inches of the shoulder joint. The arm was very much tumefied, and presented around the border of the large sphacelus a kind of erysipelatous inflammation. This inflamed surface was covered with green and yellow spots; these in turn opend and discharged filthy and very offensive sanies. The pulse beat 120 to the minute, was weak, and had a peculiar vibratory thrill. Tongue dry and glazed, very red at the tip and edges. Bowels a little loose, but not amounting to diarrhea. Appetite weak. Urine scant and highly colored; complained of considerable pain in the affected arm and shoulder; had copious nightweats; complained of chilliness of mornings and fever in the afternoon. (R Quiniae sulph., gr. xx. Pulv. Doveri, gr. x. M. ft. chart. iii and to be given every six hours in one ounce good whisky. Apply pure nitric acid to the sphacelus, evelope the whole arm in pulverized lini poultices.)
6th. Patient no better; is very anxious to have the arm amputated; gangrene extending. Pulse 125 in the morning, 137 in the evening. Tongue about the same. Bowels still loose. Appetite somewhat improved; forearm edematous; continued prescription.
7th. Gangrene still extending above the elbow; presents a pea-green appearance, and emits an intorlerable odor. Pulse 130 at 8 a. m., 141 at 5 p. m. Bowels painful; has mucous discharges. Appetite weak; cannot obtain diet of proper kinds.
8th. This morning the gangrene has extended into the shoulder joint and half way to the hand. Pulse 140, a. m.; 157, p. m. Has ysentery. Prescription continued with turpentine emulsion. In this condition the patient remained up to the 10th, at which time he began to sink, and as we could do nothing more we continued about the same treatment up to the 4th, at which time the patient died, with the whole arm in a state of sphacelus.
Now, if this was "hospital gangrene," we haved had quite a number of cases of this disease, and if not, the disease has not prevailed at this post. Although the case above described is but a faint outline of the disease, yet we hope it is sufficiently plain to be understood.
We will close this paper, lest we weary you with dry and uninteresting matter, by giving a short description of our so-called hospital. We have from 1,600 to 2,000 patients, besides, nurses and attendants, crowded together in small and almost useless tents erected on less than three acres of ground. The hospital is located on a narrow tongue of land between two small creeks on each side of which are swamps forty or fifty yards in width; on the west and up these creeks from the hospital are the camps and stockade. Now, all the debris from over 30,000 human beings have to pass along the small brook on the north of the hospital grounds and within a stone's throw of patients' tents. A large portion of this filth is deposited on the marsh and produces a most sikening stench. Our patients are carried from the stockade and placed in the tents by the attendants. We put in the common small A tent four patients, in the large wall tent eight, and in the common fly from six to eight. About one-third have bunks or scaffolds and the remainder have to lie on the ground without straw or anything else to protect them from its dampness.
Those who are not fortunate enough to have a blanket are compelled to lie on the damp ground with no covering but their clothing, which in many instances they have worn for six months without washing.
The diet is of the coarsest kind, consisting of boiled beef, rice, molasses, and coarse corn bread baked without sifting, and from one