It is subject, however, to extreme and rapid variations in temperature, to alternations of dry and humid winds (the latter, called catias, being irritating and oppressive), to chilling night mists brought up from the coast by the westerly winds, and to other influences productive of malaria, catarrh, fevers, bilious disorders and rheumatism.
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.