Another rule is that the quartan has the longest cold stage, while its paroxysm is shortest as a whole; the quotidian has the shortest cold stage and a long hot stage, while its paroxysm is longest as a whole.
In Smolensk, at the Malakhov Gate, he had hardly dozed off in a paroxysm of fever before he was awakened by the bombardment of the town--and Smolensk held out all day long.
It is the general rule, with frequent exceptions, that the quotidian paroxysm comes on in the morning, the tertian about noon, and the quartan in the afternoon.
A violent paroxysm of asthma may be arrested by the administration of morphine subcutaneously, but the practice should not be continued, as there is great danger in a chronic disease that the patient may become the victim of morphinism.
This first or cold stage of the paroxysm varies much in length; in temperate climates it lasts from one to two hours, while in tropical and subtropical countries it may be shortened.
A single paroxysm of simple ague may come upon the patient in the midst of good health or it may be preceded by some malaise.
The labours of Golgi, Marchiafava, Celli and others established the nature of the parasite and its behaviour in the blood; they proved the fact, guessed by Rasori so far back as 1846, that the periodical febrile paroxysm corresponds with the development of the organisms; and they showed that the different forms of malarial fever have their distinct parasites, and consequently fall into distinct groups,.
If the first paroxysm should not cease within the twenty-four hours, the fever is not reckoned as an intermittent, but as a remittent.
Another paroxysm begins at or near the same hour next day (quotidian ague), which results from a double tertian infection, or the interval may be fortyeight hours (tertian ague), or seventy-two hours (quartan ague).
Sleep may overtake the patient in the midst of the sweating stage, and he awakes, not without some feeling of what he has passed through, but on the whole well, with the temperature fallen almost or altogether to the normal, or it may be even below the normal; the pulse moderate and full; the spleen again of its ordinary size; the urine that is passed after the paroxysm deposits a thick brick-red sediment of urates.