P.U.O. (Pyrexia of Unknown Origin)

P.U.O (Pyrexia of Unknown Origin) – An Ayurvedic Perspective

Ayurvedic Treatment for P.U.O (Pyrexia of Unknown Origin)

Fever is a very common problem but sometimes we suffer from a persistent fever i.e. we have a high body temperature for quite a long period of time and we are clueless about the cause behind it. If this is the situation then it is possible that we have fallen a prey to P.U.O. i.e. Pyrexia of Unknown Origin.

The normal body temperature of a human being is 37 degree celcius or 96 Fahrenheit. When the body temperature rises beyond this standard then we call this condition as Fever. Fever is not a disease but just a symptom of a disease. One such fever is P.U.O. i.e. Pyrexia of Unknown Origin. In this condition, the temperature of the patient’s body rises above 38.3 degree celcius and this condition continues to remains so for atleast 3 weeks time or more. Even the tests conducted after a week of illness don’t help in the treatment.

To know about P.U.O. in more detail, we have with us our Ayurvedic expert, Dr. Parmeshwar Arora. Welcome to our show Dr. Parmeshwar.

Q. Most of the people are not aware of P.U.O., so how would you define this condition?

Generally if a person has persistent fever for three weeks or more and we have no clue about the reason for the fever even after various diagnostic lab tests and after studying patient’s history then we term this condition as P.U.O.. So, a fever which persists for a long period of time and has not been diagnosed even after various lab tests can be considered as Pyrexia of Unknown Origin.

Q. In Ayurvedic perspective, what could be the reasons behind this condition?

Generally these days when someone gets a fever, he tends to suppress it with the help of antipyretic drug. In my opinion, this is the main reason behind the problem of P.U.O.. Besides, a patient having fever is advised to get a bathe. By doing so, we are stopping the heat of body to escape. This results in the fever turning inwards. It is termed as antarmukhi jwar. For similar condition in recent times, people used to say that the fever has gone into the bones which meant that instead of escaping the body it has become internal. So, according to me, the suppressive treatment of fever is the main reason behind the problem of P.U.O. and this condition happens when the fever is suppressed beyond a certain extent.

Q. As you said, the fever which persists for 3 weeks is termed as P.U.O.. This is the primary symptom of P.U.O. but besides this are there any other symptoms too which can help the patient in identifying the disease?

I would like to make a correction here. See the fever can persist for three weeks in certain conditions like typhoid, tuberculosis and there are conditions where the fever can even persist for 3 months. But P.U.O. refers to such a persistent fever where even after investigations (on the basis of objective and subjective parameters) we are unable to make a diagnosis.

Q. Sometimes as people believe, fever can also happen as a result of fatigue or exertion. Then why is it so that we are unable to find a reason for this kind of fever i.e. P.U.O.?

Generally whenever a patient comes to us with a problem, we have two criteria. There are some subjective parameters e.g. a patients tells us that he gets fever every evening. During our investigation we ask him several questions like is he eating normally, or is he losing weight or is there any coughing involved too etc.. So on the basis of his symptoms we make a primary diagnosis that probably he is a patient of tuberculosis. This is an indication based on primary parameters. After that we consider objective parameters e.g. we send him for ELISA test, Mantoux test and other blood tests to ascertain increase in ESR and lymphocytes. So by investigating objective parameters we confirm the preliminary diagnosis prepared on the basis of subjective parameters. So, a condition where we have a symptoms of fever but we have no indication of any other problem. Besides, we have done all the investigations for objective parameters e.g. the test for malaria, Widal test for typhoid, ELISA test for tuberculosis, tests for oncology and inflammatory conditions like RA factor, CRP, NA etc.. If all the test reports are normal then we say that the person is a patient of P.U.O.. Sometimes the fever could be induced by a medicine too. So we ask our patient to stop taking certain medicine which he has been taking for a long time. Sometimes by doing so, his fever goes away on its own.

But if the condition is of P.U.O. then we have very good medicines in Ayurveda for it. I think Ayurveda can prove to be a very good solution to this problem.

Q. What kind of preventive measures are advisable for patients of P.U.O and what kind of treatment is available in Ayurveda for this health condition?

