Talk:Fever

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Contents 1 Big Mikey Sweet disease 2 Treatment section 3 History of Fever 4 Cure for cancer 5 Rectal/Oral Temperature 6 Autoimmune disorders 7 Overlapping Image 8 Some incorrect information 9 Altered States of Consciousness??? 10 The references in the article 11 Rewrite 12 Prostaglandin E2 as possible source of pain in fever? 13 Effects of prolonged fever 14 Measurement question 15 Study identifies source of fever 16 Should generally not be suppressed? 17 History and other cultures needed 18 Temperature accuracy? 19 Normal body temperature 20 Too hard to understand

[edit] Big Mikey Sweet disease

Is this a real disease? I looked and couldn't find any other information about this. It is currently listed as one cause of fever. The name strikes me as a little fishy.

68.110.100.32 19:23, 30 September 2006 (UTC)Oxaric

Has been removed.--Steven Fruitsmaak (Reply) 02:23, 1 October 2006 (UTC)

[edit] Treatment section

The treatment section is a bit unclear - when you have a fever, do you want to keep warm to help fight off the infection? Or is it more complicated? --SPUI (talk) 18:28, 4 Apr 2005 (UTC)

It seems fever is an evolutionary anomaly. Reducing fever (e.g. with paracetamol) does not affect the prognosis of febrile disease. JFW | T@lk 20:24, 4 Apr 2005 (UTC)

In animal studies, animals who had their fever's broken by drugs were significantly more likely to die from infection compared to those animals who were allowed to express the febrile response. Technically, fever is nothing more than an increase in thermoregulatory set-point. People expressing the febrile response will report to be feeling cold, even though their body's temperature may be over 40 degrees celsius. I'm not a physician, but I would suggest that you would want to increase the room temperature until you no longer feel "cold." The less energy that your body must use metabolically to meet the new thermoregulatory set-point, the more energy it can use when trying to fight the infection off.Taylor Sando 17:28, 29 Jul 2005 (UTC)

Please cite sources for this. I have not heard of evidence suggesting that we should increase the room temperature when someone has a fever instead of given anti-pyretics. Also note that unless there's some good evidence, we'll have to remove the diagram you just inserted in the article. Alex.tan 02:06, July 30, 2005 (UTC)

The evidence on the diagram for hyperthermia and hypothermia is basically a graphical representation of the very definition of them respectively. The body maintains a roughly constant internal body temperature around 37 degrees Celsius. This fact surely can’t be disputed, right?

Ok, following from that, we know that anything that increases body temperature above this set-point will activate thermoregulatory mechanisms (Vasodilation, sweating, decreased motor activity, etc) to bring the temperature back down to the set-point value of 37 degrees Celsius. Therefore, when you turn up the temperature in the room, or you exercise, you are inducing hyperthermia on yourself and your body will attempt to counteract this increase in body temperature.

Same with hypothermia, anything that decreases body temperature below the normal set-point will activate thermoregulatory mechanisms (vasoconstriction, decreased sweating, increased motor activity, etc) to bring the temperature back up to the set-point value of 37 degrees Celsius.

Now for the evidence for fever being an increase in set-point. I would draw your attention to two papers. The first: Feng, JD, Price M, Cohen J, and Satinoff E. (1989) prostaglandin fevers in rats: regulated change in body temperature or change in regulated body temperature? American Journal of Physiology: Regulatory, Integrative and Comparative Physiology 257: R695-R699. Here is the abstract: “Experiments examining the effects of central injections of E-series prostaglandins (PGE) on body temperature have only been done in the light part of a light-dark cycle. The present experiments examined the characteristics of fevers in rats after intraventricular PGE2 injections in both light and dark in a 12:12 h photoperiod. In the light, the change in body temperature (Tb) after 0.5 microgram was not significantly different from the change after vehicle injection. After injection of PGE2 (1, 2, 4, and 8 micrograms), Tb rose in a dose-dependent fashion. Mean initial Tb in the light was 36.4-36.6 degrees C. Tb rose a mean of 1.5 degrees C after 1 microgram, 1.9 degrees C after 2 micrograms, 2.7 degrees C after 4 micrograms, and 3.5 degrees C after 8 micrograms PGE2. A dose of 16 micrograms gave almost identical results as 8 micrograms. In the dark, mean initial Tb was 37.4-37.7 degrees C. Tb rose less than 0.8, 1.1, 1.4, and 2.3 degrees C after 1-8 micrograms PGE2, respectively. Thus there were two distinct dose-response curves for day and night. Nevertheless, peak Tb values attained in the two conditions were not significantly different from each other at any given dose. These results show that a particular dose of PGE2 raises Tb to a particular level, largely independent of either the Tb at the time of the injection or the phase of the light-dark cycle. However, the change in Tb at any dose depends strongly on initial Tb. Therefore, we urge researchers in the pharmacology of thermoregulation to report initial and final Tb values as well as changes in Tb. “

