eli5: If fever is our body’s response to kill an infection, then why do we take medicines like paracetamol that control the fever?

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Also, I get that the fever can get really high at some point, which causes other effects, but why is our body not able to control its response to the infection so as to not do more harm with the fever?

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The body’s fever response isn’t exactly a precision tool. Sometimes a fever gets higher than necessary. Also, research suggests that suppressing a fever using over-the-counter drugs does not substantially prolong diseases like the flu or common cold. So there is very little harm, if any, and on the flipside suppressing your fever can make you feel much better.

The immune system is simultaneously very complex, powerful and adaptive in some respects, while also being primitive and dumb in others. It’s also not just one system – it has multiple components with various degrees of finesse. When you first get infected with a pathogen for which you do not have an immune memory, the first responders of your immune system are of the dumb, primitive type whose motto can be summed up as “set fire to everything that looks bad”. If your immune system is an air force, these are its carpet bombers. They kill the enemy, but they also do a lot of collateral damage. This is your *innate* immune system.

Your *adaptive* immune system is much more of a precision-bombing, navy seals type of operation. But it needs time to gather intel on the enemy. Once it has that, it can mount a massive precision operation throughout the body that rounds up all the enemies while being much less dangerous to civilians. Once this part of your immune system kicks in, you usually start feeling better pretty quickly, and your fever will also subside.

Why is your body not able to control the fever itself? Because evolution is not a purposeful, intelligent process. It just keeps the stuff that works most of the time. The human body (like every other species) is a whole bag of ad-hoc solutions that have been duct-taped together. It’s not engineered to work well in all edge cases. It’s built to work most of the time, and evolution doesn’t care about the minority of cases when it doesn’t. That even means your own body can kill you in rare cases, and when it does the immune system is often the culprit, because it’s just so damn complex that it’s easy for things to go wrong. Complex systems have more edge cases than simple ones, like, say, your heart, which is just a big ol’ pump.

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