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).
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.
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.
Quotidian intermittent is on the whole more common than tertian in hot countries; elsewhere the tertian is the usual type, and quartan is only occasional.
A fever that is to be remittent will usually declare itself from the outset: it begins with chills, but without the shivering and shaking fit of the intermittent; the hot stage soon follows, presenting the same characters as the prolonged hot stage of the quotidian, with the frequent addition of bilious symptoms, and it may be even of jaundice and of tenderness over the stomach and liver.
Ague, and the malignant or "aestivo-autumnal" group, which includes a tertian or a semi-tertian and the true quotidian type.