The take home message is “peak Tb values attained in the two conditions were not significantly different from each other at any given dose.” Rats have higher body temperature in the Night then they do in the Day, this reflects their thermoregulatory set-point. If fever was an absolute rise in body temperature, the Dark phase group would have shown a higher peak body temperature compared to the Light phase group. Think of it this way. If fever was always a temperature increase of say, 3 degree Celsius, and the light group’s normal body temperature is 36 degree Celsius, while the dark group’s normal body temperature is 37 degree Celsius, then the light group would have had fever numbers around 39 degrees Celsius, whereas the dark group would have had fever numbers around 40 degrees Celsius. This did not occur. The light group and dark group’s peak fever body temperatures were not significantly different from each other. This reflects an elevation in set-point, rather than an absolute rise in body temperature.

The second is a review article: Moltz, H. (1993) Fever: causes and consequences. Neuroscience Biobehavioral Review, 17(3), 237-269. Unfortunately, I don’t have this on me right now, but in this review paper it talks about Ectoderm (Cold blooded animals incapable of metabolic thermoregulation) thermal preferences after injection with an endotoxin. The experimental group was compared to controls that did not receive the injection. The experimental group showed a clear preference for higher temperatures compared to the control group. This preference lasted the course of the endotoxin challenge. This reflects a temporary elevation in the thermoregulatory set-point.

Therefore, the diagram is backed by experimental evidence.

As for the claim that fevers should be encouraged, or that a person should attempt to increase their body’s temperature during a fever. This is part speculation, and part based on experimental evidence. If you read the review of Moltz, you will find animal studies that relate to this very situation. Animals were injected with an endotoxin. The control group was left alone, while the experimental group was given anti-pyretics, such as acetaminophen. The experimental group had significantly more deaths and complications compared to the control groups. This suggested an adaptive role for fevers.

In fact, fevers have a long evolutionary history, with many species, both vertebrates and invertebrates expressing this during immune challenges. This is not surprising because fever is part of the Acute Phase Response and Innate Immunity. It is a non-specific mechanism to fight immunological challenges. One thing that this increase in body temperature is thought to do is decrease plasma iron concentrations (bacteria need it to divide). There are a lot of other things, however, like I said, I don’t have the papers with me right now. Whether or not a person should be given an anti-pyretic is dependent on the person's age and the severity of the fever. People suffer from convulsions if the internal temperature become greater than 41 degrees Celsius (106 degrees Fahrenheit), therefore, I would assume you would want to break the fever if your temperature is approaching this threshold.

On the topic of a cancer treatment, I certainly don't think inducing fever to treat cancer is a suitable option. The innate immune system generally does not fight cancerous cells. This is usually the job of the adaptive/specific immune system. Although there is quite a bit of overlap between the two systems. Taylor Sando

Is there a reason that specific drugs such are paracetamol are not mentioned in the treatment section? 129.27.12.20 07:34, 8 October 2007 (UTC)

[edit] History of Fever

Though I find the science interesting, I came to this page looking for a history of fevers, beliefs about them, evolving treatments over time, etc. Specifically I wanted to know what sorts of disfigurement untreated long-term fevers can cause. If anyone has some knowledge or resources to add to this entry apropos of a more cultural view of fever, I would be much obliged.

History of medicine... hard to find good source material here. As for "long term disfigurements", these depend on what causes the fever. Fever itself is harmless, although amyloid occurs in people with non-stop inflammation for many years. JFW | T@lk 01:05, 19 Jun 2005 (UTC)

I just wanted to mention that while placing a cold, wet cloth on someone's head may briefly reduce the patient's temperature, if the cloth is not removed and/or the moisture is not allowed to evaporate, it can actually raise the patient's temperature by trapping body heat. Using an ice pack instead would, I think, be far more beneficial.

