Akhawayni and the first fever curve

By the time of Hippocrates the typical paroxysmal fever patterns of tertian (every 48 hours) and quartan (every 72 hours) fevers caused by malaria were known. Through the ensuing centuries, ancient Greek, Roman, and Persian physicians made additional contributions to the understanding of fevers. By the end of that era, there was a working definition of what constitutes a fever, the distinction between fever as a symptom and fever as a disease, an elaborate classification scheme for multiple types of fever, hypotheses as to the causes of fever, and methods for diagnosing and treating fevers. Based on the definition of fever at that time, the 10th century ce Persian physician Akhawaynī created fever curves hundreds of years before they were routinely used in the clinical setting. In Hidāyat al-Muta'allimīn fī al-Tibb, Akhawaynī describes a system for fever curves and draws fever curves for tertian and quartan Fevers, as well as the double tertian, double quartan, and triple quartan fevers. In this work we examine the history of fevers in the ancient world and the first description of the fever curve.