The episode introduces elements of The Rot (also known as the Black), a DC Comics force of entropy and decay that opposes the Green.

Alec reveals to Abby that the disease isn't an attack, but rather the swamp "fighting back" to protect itself. This insight leads Abby to realize that antibiotics are useless; she successfully treats her friend Harlan by using immunosuppressants instead.

The episode is highly regarded for its —particularly the unsettling use of insects—and for effectively balancing medical procedural drama with supernatural suspense. Swamp Thing season 1, episode 3 recap: He Speaks

Brought in by the Sunderlands to "fix" the swamp, Woodrue begins his obsessive medical research, seemingly motivated by a desire to cure his wife’s early-onset Alzheimer’s.