The tertian fever being occasioned by yellow bile set in agitation, has a considerable rigor in the beginning, which differs, however, from the rigor of a quartan in this, that the skin feels as if it were pierced and wounded; but, in quartans, the attack is accompanied with a strong chill; and quotidians have no preceding rigor, they are only accompanied with a chill. But in tertians, the order of the pulse is regular, and the fever is attended with strong thirst towards the acme, and burns up the man; but shortly afterwards the acme takes place, and the heat is equally diffused everywhere. If you apply your hand, at first it is met by a strong and pungent heat, which seems as if carried upwards in the form of vapour, but it is soon extinguished under the hand, if it is allowed to remain. And when the person drinks, a hot vapour in great quantity immediately issues from the skin, announcing sweat. But vomiting of bile supervenes, or the belly is purged, and bilious urine is passed. With these the fever goes off, having comprehended not more than twelve hours in one paroxysm. When, therefore, it abates within twelve hours, we call it true tertian; when the paroxysm is more protracted, we name it simply tertian; and when the paroxysm is prolonged to the utmost, so as to have but a small interval, we call it prolonged tertian. * * * * * COMMENTARY. Hippocrates relates many interesting cases of tertian fevers in his ‘Epidemics.’ He attributes their origin to bile. (De Nat. Hum. 29.) Celsus describes two kinds of the tertian, the one beginning with shivering, and being succeeded by heat, the paroxysm returning every alternate day; and the other constituting the semi-tertian, of which we will have to treat afterwards. Galen treats of these fevers in different parts of his works. (In Hippocrat. Epidem. Comment., Therap. ad Glauc., de Different. Feb. ii, 3, de Typis, 3.) The symptoms of the tertian are thus described by him: It is attended with intense thirst, heat, acrid and bilious vomitings, loss of appetite, and restlessness. For the most part these symptoms are preceded by rigors, or sometimes by extreme coldness. The pulse in tertians is small and dense. At first, the night preceding an attack is passed in a restless state, but after the disease is prolonged this is not the case. The urine is yellow. In many parts of his works he announces it as his decided opinion that the quotidian intermittent is produced by phlegm; the tertian by yellow bile; and the quartan by black bile. This theory of intermittents was adopted, in a word, by all his successors. See Oribasius (Synops. vi, 9); Aëtius (v, 80); Nonnus (de Febr. 6); Palladius (de Febr. 6); Alexander (xii, 6); Synesius (iii); Avicenna (iv, 1, 2); Haly Abbas (Theor. viii); Serapion (vi, 13); Avenzoar (iii, 1, 2); Averrhoes (Collig. iv, 28.) SECT. XX.—ON THE CURE OF TERTIAN FEVER.