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gangrene depended upon the powers and state of the constitution； as well
as upon the intensity of the poison in the atmosphere； or upon the direct
application of poisonous matter to the wounded surface。 This was further
illustrated by the important fact； that hospital gangrene； or a disease
resembling this form of gangrene； attacked the intestinal canal of
patients laboring under ulceration of the bowels； although there were no
local manifestations of gangrene upon the surface of the body。 This mode
of termination in cases of dysentery was quite common in the foul
atmosphere of the Confederate States Military Prison Hospital； and in the
depressed； depraved condition of the system of these Federal prisoners；
death ensued very rapidly after the gangrenous state of the intestines
was established。
XI。 A scorbutic condition of the system appeared to favor the origin of
foul ulcers； which frequently took on true hospital gangrene。
Scurvy and gangrene frequently existed in the same individual。 In such
cases； vegetable diet with vegetable acids would remove the scorbutic
condition without curing the hospital gangrene。 。 。 Scurvy consists
not only in an alteration in the constitution of the blood； which leads
to passive hemorrhages from the bowels； and the effusion into the various
tissues of a deeply…colored fibrinous exudation； but； as we have
conclusively shown by postmortem examination； this state is attended with
consistence of the muscles of the heart； and the mucous membrane of the
alimentary canal； and of solid parts generally。 We have； according to
the extent of the deficiency of certain articles of food； every degree of
scorbutic derangement； from the most fearful depravation of the blood
and the perversion of every function subserved by the blood to those
slight derangements which are scarcely distinguishable from a state of
health。 We are as yet ignorant of the true nature of the changes of the
blood and tissues in scurvy； and wide field for investigation is open for
the determination the characteristic changesphysical； chemical； and
physiologicalof the blood and tissues； and of the secretions and
excretions of scurvy。 Such inquiries would be of great value in their
bearing upon the origin of hospital gangrene。 Up to the present war；
the results of chemical investigations upon the pathology of the blood in
scurvy were not only contradictory； but meager； and wanting in that
careful detail of the cases from which the blood was abstracted which
would enable us to explain the cause of the apparent discrepancies in
different analyses。 Thus it is not yet settled whether the fibrin is
increased or diminished in this disease； and the differences which exist
in the statements of different writers appear to be referable to the
neglect of a critical examination and record of all the symptoms of the
cases from which the blood was abstracted。 The true nature of the
changes of the blood in scurvy can be established only by numerous
analyses during different stages of the disease； and followed up by
carefully performed and recorded postmortem examinations。 With such data
we could settle such important questions as whether the increase of
fibrin in scurvy was invariably dependent upon some local inflammation。
XII。 Gangrenous spots； followed by rapid destruction of tissue； appeared
in some cases in which there had been no previous or existing wound or
abrasion； and without such well established facts； it might be assumed
that the disease was propagated from one patient to another in every
case； either by exhalations from the gangrenous surface or by direct
contact。
In such a filthy and crowded hospital as that of the Confederate； States
Military Prison of Camp Sumter； Andersonville； it was impossible to
isolate the wounded from the sources of actual contact of the gangrenous
matter。 The flies swarming over the wounds and over filth of every
description； the filthy； imperfectly washed； and scanty rags； the limited
number of sponges and wash…bowls （the same wash…bowl and sponge serving
for a score or more of patients）； were one and all sources of such
constant circulation of the gangrenous matter； that the disease might
rapidly be propagated from a single gangrenous wound。 While the fact
already considered； that a form of moist gangrene； resembling hospital
gangrene； was quite common in this foul atmosphere in cases of dysentery；
both with and without the existence of hospital gangrene upon the
surface； demonstrates the dependence of the disease upon the state of the
constitution； and proves in a clear manner that neither the contact of
the poisonous matter of gangrene； nor the direct action of the poisoned
atmosphere upon the ulcerated surface； is necessary to the development of
the disease； on the other hand； it is equally well…established that the
disease may be communicated by the various ways just mentioned。 It is
impossible to determine the length of time which rags and clothing
saturated with gangrenous matter will retain the power of reproducing the
disease when applied to healthy wounds。 Professor Brugmans； as quoted by
Guthrie in his commentaries on the surgery of the war in Portugal； Spain；
France； and the Netherlands； says that in 1797； in Holland； 'charpie；'
composed of linen threads cut of different lengths； which； on inquiry； it
was found had been already used in the great hospitals in France； and had
been subsequently washed and bleached； caused every ulcer to which it was
applied to be affected by hospital gangrene。 Guthrie affirms in the same
work； that the fact that this disease was readily communicated by the
application of instruments； lint； or bandages which had been in contact
with infected parts； was too firmly established by the experience of
every one in Portugal and Spain to be a matter of doubt。 There are facts
to show that flies may be the means of communicating malignant pustules。
Dr。 Wagner； who has related several cases of malignant pustule produced
in man and beasts； both by contact and by eating the flesh of diseased
animals； which happened in the village of Striessa in Saxony； in 1834；
gives two very remarkable cases which occurred eight days after any beast
had been affected with the disease。 Both were women； one of twenty…six
and the other of fifty years； and in them the pustules were well marked；
and the general symptoms similar to the other cases。 The latter patient
said she had been bitten by a fly upon the back d the neck； at which part
the carbuncle appeared； and the former； that she had also been bitten
upon the right upper arm by a gnat。 Upon inquiry； Wagner found that the
skin of one of the infected beasts had been hung on a neighboring wall；
and thought it very possible that the insects might have been attracted
to them by the smell； and had thence conveyed the poison。
＇End of Dr。 Stevenson's Statement＇
。。。。。。。。。。。。。。。。。。。。。。。。。。
The old adage says that 〃Hunger is the best sauce for poor food；〃 but
hunger failed to render this detestable stuff palatable； and it became so
loathsome that very many actually starved to death because unable to
force their organs of deglutition to receive the nauseous dose and pass
it to the stomach。 I was always much healthier than the average of the
boys； and my appetite consequently much better； yet for the last month
that I was in Andersonville； it required all my determination to crowd
the bread down my throat； and； as I have stated before； I could only do
this by breaking off small bits at a time； and forcing each down as I
would a pill。
A large part of this repulsiveness was due to the coarseness and foulness
of the meal； the wretched cooking； and the lack of salt； but there was a
still more potent reason than all these。 Nature does not intend that man
shall live by bread alone； nor by any one kind of food。 She indicates
this by the varying tastes and longings that she gives him。 If his body
needs one kind of constituents； his tastes lead him to desire the food
that is richest in those constituents。 When he has taken as much as his
system requires； the sense of satiety supervenes； and he 〃becomes tired〃
of that particular food。 If tastes are not perverted； but allowed a free
but temperate exercise； they are the surest indicators of the way to
preserve health and strength by a judicious selection of alimentation。
In this case Nature was protesting by a rebellion of the tastes against
any further use of that species of food。 She was saying； as plainly as
she ever spoke； that death could only be averted by a change of diet；
which would supply our bodies with the constituents they so sadly needed；
and which could not be supplied by corn meal。
How needless was this confinement of our rations to corn meal； and
especially to such wretchedly prepared meal； is conclusively shown by the
Rebel testimony heretofore given。 It would have been very little extra
trouble to the Rebels to have had our meal sifted； we would gladly have
done it ourselves if allowed the utensils and opportunity。 It would have
been as little trouble to have varied our rations with green corn and
sweet potatos； o