The Complete Works of Galen, Vol. 11

Ed. Chart. X. [349. 350.]

Ed. Bas. IV. (199.)

Chapter 5

Therefore, you would not be wrong to assume that those fevers which attack with shivering original: "rigore" (Latin) / "rhigous" (Greek); a cold fit or trembling that often precedes the hot stage of a fever. belong to the class of those that trouble the patient in cycles. Both tertian and quartan fevers generally produce their attacks with shivering.

But tertian fevers A fever that returns every third day, typically associated with yellow bile. often begin with intense shivering right at the very first onset. We have never seen a quartan fever A fever that returns every fourth day, typically associated with black bile and the spleen. begin with intense shivering. Instead, the intensity of the shivering increases as time progresses. Additionally, this fever usually does not attack as a quartan right from the start. It occurs after other fevers have already happened.

Thus, the quartan fever follows the so-called wandering or erratic fevers caused by phlegm original: "pituita" (Latin) / "phlegma" (Greek). This refers to cold, moist humors that do not follow a predictable schedule.. A daily fever original: "quotidiana" (Latin) / "amphēmerinos" (Greek); a fever that recurs every day. rarely occurs without some injury to the mouth of the stomach original: "oris ventriculi" (Latin). In ancient medicine, this referred to the upper opening of the stomach, often thought to be highly sensitive and a source of various symptoms.. In the same way, a quartan fever does not occur without a fault in the spleen, nor a tertian fever without an affliction of the liver.

Indeed, if a fever begins with intense shivering, it is more likely to be a tertian fever than any other kind. If the other signs which will be mentioned hereafter also agree, you may clearly diagnose this as a tertian fever from the very first day. However, if it begins with only a slight shivering, then other signs should be considered instead.