How does the author use foreshadowing in Fever?

The opening imagery, in which the trees are described as barren women, foreshadow the conclusion, which uses the voices of present-day characters to describe a Philadelphia as sick and dying as it was in 1793. The opening description of winter, the epidemic of the summer, and the recurring theme of the ebb and flow of the water that gave birth to the city all make for a cyclic narrative, in which the reader is brought to understand that as long as poison exists in men's hearts, epidemics will recur and slavery will continue.