Ice would be even worse? I thought the water had to be lukewarm to cold.

[edit] Cure for cancer

I'm not familiar enough with cancer treatment issues to know just how widely-accepted the idea of inducing fever as a cancer therapy might be, but... if the only sources for this claim are books like Airola's - which make a great many claims at odds with conventional medicine[1] - then that status should be acknowledged. If there are less controversial sources, those should be listed instead. --Calair 00:45, 20 Jun 2005 (UTC)

[edit] Rectal/Oral Temperature

I've read elsewhere (WebMD primarily) that rectal and oral temperatures can differ by up to a degree F. This makes the listed categorizations of low grade/moderate/high grade somewhat ambiguous, especially to someone perusing Wikipedia to get high-quality information. Could someone with deeper knowledge of the subject please clarify this?

[edit] Autoimmune disorders

Assuming the fevers are part of an immune response, can fevers be wrongly created (in the face of no real pathogens) when patients have immune disorders (allergies, lupus, etc)? jengod 07:11, 6 October 2005 (UTC)

They can indeed. Many autoimmune conditions (such as the lupus you suggested) may feature low-grade fevers. So can some tumours, particularly Hodgkin's lymphoma (Pel-Ebstein fever), presumable also due to the secretion of pyrogenic cytokines. Allergies do not typically cause fevers. JFW | T@lk 20:45, 9 November 2005 (UTC)

[edit] Overlapping Image

One of the first images on the page is overlapping some of the text. Unfortunately I don't know wikipedia well enough to be able to fix this on my own, otherwise I would.Veluet 18:49, 12 December 2005 (UTC)

It appears there could be a conflict between the two floating boxes on the page (the symptom box and the image box) and so the image box doesn't float correctly. I fixed it by moving the image lower on the page. Noelle De Guzman 08:24, 14 December 2005 (UTC)

[edit] Some incorrect information

I believe that this page's temperature for a serious fever is far too high. The page lists 107.6 Fahrenheit as definitely harmful. 103 Fahrenheit is more realistic. See

http://www.mayoclinic.com/health/fever/DS00077/DSECTION=2

Someone could see this info and interpret anything below 107.6 as not truly serious. I hope it will be changed.

The paragraph preceding that describes anything above 104F as 'high grade fever'. AFAICT, the figure of 107F refers specifically to the temperature at which the heat is likely to cause tissue damage. However, I removed the 'would most certainly be harmful' from that sentence because it's too easy to misread it as meaning that temperatures below 107F aren't harmful. --Calair 03:09, 23 January 2006 (UTC)

[edit] Altered States of Consciousness???

I arrived here via a link from altered states of consciousness. I was hoping that maybe, there would be information explaining how and why fever induces altered states of consciousness. What we have here is a medicine centric POV, which is probably as it should be, but this entire article is totally useless for Shamanic or Psychonaut POV which is sad. Prometheuspan 23:23, 21 February 2006 (UTC)

I believe that my state of consciousness was once altered while I had a fever. I couldn't speak or think straight and I saw purple triangles everywhere, yet I see nothing about altered states of consciousness in this article. CorpseJester (talk) 01:04, 28 February 2008 (UTC)

[edit] The references in the article

Currenty this article contains ten references to original scientific works, three review articles and one textbook - I just added the latter, for my addition of the source of the endogenous pyrogens. While I do not doubt these sources, I think this kind of article would better be based on textbooks and refer to original research only in specific cases. I can find original articles with data supporting all kinds of theories, that does not mean these theories are generally considered true. // Habj 09:56, 22 April 2006 (UTC)

Yes, I noticed this as well and was going to make a comment. We have some seemingly selected-at-random review articles arguing for or against treating fever, some from rather obscure journals. As a nonspecialist I have no way of knowing to what extent these represent any sort of consensus, versus merely the opinion of one author. I'd be more confident with, for example, a review article published in a top-tier journal, or some sort of treatment recommendation from a mainstream professional body. --Delirium 13:23, 5 October 2006 (UTC)

Well, you might have noticed that 5/6 refs are about the purpose of fever, discussed in the topic right below this one. This was controversial. It's my opinion that the section reflects general belief: however, while I was doing a big pubmed screening, I didn't find any top-quality review papers about it, just measly obscure ones...--Steven Fruitsmaak (Reply) 15:00, 5 October 2006 (UTC)

[edit] Rewrite

I've rewritten and reorganised some parts of the article, deleting unnecessary content where I considered feasible. I added a measurement chapter, causes chapter, treatment chapter, and a chapter on the usefulness of fever, articulating the mainstream theory that it is not usefull (indeed, as Jfdwolff calls it, an "evolutionary anomaly", or remnant).

