌了手脚，赶紧上医院，本来是对医生的信任，来寻求帮助，可是我们的白衣天使们（不是所有）却滥用这种信任，为了自己的经济收入，不惜以戕害无辜孩子的身体作代价。

如果有兴趣，还是读原文吧。我感觉跟中医的处理很像，只是他们没有中药。


Original Article:http://www.mayoclinic.com/health/fever/DS00077
________________________________________
Fever
Overview
When you or your children aren't feeling well, one of the first things you may do is check for a fever. Although a fever isn't an illness itself, it's usually a sign that something's going on in your body. Yet fevers aren't necessarily bad. In fact, they seem to play a key role in helping your body fight off a number of bacterial and viral infections.
If you're an adult, a fever may be uncomfortable, but it usually isn't dangerous unless it measures 103 F or higher. For very young children and infants, however, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature — rather than a fever — may be a sign of serious illness.
Because a fever can occur with many different conditions, other signs and symptoms can often help identify the cause. If you don't know why you have a fever, it's best not to try to lower your temperature. This may only mask your symptoms and make it harder to determine the cause. In addition, some experts think that aggressively treating all fevers actually interferes with your body's immune response. That's because the viruses that cause colds and other respiratory infections thrive at cool temperatures. By producing a low-grade fever, your body may actually be helping eliminate the virus. What's more, most fevers go away in a relatively short time — usually within a few days.
Signs and symptoms
A fever occurs when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average temperature of 98.6 F. That's why it's hard to say just what a fever is. But a "significant" fever is usually defined as an oral or ear temperature of 102 F or a rectal temperature of 103 F. A rectal temperature reading is generally 1 degree Fahrenheit higher than an oral reading.
Depending on what's causing your fever, additional signs and symptoms may include:
•        Sweating
•        Shivering
•        Headache
•        Muscle aches
•        Lack of appetite
•        Dehydration
•        General weakness
Very high fevers, between 103 and 106 F, may cause hallucinations, confusion, irritability and even convulsions.
Approximately four percent of children younger than age 5 experience fever-induced seizures (febrile seizures). The signs of febrile seizures, which occur when a child's temperature rises or falls rapidly, include a brief loss of consciousness and convulsions. Although these seizures can be extremely alarming, most children don't experience any lasting effects. Febrile seizures are often triggered by a fever from a common childhood illness such as roseola, a viral infection that causes a high fever, swollen glands and a rash.
Causes
Even when you're well, your body temperature varies throughout the day — it's lower in the morning and higher in the late afternoon and evening. In fact, your normal temperature can range from about 97 to 99 F. Although most people consider 98.6 F a healthy body temperature, yours may vary by a degree or more.
Your body temperature is set by your hypothalamus, an area at the base of your brain that acts as a thermostat for your whole system. When something's wrong, your normal temperature is simply set a few points higher. The new set-point, for example, may be 102 F instead of 97 or 98 F.
What happens with a fever
When a fever starts and your body tries to elevate its temperature, you feel chilly and may shiver to generate heat. At this point, you probably wrap yourself in your thickest blanket and turn up the heating pad. But eventually, as your body reaches its new set-point, you likely feel hot. And when your temperature finally begins to return to normal, you may sweat profusely, which is your body's way of dissipating the excess heat.
A fever usually means your body is responding to a viral or bacterial infection. Sometimes heat exhaustion, an extreme sunburn or certain inflammatory conditions such as temporal arteritis — inflammation of an artery in your head — may trigger fever as well. In rare instances, a malignant tumor or some forms of kidney cancer may cause a fever.
Fever can be a side effect of some medications such as antibiotics and drugs used to treat hypertension or seizures. Some infants and children develop fevers after receiving routine immunizations, such as the diphtheria, tetanus and pertussis (DTaP) or pneumococcal vaccines.
Sometimes it's not possible to identify the cause of a fever. If you have a temperature higher than 100.9 F for more than three weeks and your doctor isn't able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin. In most cases, though, the reason for your fever can be found and treated.
When to seek medical advice
Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.
For infants
An unexplained fever is greater cause for concern in infants and children than in adults. Call your baby's doctor if your baby:
•        Is younger than 2 months of age and has a rectal temperature of 100.4 F or higher. Even if your baby doesn't have other signs or symptoms, call your doctor just to be safe.
•        Is older than 2 months of age and has a temperature of 102 F or higher.
•        Is a newborn who has a lower-than-normal temperature — under 95 F rectally.
•        Has a fever and unexplained irritability, such as marked crying when you change your baby's diapers or when he or she is moved. Some infants might have a fever and seem lethargic and unresponsive. In infants and children younger than age 2, these may be signs of meningitis — an infection and inflammation of the membranes and fluid surrounding your brain and spinal cord. If you're worried that your baby might have meningitis, see your doctor right away. Don't wait until morning to see your usual physician — meningitis is an emergency.
For children
Children often tolerate fevers quite well, although high temperatures may cause parents a great deal of concern. Still, it's best to be guided more by how your child acts than by any particular temperature measurement. If your child has a fever but is responsive and is drinking plenty of fluids and wanting to play, there's probably no cause for alarm.
Call your pediatrician if your child is listless or irritable, vomits repeatedly, has a severe headache or stomachache or has any other symptoms causing significant discomfort. If your child has a fever after being left in a very hot car, seek medical care immediately.
Also call your doctor if fever persists longer than one day in a child younger than age 2 or longer than three days in a child age 2 or older.
Don't treat fevers below 101 F with any medications unless advised by your doctor.
For adults
Call your doctor about a fever if:
•        Your temperature is more than 104 F
•        You've had a fever for more than three days
In addition, call your doctor immediately if any of these signs and symptoms accompany a fever:
•        A severe headache
•        Severe swelling of your throat
•        Unusual skin rash
•        Unusual eye sensitivity to bright light
•        A stiff neck and pain when you bend your head forward
•        Mental confusion
•        Persistent vomiting
•        Difficulty breathing or chest pain
•        Extreme listlessness or irritability
•        Abdominal pain or pain when urinating
•        Any other unexplained symptoms
Screening and diagnosis
Your doctor will likely diagnose the cause of your fever based on your other symptoms and a physical exam. Sometimes you may need additional tests to confirm a diagnosis. If your doctor suspects pneumonia, for instance, you may have a chest X-ray following your physical exam. In other cases you may have blood or urine tests to check for signs of infection.
If you have a low-grade fever that persists for three weeks or more, but have no other symptoms, your doctor may recommend a variety of tests to help find the cause. These may include blood tests and X-rays.
Complications
A rapid rise or fall in temperature may cause a febrile seizure in a small percentage of children younger than age 5. Although they're alarming for parents, the vast majority of febrile seizures cause no lasting effects.
If a seizure occurs, lay your child on his or her side. Remove any sharp objects that are near your child, loosen tight clothing and hold your child to prevent injury. Don't place anything in your child's mouth or try to stop the seizure. Although most seizures stop on their own, call for emergency medical assistance if the seizure lasts longer than 10 minutes.
If possible, try to time the seizure using your watch or a clock. Because they're so alarming, seizures often seem to last longer than they really do. Also try to note which part of your child's body begins to shake first. This can help your doctor understand the cause of the seizure. Your pediatrician should see your child as soon as possible.
Treatment
Medical treatment depends on the cause of your fever. Your doctor will likely prescribe antibiotics for bacterial infections, such as pneumonia or strep throat. For viral infections, including stomach flu (gastroenteritis) and mononucleosis, the best treatment is often rest and plenty of fluids.
Your doctor may also suggest taking over-the-counter medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to lower a very high fever. Adults may also use aspirin. But don't give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome.
Prevention
The best way to prevent fevers is to reduce your exposure to infectious diseases. One of the most effective ways to do that is also one of the simplest — frequent hand washing.
Teach your children to wash their hands often, especially before they eat and after using the toilet, spending time in a crowded public place or petting animals. Show them how to wash their hands vigorously, covering both the front and back of each hand with soap, and rinsing thoroughly under running water. Carry hand-washing towelettes with you for times when you don't have access to soap and water. When possible, teach your kids not to touch their noses, mouths or eyes — the main way viral infections are transmitted.

