sanitary regulations, and urged the necessity of procuring for the use of the sick a number of cows, so that a certain and abundant supply of fresh milk might at all times be accessible to the sick.
The results of my post-mortem examinations showed that in many of the cases of diarrhea and dysentery of long standing no treatment whatever would have availed, so thoroughly was the mucous membrane of the intestinal canal diseased. In those cases of diarrhea and dysentery which I examined after death the congestion of the mucous membrane was intense, and was often accompanied with ulceration and mortification. The mortifications in many of these cases appeared to be similar in its nature and to be due to the same causes as that form of mortification know as hospital gangrene.
Scurvy.-From the 1st of March to the 1st of September 9.051 cases and 999 deaths were recorded under the head of scorbutus. We also observe during the same period the record of 1,510 cases of anasarca and 315 deaths also 46 cases of ascites and 4 deaths. It is probable that these cases of anasarca and ascites were caused by by scorbutic condition of the blood, as wel as by the deranged condition of the alimentary canal. The large number of deaths set down under the head of morbi varii and marasmus were in like manner due chiefly to diarrhea, dysentery, scurvy, and their various effects.
Notwithstanding that hese figures represent nearly one-fourth of the Federal prisoners as sufring with scurvy, the statement is below the truth. During the period of my investigations a much larger proportion than one-fourth of the prisoners were suffering with scurvy, and it appeared that almost every one of the older prisoners was more or less scorbutic.
We have before alluded to the various symptons manifested by this disease, as the enlargement of the parotid glands, the livid, swollen, spongy, fungoid gums, loose teeth, the dark purple blotches upon the skin, the hard rough feeling of the lower extermities, and the foul spreading scorbutic ulcers. The swelling of the parotid glands in these cases of scurvy was generally a fatal symptom, and in most cases preceded death by only a few days. In this foul atmosphere the scorbutic ulcers, however excited, soon took on the appearance and action of hospital gangrene.
The scurvy was not confined to the prisoners. I saw a well-marked case of scurvy in a full surgeon in charge of one of the wards of the hospital. This fact, taken in conjunction with one already stated, that this disease is at the present time prevailing extensively in the Army of Tennessee, indicates in a strong light the difficulties with which the medical staff had to contend in attempting to combat this disease.
Hospital gangrene.-In the depraved and depressed condition of the systems of these prisoners, in the foul atmosphere of the stockade and hospital, reeking with noxious exhalations, the smallest injury, as a splinter running into a hand or foot, the blistering of the arms of hands in the hot sun, or even the abrasions of the skin in scratching a mosquito bite, were often followed by the most extensive and alarming gangrenous ulceration. In these spreading ulcers of the foot the Federal prisoners almost invariably referred the origin of the gangrene to the filthy mud mixed with human excrements upon the borders of the stream flowing through the stockade. Numerous amputations have been performed in the hospital for gangrene supervening upon slight injuries, as the prick of a splinter, a scratch, or upon scorbutic ulcers.
I endeavored to collect a record of all the cases of amputation for hospital gangrene, with the progress and results, but was unable to