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Gên. II. In the ANTICIPATING QUOTIDIAN, which is the name
Spec. 1. à A. quoti
: given to our FOURTH VARIETY from Dr. Fordyce, the padianus antic roxysm precedes its antecedent period usually by about cipans,
bating two hours, and continues the same fore-march at every requotidian. currence; so that the accession may hereby be thrown into
any hour of the day or night. This form is denominated a febris subintrans by Professor Frank and various other
writers *. : A. quoti. The RETARDING QUOTIDIAN, which like the last, has
been particularly noticed and named by Dr. ·Fordyce, Retarding forms a direct counterpart to the anticipating; the paroquotidian.
xysm delaying its antecedent period usually by about two hours, and continuing the same delay at every recurrence; so that here also the accession may be thrown into any hour of the day or night.
There are few diseases, moreover, in which the quotidian is not occasionally to be found as a symptom; but it occurs especially in hysteria, catarrh, gout, pe-, ripneumony, ischury, quinsy, and several species of odontia.
· Tertian Ague.
INTERMISSION ABOUT FORTY-EIGHT HOURS: PAROXYSM
COMMENCING AT NOON : USUAL DURATION. UNDER
Gen. II. The tertian ague, the tritæus of the Greeks, occurs most SPEC. 11. frequently in the spring and summer months; though Description.
• J. P. Frank, De Curandis Hominum Morbis Epitome. Tom. I. p. 41. Mannhemü. 1792.
mon in the
there is a spurious kind that shows itself in the autumn. Gen. II. The chill, during the cold fit, is intense, with convulsive
· Anetus shivering, rigidity, and gnashing of the teeth. It is, how- tertiamus. ever, of shorter duration than that of the quartan, and Ter sometimes passes off in less than half an hour; and is succeeded first by nausea or vomiting, and afterwards by a pungent penetrating heat, frequent respiration, urgent desire for cold drink, wakefulness, and head-ache, sometimes delirium. At length a moisture on the skin, gradually advancing to a copious sweat, breaks forth, the urine commonly deposites a lateritious sediment, and there is often some looseness of the bowels. The entire paroxysm sometimes ceases in six hours, but more generally extends to eight or ten; if it exceed twelve, as it does occasionally in the autumn, the disease forms the spurious tertian I have just alluded to. As the quotidian is Most commostly common to infants and persons of delicate habits, hale and the tertian chiefly affects those of riper years or of firmer robust. fibres, and especially persons of a bilious temperament. It was the opinion of Hippocrates that the tertian ague, Duration as
calculated if left to nature, would run itself out in seven paroxysms; by Hippo and Vogel adds, that, when this is the case, there is crátes. usually the appearance of a dry scabby eruption about the lips on the fourth or fifth paroxysm. But the period pointed out by the former does not hold in our own day; and the disease has often continued obstinate in spite of cutaneous eruptions, not only about the lips but over the body. Sydenham asserts that in the autumn, in which, however, a genuine tertian is rarely to be met with, its ordinary natural course is double the term allotted by Hippocrates, or rather that the term of its paroxysms amounts to the space of fourteen days. The tertian exhibits occasionally the two following varieties :
a Comitatus. Catenating tertian.
B Protractus. Protracted tertian. to both which the explanation already given under Explanation
under the the same terms in the preceding species will equally wr apply. As an associate disease, it is chiefly to be found species will Gen. II. united with syncopal and soporose affections, indicating Spec. II.
apply to VOL. II.
some oppression of the brain; or with cholera, or dysentery, mostly indicating irritation or congestion in the
ague, these vari ties.
It is also to be traced occasionally as a species in syphilis, sea-scurvy, worms, and scabid eruptions. ,',
INTERMISSION ABOUT SEVENTY-TWO HOURS: PAROXYSM
COMMENCING IN THE AFTERNOON : USUAL DURATION • UNDER NINE HOURS.
ĢEN. II. SPEC. III. General character,
This, which is also the quartana of Celsus, is the tetartæus of the Greek writers. It is rarely found in the vernal season, but is common in the autumnal ; in which quarter, also, it is far the most obstinate of all the species, and especially if, as Celsus observes, it show itself only a short time before the commencement of winter. Its chief subjects and sufferers are those of advanced years, and of a melancholic habit; for children and young persons, who principally feel the effects of the two former species, are but little obnoxious to it. It commences usually about or a little before five o'clock in the afternoon. The cold fit'is less vehement than in the tertian, but of longer duration, and will sometimes continue for two hours, but usually without sickness or diarrhoea. It yields to a heat that is rather troublesome from its dryness than from its intensity, 'and which is rarely súcceeded by a sensible perspiration. There is a heaviness or dullness in the head rather than acute pain; and often during the intermediate days, a sense of sore
ness over the body, as though it had been generally Gen. II.
Spec. III. bruişed, which strikes through to the bones. It is here also we principally meet with parabysmic tumours, and especially of the spleen and liver: in the former of which Quartan
a Comitatus. Catenating quartan.
à Cunctans. Retarding quartan.
From the tendency which this species has to affect the abdominal viscera, it is often met with as a symptom in diseases of the spleen, liver, and various adjoining organs. And hence it occasionally interchanges with dysentery, Often ac.
companies and particularly when the latter is a prevailing or epi- or alternates demic disease. This remark will also apply to the pre- with other
diseases. ceding species: and under the one or the other form was often found exemplified in the fatal dysentery that ravaged a larger part of Ireland in the year 1818*; and which still more frequently occurs in tropical climatest:
• Medical Report of the Whitworth Hospital, &c. By J. Cheyne, M.D. &c. Dublin Reports, Vol. 111.
+ Climate and Diseases of Tropical Countries, &c. By C. Chisholm, M.D. p. 52, Lond. 1822.
INTERMISSION AND PAROXYSM POSSESSING LITTLE RE-
some degree of irregularity in all the preceding species,
least of all, however, in the quartan. And hence all the Distinctive above might, in such instances, be named erratic. But
the peculiar character of the present species is, that the duration of the intermission exceeds that of all of them; on which account it can never be confounded with any of the rest.
The chief varieties are the following; which, however might be considerably enlarged, but it is unnecessary. They are principally taken from Sauvages and Vogel : and for other authorities the reader may turn to the volume of Nosology.
. a Quintanus. . Five-day ague.
B Sextanus. Six-day ague.
Octanus. Eight-day ague.
n Vagus. Vague and irreducible. Sometimes Several of the above have occasionally persevered with peculiarly obstinate.
great obstinacy; in some instances for upwards of two years without ceasing. The last variety is equally irregular as to the violence of its paroxysm, the duration of its stages, and the period of its return. Several of Sauvages's species of hemicrania may be properly referred to this place, and especially those which, by some wri