I concurred with the previous editor that the references where a bit copious, so here they are below :-) . Please feel free to use them as citations for specific or controversial claims where necessary, or if you have actually read them and based your changes to this article on them. --Steven Fruitsmaak 16:54, 7 June 2006 (UTC)

I'd like to see some specific references for the section on the usefulness of fever. All of the other advice I can find on the web indicates that it is useful, e.g. http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm http://www.mayoclinic.com/health/fever/DS00077 -- rasgoo 07:20, 28 Jun 2006 (UTC)

After a look in the literature, I was indeed forced to change my opinion!--Steven Fruitsmaak 15:58, 28 June 2006 (UTC)

The last paragraph of the usefulness section is stylistically horrible. I made a few edits to the first sentence, but once I started, I decided it needed such extensive work that I didn't feel comfortable continuing. --DelCavallo 17:08, 2 March 2007 (UTC)

[edit] Prostaglandin E2 as possible source of pain in fever?

The article mentions PGE2 as one of the final stages in the induction of fever; fevers are also commonly associated with pain and discomfort over the whole body. I posit that it's the prostaglandin E2 that causes that pain, as it's part of the pain mechanism as well; NSAIDs act primarily by suppressing cyclooxygenase in the body, and thereby the resulting prostaglandins, which would explain both the pain relief and the reduction of fever.

As I'm neither a doctor nor a pharmacologist I would like some feedback from other Wikipedians on this matter before we put it in. If there are references that might explain the role of prostaglandin in fever and fever pain in more detail, please direct me to them. Rhombus 19:28, 14 July 2006 (UTC)

---

Primary Sources

• Cao, C., Matsumura, K., Yamagata, K., and Watanabe, Y., (1996) Endothelial cells of the rat brain vasculature express cyclooxygenase-2 mRNA in response to systemic interleukin-1B: a possible site of prostaglandin synthesis responsible for fever. Brain Res 733, 263-272.
• Castellani JW, Young AJ, Sawka MN, Pandolf KB.(1998) Human thermoregulatory responses during serial cold-water immersions. J Appl Physiol, 85(1), 204-209.
• Feng, JD, Price M, Cohen J, and Satinoff E. (1989) Prostaglandin fevers in rats: regulated change in body temperature or change in regulated body temperature? Am J Physiol Regulatory Integrative Comp Physiol 257: R695-R699.
• Jakobsson, P. J., Thoren, S, Morgenstern, R., and Samuelsson B. (1999) Identification of human prostaglandin E synthase: A microsomal, glutathione-dependent, inducible enzyme, constituting a potential novel drug target. Proc Natl Acad Sci U S A. 96, 7220-7225
• Milton, A. S. & Wendlandt, S. (1970). A possible role for prostaglandin E1 as a modulator for temperature regulation in the central nervous system. J Physiol, 207(2), 76P-77P.
• Milton, A. S. & Wendlandt, S. (1971) Effects on body temperature of prostaglandins of the A, E and F series on injection into the third ventricle of unanaesthetized cats and rabbits. J Physiol, 218, 325-336.
• Nakamura, K., Matsumura, K., Kaneko, T., Kobayashi, S., Katoh, H. & Negishi, M. (2002) The rostral raphe pallidus nucleus mediates pyrogenic transmission from the preoptic area. J Neurosci, 22(11), 4600-4610.
• Nakamura, Y., Nakamura, K., Matsumura, K., Kobayashi, S., Kaneko, T. & Morrison, S. F. (2005) Direct pyrogenic input from prostaglandin EP3 receptor-expressing preoptic neurons to the dorsomedial hypothalamus. Eur J Neurosci, 22(12), 3137-3146.
• Opp M. R. & Krueger J. M. (1991) Interleukin 1-receptor antagonist blocks interleukin 1-induced sleep and fever. Am J Physiol, 260(2), R453-R457.
• Scammell, T. E., Elmquist, J. K., Griffin, J. D., & Saper, C. B., (1996) Ventromedial preoptic prostaglandin E2 activates fever-producing autonomic pathways. J Neurosci, 16(19), 6246-6254.
• Scammel., T. E., Griffin, J. D., Elquist, J. K. and Saper C. B. (1998) Microinjection of a cyclooxygenase inhibitor into the anteroventral preoptic region attenuates LPS fever. Am J Physiol Regulatory Integrative Comp Physiol. 274 (3), R783-R789.
• Vane, J. R. & Flower, R. J. (1972) Inhibition of prostaglandin synthetase in brain explains the anti-pyretic activity of paracetamol (4-Acetamidophenol). Nature, 240, 410-411.

