to two ordinary-sized biscuits. To this we sometimes have added a small allowance of vegetables, such as peas, potatoes, and collards. These vegetables are generally issued raw and the patients are compelled to hire their comrades to cook them in some sort of style and pay them out of their scanty allowance.
We also have great difficulty in procuring medicines. The supplies for a month are usually exhausted in ten days, and the remainder of the time we are compelled to rely on such indigenous remedies as we can procure from the adjacent woods. Our cooking department has been very deficient all summer, consisting of two large salt kettles placed on a furnance in the open air. The water is good and the supply plenteous.
With these facts before you you will not wonder at the fearful mortality presented in our report and in the tabular statement from our ward, presented above.
Feeling we have done our whole duty, both in the eyes of God and man, we leave the matter to rest with those whose duty it was to furnish supplies and build up a hospital that might have reflected credit on the Government and saved the lives of thousands of our race.
The above description of ulcers attended with gangrene are so nearly allied to hospital gangrene that we are of the opinion that many cases of the above diseases are identical with this disease.
As hospital gangrene proper is of rare occurrence in our country, and as our public institutions have never been visited by this disease in its epidemic form like the large hospitals of Europe, it has rarely happened that our teachers of medicines and surgery have had an opportunity of witnessing and investigating the disease in its most aggravated forms. Hence we have comparatively little written on the subject by American authors; and what little has been written is difficult to understand, on account of the very different descriptions given by different authors, both of this and other countries, so that we are at a loss to know how to proceed with our investigation, lest in forming an opinion on a subject so interesting and important we should make some fatal blunders. We will therefore content ourselves by giving such answers to the questions you honored us with while with us as may seem in our humble judgment proper.
We take the ground that we have hospital gangrene in its most aggraated form in this hospital; and also that it has and is still prevailing to an alarming extent among these unfortunate prisoners. we regard the sloughing phagedaena so common and so fatal in its consequences as a true type of this disease. At least, this disease corresponds so accurately with descriptions of hospital gangrene given by European writers that we conclude the disease is one and the same.
We have had under our immediate care a goodly number of cases of this disease within the last few months, and have witnessed a great many more in other wards, and have consulted with various medical gentlemen on the subject, and find but few who differ in opinion with reference to the diseaseusually diagnosed "phagedaena gangraenosa" and "hospital gangrene" being the same disease.
From the experience we have had with hospital gangrene we regard it as a constitutional disease, from the fact that we invariably have it marked by constitutional symptoms, generally of a low grade. These