Ague may exist without any alteration of structure being set up; but in the milder forms of this fever a greater number of organs and tissues are morbidly altered than perhaps in any other form of disease. The parts so affected are the liver, spleen, lungs, heart, brain, and the serous and mucous membranes of the body generally. Within certain limits, the specific action of the malarial poison may be said to be in the inverse ratio of the intensity of the fever which attends its action. The affections of the liver and spleen also vary greatly according to the locality in which the patient is attacked; for instance, whilst in some parts of India the spleen is the organ principally involved, in other districts of the same continent it is the liver. In England, under proper medical treatment, the patient usually recovers without any manifest derangement either of structure or impairment of function of any organ or tissue. The liver may, however, become affected if the patient suffering from the disease has been neglected for any length of time. Notwithstanding the opinions of Finke and Professor Colin, there appears to be considerable ground for the supposition that ague may be caused by drinking marsh and surface water. In an interesting paper on the ‘Indian Annals’ for 1856, Mr Bettington, of the Madras Civil Service, says:——“It is notorious that the water produces fever and affections of the spleen.” In confirmation of this assertion, he brings forward what seems to be some remarkably strong evidence. He cites cases of villages placed under the same conditions as to marsh-air in some of which fevers were prevalent, whilst in others they were absent; and he found on inquiry that whilst the latter villages were supplied with pure water, the inhabitants of the former had to drink marsh or mullah water, full of vegetable _débris_. In one village there were two sources of supply——a spring and a tank, the first fed by surface, and the other by marsh water. Those only who partook of the tank water were attacked by fever. Again, in Tulliwaree the fever was so universal that scarcely any inhabitant escaped it. In this village Mr Bettington caused a well to be dug, and the result was that the fever disappeared. Similar cases have occurred in this country. Twenty years ago Mr Blower, of Bedford, directed the attention of medical men to a case that occurred in a village, in which ague had nearly disappeared when a well was dug; and to another instance which occurred in the village of Houghton. In this parish almost the only family which escaped ague was that of a farmer; the members of this family partook of well water; whilst those who did not escape the disease drank ditch water.