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Commentary
Published in Yvette Hunt, The Medicina Plinii, 2019
Quartan fever is the malarial infection of Plasmodium malariae parasites. Its 72-hour development cycle causes an equally cyclical recurrence of symptoms; a day of fever and chills, two days without, followed by a day of fever and chills. This was counted as four days and gave the disease its name.
The Golden Age of Greek Medicine
Published in Arturo Castiglioni, A History of Medicine, 2019
Among the most remarkable of the Hippocratic observations is that concerning the effect that malaria has on certain diseases: “Those who are stricken with the quartan fever do not become sick of the great disease (epilepsy). But if they are first stricken with this disease and then take a quartan, they are then cured of the great disease” (Epidemics, VI, Sect. VI, 5). And in The Aphorisms: “ Persons attacked with quartans are not readily attacked with convulsions, or if previously attacked with convulsions, they cease if a quartan supervene” (V, 70); and in another place: “Elcippus became sick with maniacal attacks; when an acute fever supervened the attacks stopped” (Epidemics, VI, 48).
Hebd. (περὶ ἑβδομάδων, de hebdomadibus)
Published in Elizabeth M. Craik, The ‘Hippocratic’ Corpus, 2014
In a dense section, which effectively introduces this new topic, it is first explained that health is assured as long as the elements of hot and cold in the anima are balanced, then the effects of imbalance are explored. Prognostic observations follow on the significance of sweats and of critical days. Comments are then made on nomenclature in nosology; this is apparently viewed as otiose, ‘fever’ serving as an overarching term (24). After remarks on the duration, causation and outcome of different types of fever (25), there is comment on the significance of crisis and critical days (26–27). The nature of quartan fever is discussed (28). Instructions follow on the treatment appropriate for different fevers and on circumstances to be avoided (29–39).
Stephanus Bisius (1724–1790) on mania and melancholy, and the disorder called plica polonica
Published in Journal of the History of the Neurosciences, 2021
Eglė Sakalauskaitė-Juodeikienė, Paul Eling, Stanley Finger
Melancholy or melancholia was, in many ways, the opposite of mania. Two of its features are decreased motility and feeling lethargic or morose; both recognized as symptoms of depression today (Berrios 1988). The label “melancholy,” however, meant more than depression in the past. It was frequently applied to any condition involving physical and mental prostration, even quartan fever (malaria). Like mania, melancholy was interpreted in terms of the humoral theory during the Greco–Roman period and for many centuries thereafter. It was supposedly caused by melaina kole—in effect, an overabundance of “black bile” produced by the spleen (Jones 1972). Some ancient Greek philosophers had already begun to maintain that men known to be outstanding in philosophy, statesmanship, poetry, or the arts had a propensity to be melancholic. During the Renaissance, Italian humanist Marsilio Ficino (1433–1499) even pointed to an astrological connection, claiming that those born under Saturn—the “gloomy” planet commonly associated with contemplative life—were prone to melancholic brilliance (Klibansky, Panofsky, and Saxl 1964; Sullivan 2008).
Recrudescing Plasmodium malariae infection despite appropriate treatment in an immigrant toddler
Published in Paediatrics and International Child Health, 2018
The distribution of P. malariae is widespread and parallels that of P. falciparum: it includes sub-Saharan Africa, South-east Asia, the Western Pacific Islands and the Amazon Basin of South America [4]. Historically, P. malariae was distinguished for causing febrile paroxysms on days 1 and 4 (rather than 3) and was thus termed ‘quartan fever/malaria’. This periodicity reflects a slower 72-h intra-erythrocytic developmental cycle in which the number of released merozoites is also lower than other plasmodia [4]. These factors and the parasite’s preference for older erythrocytes leads to lower parasite counts, milder acute disease and earlier development of human host immunity [4]. Immune complex-mediated nephrotic syndrome is a well known complication of prolonged P. malariae infection, occurring in ~0.5% of cases [4,5]. Gauging the global burden of P. malariae is challenging, but recent studies which include the use of molecular diagnostics indicate that its prevalence has been under-reported [5,6]. For example, of nearly 1400 malaria cases in Columbia in whom P. malariae had not been noted on initial blood microscopy, ~39% were found to have P. malariae when tested by nested-PCR (mostly as a part of mixed infections) [6].