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tents。 Large numbers of them were without any bunks in the tents； and
lay upon the ground； oft…times without even a blanket。 No beds or straw
appeared to have been furnished。 The tents extend to within a few yards
of the small stream； the eastern portion of which； as we have before
said； is used as a privy and is loaded with excrements； and I observed a
large pile of corn…bread； bones； and filth of all kinds； thirty feet in
diameter and several feet in hight； swarming with myriads of flies； in a
vacant space near the pots used for cooking。 Millions of flies swarmed
over everything； and covered the faces of the sleeping patients； and
crawled down their open mouths； and deposited their maggots in the
gangrenous wounds of the living； and in the mouths of the dead。 Musketos
in great numbers also infested the tents； and many of the patients were
so stung by these pestiferous insects； that they resembled those
suffering from a slight attack of the measles。
The police and hygiene of the hospital were defective in the extreme；
the attendants； who appeared in almost every instance to have been
selected from the prisoners； seemed to have in many cases but little
interest in the welfare of their fellow…captives。 The accusation was
made that the nurses in many cases robbed the sick of their clothing；
money； and rations； and carried on a clandestine trade with the paroled
prisoners and Confederate guards without the hospital enclosure； in the
clothing； effects of the sick； dying； and dead Federals。 They certainly
appeared to neglect the comfort and cleanliness of the sick intrusted to
their care in a most shameful manner； even after making due allowances
for the difficulties of the situation。 Many of the sick were literally
encrusted with dirt and filth and covered with vermin。 When a gangrenous
wound needed washing； the limb was thrust out a little from the blanket；
or board； or rags upon which the patient was lying； and water poured over
it； and all the putrescent matter allowed to soak into the ground floor
of the tent。 The supply of rags for dressing wounds was said to be very
scant； and I saw the most filthy rags which had been applied several
times； and imperfectly washed； used in dressing wounds。 Where hospital
gangrene was prevailing； it was impossible for any wound to escape
contagion under these circumstances。 The results of the treatment of
wounds in the hospital were of the most unsatisfactory character； from
this neglect of cleanliness； in the dressings and wounds themselves； as
well as from various other causes which will be more fully considered。
I saw several gangrenous wounds filled with maggots。 I have frequently
seen neglected wounds amongst the Confederate soldiers similarly
affected； and as far as my experience extends； these worms destroy only
the dead tissues and do not injure specially the well parts。 I have even
heard surgeons affirm that a gangrenous wound which had been thoroughly
cleansed by maggots； healed more rapidly than if it had been left to
itself。 This want of cleanliness on the part of the nurses appeared to
be the result of carelessness and inattention； rather than of malignant
design； and the whole trouble can be traced to the want of the proper
police and sanitary regulations； and to the absence of intelligent
organization and division of labor。 The abuses were in a large measure
due to the almost total absence of system； government； and rigid； but
wholesome sanitary regulations。 In extenuation of these abuses it was
alleged by the medical officers that the Confederate troops were barely
sufficient to guard the prisoners； and that it was impossible to obtain
any number of experienced nurses from the Confederate forces。 In fact
the guard appeared to be too small； even for the regulation of the
internal hygiene and police of the hospital。
The manner of disposing of the dead was also calculated to depress the
already desponding spirits of these men； many of whom have been confined
for months； and even for nearly two years in Richmond and other places；
and whose strength had been wasted by bad air； bad food； and neglect of
personal cleanliness。 The dead…house is merely a frame covered with old
tent cloth and a few bushes； situated in the southwestern corner of the
hospital grounds。 When a patient dies； he is simply laid in the narrow
street in front of his tent； until he is removed by Federal negros
detailed to carry off the dead； if a patient dies during the night； he
lies there until the morning； and during the day even the dead were
frequently allowed to remain for hours in these walks。 In the dead…house
the corpses lie upon the bare ground； and were in most cases covered with
filth and vermin。
。。。。。。。。。。。。。。。。。。。。。。。。。。。。
The cooking arrangements are of the most defective character。 Five large
iron pots similar to those used for boiling sugar cane； appeared to be
the only cooking utensils furnished by the hospital for the cooking of
nearly two thousand men； and the patients were dependent in great measure
upon their own miserable utensils。 They were allowed to cook in the tent
doors and in the lanes； and this was another source of filth； and another
favorable condition for the generation and multiplication of flies and
other vermin。
The air of the tents was foul and disagreeable in the extreme； and in
fact the entire grounds emitted a most nauseous and disgusting smell。
I entered nearly all the tents and carefully examined the cases of
interest； and especially the cases of gangrene； upon numerous occasions；
during the prosecution of my pathological inquiries at Andersonville； and
therefore enjoyed every opportunity to judge correctly of the hygiene and
police of the hospital。
There appeared to be almost absolute indifference and neglect on the part
of the patients of personal cleanliness； their persons and clothing
inmost instances； and especially of those suffering with gangrene and
scorbutic ulcers； were filthy in the extreme and covered with vermin。
It was too often the case that patients were received from the Stockade
in a most deplorable condition。 I have seen men brought in from the
Stockade in a dying condition； begrimed from head to foot with their own
excrements； and so black from smoke and filth that they； resembled negros
rather than white men。 That this description of the Stockade and
hospital has not been overdrawn； will appear from the reports of the
surgeons in charge； appended to this report。
。。。。。。。。。。。。。。。。。。。。。。。。。
We will examine first the consolidated report of the sick and wounded
Federal prisoners。 During six months； from the 1st of March to the 31st
of August； forty…two thousand six hundred and eighty…six cases of
diseases and wounds were reported。 No classified record of the sick in
the Stockade was kept after the establishment of the hospital without the
Prison。 This fact； in conjunction with those already presented relating
to the insufficiency of medical officers and the extreme illness and even
death of many prisoners in the tents in the Stockade； without any medical
attention or record beyond the bare number of the dead； demonstrate that
these figures； large as they； appear to be； are far below the truth。
As the number of prisoners varied greatly at different periods； the
relations between those reported sick and well； as far as those
statistics extend； can best be determined by a comparison of the
statistics of each month。
During this period of six months no less than five hundred and sixty…five
deaths are recorded under the head of 'morbi vanie。' In other words；
those men died without having received sufficient medical attention for
the determination of even the name of the disease causing death。
During the month of August fifty…three cases and fifty…three deaths are
recorded as due to marasmus。 Surely this large number of deaths must
have been due to some other morbid state than slow wasting。 If they were
due to improper and insufficient food； they should have been classed
accordingly； and if to diarrhea or dysentery or scurvy； the
classification should in like manner have been explicit。
We observe a progressive increase of the rate of mortality； from 3。11 per
cent。 in March to 9。09 per cent。 of mean strength； sick and well； in
August。 The ratio of mortality continued to increase during September；
for notwithstanding the removal of one…half of the entire number of
prisoners during the early portion of the month； one thousand seven
hundred and sixty…seven （1；767） deaths are registered from September 1 to
21； and the largest number of deaths upon any one day occurred during
this month； on the 16th； viz。 one hundred and nineteen。
The entire number of Federal prisoners confined at Andersonville was
about forty thousand six hundred and eleven； and during the period of
near seven months； from February 24 to September 21； nine thousand four
hundred and seventy…nine （9；479） deaths were recorded； that is； during
this period near one…fourth； or more； exactly one in 4。2； or 13。3 per
cent。； terminated fatally。 This increase of mortality was due in great
measure