三彩风车

加州的同学回来也是这样说的。主治医生告诉她们，39度以下基本是休息和喝多点水，烧一下能增强免疫力，39度以上才服非处方退烧药。她孩子都6岁了，从没挂水，身体很康健。
所以我觉得西药不可怕，可怕的是为医者贪婪的心。中国滥用抗生素太烂了。

dglolo

中国政府是以药养医，发药产业支持GPD增长。

“人”对中国来讲从来不缺。

成成

我上星期烧到37.8，吃了一片安乃近

taracat

多谢分享!
译者辛苦了!

棒棒老妈

感谢分享！
中国的悲哀啊

开心一笑

一定推荐给更多的朋友看

柠檬绿茶

感谢分享!现在对医院没有信心了.这次孩子感冒发烧40度,也没有到医院.

laurymao

这跟国内的医学院的教育相关，师道授业，口口相传，造就了现在医生对发烧普遍的错误用药，要从根本上解决问题，还是要解决源头的问题。

濡沫斋

这也是我一贯的观点，不要对立思维，靠贬低西医来抬高中医。要看真正的西医是如何看待和治疗疾病的。我觉得中国西医发展到目前的状况，主要原因是体制和人心的问题，而不是西医这种技术本身的问题。中国文化向来兼容并包，海纳百川，而不是固步自封的。

濡沫斋

希望多一些人来翻译和传播正确的观点。

妞妞06

谢谢先生的分享，我宝宝之前还吃过阿司匹林，现在想想都怕怕。上次宝宝感冒，她爷爷总是问我有没给她消炎药等吃，我就总是说给了给了（他之前是铁路医院药材科的，没法说服他，只好善意的骗了）。从两个月前进了三七网，我是绝不会再宝宝这些药吃的了。希望在中国能有多些传播这些正确的观点，不要利益熏心。

内伤

有一件事我一直耿耿于怀。。。

我宝宝三个月大时，在儿童医院做手术后发烧，回到病房一量38。5度，那时候我什么也还都不懂，就飞快去找医生，中午医生都下班了，护士就去冰柜给我拿个冰袋来，叫我放孩子头上，我什么都不懂，就把冰袋直接放在孩子头上了，任她怎么哭都没有再拿开过。因为术后不能动。宝宝由我和我婆婆还有保姆压着腿和胳膊。没多久我婆婆骂我，我受不了就跑出病房，冰袋由保姆继续敷宝宝头上。一个小时后我回病房，那个冰袋已经完全化成了水。这时候隔壁病床过来一个人，说冰袋不能这么直接放头上，要垫一个毛巾。。。
刚做过大手术的宝宝又直接吸入这些寒，对宝宝有什么影响？影响多大？
这事我一想起心就抽搐。谁能给我解解惑？？
我宝现在十个月大。

strongwsq

我们这里的的儿科，只要孩子烧到38.5度以上，用听诊器一听，什么也不说就说要输水，问他不输行不行，他说不输好不了。我儿子从小到现在的几次发烧，都是有点高烧，血象不高，问他怎么回事，就说气管炎什么的，然后就输水。弄的孩子现在脾胃弱，吃饭很不好。