The quotidian does not make its attack with a rigor on the first day, but
in progress of time, a chill rather than rigor takes place, which is,
with difficulty, succeeded by heat, and it has a protracted increase.
Yet, it does not make those affected hot, nor their respiration frequent
and thick, nor does it make them pant or drink cold water. But they have
vomitings of phlegm, and whatever is voided by the belly is cold, crude,
and watery, in these fevers. And they have no sweats during the first
days, neither have they an interval of freedom from fever. Their colour
is white and pale; their urine thin and white, or thick, turbid, and red.
* * * * *
COMMENTARY. We have stated, in the 18th Section, that the ancients were
of opinion that quotidians derive their origin from phlegm, that is to
say, serum.
Our author’s description is abridged from Galen (Therap. ad Glauc. i.)
The other authorities treat of it in much the same terms. Even Alexander,
who aims at originality, agrees with Galen and Hippocrates, in referring
the origin of quotidians to phlegm. Palladius, in his valuable little
treatise on Fever, is at great pains to explain the manner in which
putrid extravasated phlegm gives rise to quotidian. He represents the
heat as being smothered and concealed like that of moist fuel. Celsus
describes all the varieties of the disease very minutely. Constantinus
Africanus gives an accurate description of this intermittent. He says
that the paroxysm lasts for twenty-four (eighteen?) hours, and is
followed by an interval of six hours. First, old persons, and then boys,
are said to be peculiarly subject to the disease, which is apt to make
its attack in cold countries and at cold seasons of the year. It is
attended with a great degree of cold, especially of the extremities; the
face is swelled, the colour pale, and no thirst is present.
As the Arabians give the same account of the origin and symptoms of
quotidians, we need not enter upon a detail of their descriptions. All
agree that they are connected with phlegm as an exciting cause, and that
the fever is less ardent and well-marked than in the case of tertians.