Secondary Sources

• Engblom, D., Ek, M., Saha, Sipra, S., Ericsson-Dahistrand, A., Jakobsson P.J., Blomqvist, A (2002) Prostaglandins as inflammatory messengers across the blood-brain barrier. J Mol Med, 80, 5-15.
• Moltz, H. (1993). Fever: causes and consequences. Neurosci Biobehav Rev. 17(3), 237-69
• Waag T, Hesselberg O, Reinertsen RE. (1995) Heat production during cold water immersion: the role of shivering and exercise in the development of hypothermia. Arctic Med Res. 54(2), 60-64.

[edit] Effects of prolonged fever

What are the effects, if any, of having a very high or prolonged fever? I've heard of everything from mental retardation to death, and I was hoping this article could help set me straight. Shouldn't there be a section? BethEnd 05:09, 30 July 2006 (UTC)

Seconded. I know it does cause mental retardation, though, because my dad's friend's daughter (she's twenty now) had a fever when she was around nine. Since she's Asian, her family is Asian, so instead of taking her to the doctor, her parents just made her sleep. Well, something major happened (overheating or something like that) and she 'burned up' (from not receiving adequate treatment for recovery). By the time her parents took her to the hospital, it was too late. Now she's mute and has all these involuntary movements. She can't speak or think or walk, much less drive a car or go to school. She can still eat and laugh and see things, but always slowly and always with added involuntary movements, so she's mentally retarded. Why sigh, cutie pie? 21:26, 23 September 2006 (UTC)

[edit] Measurement question

In the measurement section, the article lists three measurements for fever, however it is not mentioned if these are ands or ors. I.e., do all of these conditions need to be met for it to technically be considered a fever, or will only one measurement do?

[edit] Study identifies source of fever

“Our laboratory identified the key site in the brain at which a hormone called prostaglandin E2 (PGE2) acts on a target, called the EP3 receptor, on neurons to cause the fever response.” [2] Brian Pearson 23:54, 5 August 2007 (UTC)

[edit] Should generally not be suppressed?

I question this information. I doubt there is a concensus among doctors and within the medical science on this point. These sentences should IMO be rephrased. // Habj 09:51, 22 April 2006 (UTC)

Agreed. I've heard (anecdotally) of people suffering brain damage an even dying from fevers. Dehydration is one mechanism, but I've heard that going above a certain temperature is harmful to the brain. I won't add to the article as "a smart person told me" is not a great source. But a section on the dangers of fevers - or at least why doctors stress the control of fevers - is important, I believe. The info I'd really like to have is: should I let my temperature rise to a certain temperature, by not treating the fever too aggressively?

This begs the question: if fevers are dangerous, why have we evolved to have them. Perhaps some diseases interfere with the normal temperature regulation, e.g. by releasing pyrogens; or else the reaction we've developed gives an evolutionary advantage by dealing with common illnesses, but it's not sophisticated enough to not go overboard with really nasty illnesses. Another thought is that a bit of brain damage or other side-effects are not complete disasters from an evolutionary point of view. That's all speculation of course, and I don't think they're adequate explanations, but I'd be surprised if there weren't citable info on this somewhere.

Btw, re the bit that says Most people take medication against fever because the symptoms cause discomfort: In my personal experience, it's hard to sleep with an untreated fever. Taking paracetamol helps me sleep, and when I awake I usually feel a lot better. I suspect that in mild fevers at least, the pain relief and resulting rest contributes to recovery. But again I don't have sources. --Chriswaterguy talk (currently in Jakarta with a fever) 06:46, 13 November 2007 (UTC)

[edit] History and other cultures needed

"Give me a fever, and I can cure any illness" -- Hippocrates.

This article is much too narrowly focused exclusively on current Western medical conventional wisdom.