If we talk about preventions then the patient of P.U.O. should avoid bathing. Fasting for a few days would also be helpful to the patients of P.U.O.. One should avoid oil massage, sexual intercourse, and physical exercises. One should also avoid strong medication in case of fever, atleast initially.

Q. Here one question comes to my mind. As you said, fasting helps in case of P.U.O.. Some people completely refrain from eating when they have fever or P.U.O.. Here I would like to know that whether the food intake should be entirely stopped or light food has to be eaten?

Definitely! one should eat easily digestible food like juice, daliya  (i.e. wheat porridge) etc.. You would have noticed, our elders used to do two things when they had fever. They would reduce their food intake and would sleep inside blanket. By doing so, they used to sweat a lot and their fever used to vanish. But today, it is said that one should not wear too many clothes and should not cover his body when in fever. So somehow, these are entirely opposite treatments. But the result is for all of us to see. There is continuous rise in the number of cases of P.U.O.. Nowadays, we get the fever which refuses to go away. It’s time now that we should go back to our shastras and refer to the directions mentioned in it. We should refer to the ways of getting rid of fever and should follow them as it is. This Ayurveda has been created by God himself and one should not have any suspicion about its efficacy. So whatever is mentioned in shastra , we should have complete faith in it whether we have a scientific explanation available for it or not. Probably even till today our intelligence is not as developed to explain them all so all we need to do is to follow them as mentioned.

We generally have a tendency of giving bath to children when they have fever. We should give them cold sponging but here we need to understand that cold sponging and bathing are two different things. In cold sponging too, as I believe, if instead of sponging the forehead we do sponging on feet and stomach then it would give better results. Also it is safer than directly sponging head with ice cold water. Obviously there are certain conditions where we can’t stick to rules and principles but if possible we should avoid bathing, eating grains, exercising, sexual intercourse and medication. The reason why we should avoid medication is that the medication somehow stops the fever from escaping out of the body and as I believe this obstructed fever is what ultimately takes the form of P.U.O..

This was all about preventions but now the question is if once you have become a patient of P.U.O how can you get rid of it. There is a very simple remedy which is very easily available also. I am talking about giloy   (i.e. Indian Tinospora). Giloy  (i.e. Indian Tinospora) is very effective medicine and provides relief from P.U.O. in only a few days. I would even ask the patients to set aside all the medicines prescribed by their doctor which have till yet failed to bring any relief and forget about the fat files of their illness and just take giloy  (i.e. Indian Tinospora) for a week or two. Believe me, giloy  (i.e. Indian Tinospora) alone is sufficient to cure P.U.O.. Giloy  (i.e. Indian Tinospora) is also known as amrita and chakralakshanika . The method of taking giloy  (i.e. Indian Tinospora) is quite simple. You just have to take giloy  (i.e. Indian Tinospora) stem of a foot length and a thumbs thickness (in case you don’t get a fresh stem you can get it from provision store as well). Cut it into small pieces and soak them in about 4 cups of water overnight. The following morning, you would have to boil this water till it is reduced to about a cup. Half of this water has to be consumed in morning and remaining half in the evening with muktabhrayog (approx. 1.5 g). If you continue to consume this then trust me within a period of seven days to maximum 15 days your fever (let it be for any reason) would definitely go away.

Here, I would like to tell you about one more remedy. This is for people who get fever frequently or who have the complaint of recurrent typhoid. We have a preparation called jwaradiyog . We give 7 sachets of this preparation to such patients. This medicine provides relief from recurrent typhoid and long existing fever too. There is unique method for taking this medicine. Take about 8 pieces of munnaka (i.e.Currant), deseed them and fill 1 sachet of the medicine in them. Heat these medicine filled munnka on a hot skillet. These slightly roasted munnaka (i.e. Currant) have to be consumed with little specially prepared milk. This milk has to be prepared by adding approx. 500 mg (4 pinch) of sonth (dried ginger powder) to a cup of milk and then boiling it. These munnaka (i.e. Currants) have to be chewed and eaten at bedtime followed by a cup of milk (prepared in above mentioned way). If you do this you will see that your recurrent typhoid would go away and you will get rid of any remnent symptoms too within a period of seven days. I have told you about some very simple home remedies sort of things which are very effective. You will see that your files and renowned doctors would be left behind and giloy  (i.e. Indian Tinospora) would get ahead all of them.