http://www.silentpcreview.com/article33-page2.html shows someone taking a soldering iron, a resister, and modifying the bios on the video card to underclock his older geforce video card so he could run it fanless and still be in spec heat wise. I think that is farther than I would like to go.
Apparently the GeForce FX line from the lowly 5200 all the way to the highest 5950 use fan speed control and underclock on the fly if the heat gets too nasty.
So if you are just typing a GeForce FX should turn the fan off.
Apparently you can use coolbits http://www.overclockers.com.au/techstuff/a_coolbits/ or http://oc3dmark.octeams.com/tip02.html to underclock your video card without the goofy soldering iron issues. Since the fan is temp controled just lowering the core and memory speeds should keep the fan out of the picture and make for a quiet card. Some versions of the driver have the sliders enabled when you install and some don't, there are also third party utilites that do this but it seems better to me to use the Nvidia supplied tool even it was hidden.
You can easily sell a 4600 on eBay for more than a Geforce FX costs anyway and then "upgrade"/"downgrade"/"sidegrade?" to a GeForce FX card of your choosing.