Humans have been getting and dealing with fevers since the beginning of time. The article should tell us the history of how healers have viewed and dealt with fevers for the last few thousand years, in cultures around the world.

My impression is that where fevers are currently viewed by conventional medicine as an inconvenience to be suppressed, previously they were generally viewed as part of the cure and often encouraged/enhanced by bundling, sweats etc. -69.87.199.175 (talk) 18:19, 28 February 2008 (UTC)

Any particular reason you aren't fixing this omission yourself? WhatamIdoing (talk) 18:38, 28 February 2008 (UTC)

[edit] Temperature accuracy?

The given Farenheit temperatures considered normal and for different states of fever all seem a little high (about 1 degree). Clicking on the low-grade link takes you to an article that lists a low-grade fever as one never exceeding about 101 degrees Farenheit, yet this page says a low grade fever is defined as one not exceeding 102.2 degrees. Also, most things I've read say normal oral temperatures are about 98.6 degrees, not 99.5 degrees. Can someone with more expertise advise on this issue? 70.250.179.232 (talk) 15:06, 10 March 2008 (UTC)

First, the actual median oral temperature for humans is 98.2 F, no matter what old textbooks say. The 98.6 number comes from a sloppy conversion of 37 C to F -- except that the original number, from a 19th century study, was 37 C, not 37.0 C (as in: "37 C, not 36 or 38," instead of "37.0 C, not 36.9 or 37.1"). The correct conversion is 98 F (not 96 or 100). Fortunately for us, the antique work has been entirely superseded by modern studies, which give us a median of 98.2 F.

Importantly, there is a significant range. You, personally, might run a little hotter or a little cooler than average. Furthermore, your temperature changes from day to day. This is why this article gives the normal oral temperature as 98.2±1.3 F. This means that 99.5 F could be a perfectly normal temperature at times. So could 96.9 F.

So if you have a temperature of 99.5 F, then you have to decide what that means for you. If you're naturally a little cooler than average, plus you haven't eaten for a day or just woke up in the morning, and you have a temperature of 99.5 F, then you might have a fever. If you're naturally a little warmer than average anyway, plus you've been exercising outside in the middle of the summer, then 99.5 is exactly what you'd expect.

Although most clinicians use the simpler rule of thumb (100.2 F is not a fever; 100.4 F is), the existing studies indicate that anything outside of the ±1.3F range is a clinically significant variation.

Hope this helps, WhatamIdoing (talk) 18:44, 11 March 2008 (UTC)

[edit] Normal body temperature

The numbers for normal body temperature get changed periodically, usually in ways that are obviously wrong. Today's, however, is an assertion that 37.2C during the morning is a fever, despite the fact that this is well within the normal range of 36.8C±0.7.

Can this change be sourced? I ask because I can source the normal range, and my source for the normal range specifies that temperatures were measured in the morning (although after breakfast). WhatamIdoing (talk) 02:10, 4 April 2008 (UTC)

[edit] Too hard to understand

This article is not written in an encyclopedic style. (Regret I don't know the tag to add.) It's too technical for non-medical people to understand. It needs sentences along the lines of "When the body's immune system detects the chemical signature of certain bacteria, it sets off a chemical chain reaction which induces a fever. Scientists believe that the body does this to help it fight the infection (the bacteria don't like the higher temperature, but the immune system does) but nobody really knows for sure." I can't add sentences like that because I'm not an expert and the article is too difficult for me to understand it well enough to be able to simplify it. Somebody please do the necessary. Macguba (talk) 22:17, 1 May 2008 (UTC) PS - Must declare an interest here ... I'm currently suffering from one.

I hope that you feel better soon.

I think this is written in an encyclopedic style: It is a formal, impersonal, dispassionate summary of information. Do you mean instead that it's not written simply enough? Perhaps you would like to try this version. WhatamIdoing (talk) 18:31, 2 May 2008 (UTC)

Yes, it's too technical to be encyclopedic. (It is indeed formal, impersonal and dispassionate and is encyclopedic to that extent.) It is of course difficult to judge the right level for any article. One test is the prevalence of 'link words', and density of them in this article is much too high. I haven't encountered the Simple English version of Wikipedia before, thanks for the link. You won't be surprised to learn that I think it's good as far as it goes, but that isn't far enough for me. Macguba (talk) 11:51, 3 May 2008 (UTC) PS Feeling much better, thank you.