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Nearly a million cubic yards of sediment had made the five-mile journey, resulting in the creation—or, to be more accurate, the re-creation—of a hundred and eighty-six paludal acres.

Imperfect reaction from a chill, long persistent hyperpyrexia, diarrhoea or vomiting, or chronic paludal cachexia, or, it may be, some epidemic influence, may produce it.

At first the temperature tables indicate the prevalence of milk fever; next follow cases closely resembling those of mild paludal poisoning; and, finally, if these warnings are unheeded and reliance is placed upon antiperiodic remedies rather than upon prompt closure of the threatened ward, the pestilence develops.

Ten years' study and observation of the malady under a great variety of circumstances and conditions have led me to the definite conclusion that its exciting cause is a specific poison or germ, having many striking resemblances in its mode of production to paludal or marsh miasm, though entirely distinct and separate from it.

Such aliases as hemorrhagic malarial fever, climatic fever, rice fever, h�matemesic paludal fever, and many more of the same character, should receive the severest examination before approval and adoption.