Scurvy, diarrhea, dysentery, and hospital gangrene were the prevailing diseases. I was surprised to find but few cases of malarial fever, and no well-marked cases of either typhus or typhoid fever. The absence of the different forms of malarial fever may be accounted for on the supposition that the artificial atmosphere of the stockade, crowded densely with human beings and loaded with animal exhalations, was unfavorable to the existence and action of the mal anal poison. The absence of typhoid and typhus fevers amongst all the causes which are supposed to generate these diseases appeared to-be due to the fact that the great majority of these prisoners had been in captivity in Virginia, at Belle Island, and in other parts of the Confederacy for months, and even as long as two years, and during this time they had been subjected to the same bad influences, and those who had not had these fevers before either had them during their confinement in Confederate prisons or else their systems from long exposure were proof against their action.

The effects of scurvy were manifest on every hand, and in all its various stages, from the muddy, pale complexion, pale gums, feeble, languid, muscular motions, lowness of spirits and fetid breath, to the dusky, dirty, leaden complexion, swollen features, spongy, purple, livid fungoid bleeding gums, loose teeth, edematous limbs covered with livid vibices and petechiae, spasmodically flexed, painful and

DATE REMAIN- RECVED. RECVED. TOTAL RETURN- DESERT-

ING IN IN ED TO ED

1864 HOSP. FROM FROM HOSPI- STOCK-

STOCK- ATTEND- TAL ADE

LAST ADE ANTS

REPORT

9/14 1,609 76 ---- 1,685 1 ----

9/15 1,598 114 ---- 1,712 14 ----

9/16 1,651 16 ---- 1,667 1 ----

9/17 1,617 109 4 1,730 ---- ----

9/18 1,690 3 ---- 1,693 ---- ----

9/19 1,635 32 1 1,668 ---- 2

9/20 1,611 63 3 1,676 ---- ----

|MEDICAL OFFICERS ON | | DUTY IN HOSPITAL |

DATE DETAIL DIED REMAIN SURG- ASSIST ACTING TOTAL

-ED -ING EONS -ANT AS

FROM IN SURG- ASSIST

1864 HOSP. HOSP. EONS -ANT

SURG-

EONS

9/14 49 37 1598 3 11 8 22

9/15 ---- 47 1651 3 11 8 22

9/16 ---- 49 1617 3 11 8 22

9/17 ---- 40 1690 3 11 8 22

9/18 ---- 58 1635 3 11 9 23

9/19 ---- 55 1611 3 11 9 23

9/20 ---- 48 1628 3 11 9 23

hardened extremities, spontaneous hemorrhages from mucus canals, and large ill-conditioned spreading ulcers, covered with a dark-purplish fungous growth. I observed that in some of the cases of scurvy the parotid glands were greatly swollen, and in some instances to such an extent as to preclude entirely the power to articulate. In several cases of dropsy of the abdomen and lower extremities, supervening upon scurvy, the patients affirmed that previously to the appearance of the dropsy they had suffered with profuse and obstinate diarrhea, and that when this was checked by a change of diet from Indian-corn bread, baked with the husk, to boiled rice the dropsy appeared.

The severe pains and livid patches were frequently associated with swellings in various parts, and especially in the lower extremities, accompanied with stiffness and contractions of the knee joints and ankles, and often with a brawny feel of the parts, as if lymph had been effused between the integuments and aponeurosis, preventing the motion of the skin over the swollen parts.

Many of the prisoners believed that the scurvy was contagious, and I saw men guarding their wells and springs, fearing lest some man suffering with the scurvy might use the waters and thus poison them.

I observed also numerous cases of hospital gangrene and of spreading scorbutic ulcers, which had supervened upon slight injuries. The scorbutic ulcers presented a dark purple fungoid elevated surface, with livid swollen edges, and exuded a thin fetid sanious fluid instead of pus. Many ulcers which originated from the scorbutic condition of the system appeared to become truly gangrenous, assuming all the characteristics of hospital gangrene.

From the crowded condition, filthy habits, bad diet, and dejected, depressed condition of the prisoners, their systems had become so disordered that the smallest abrasion of the skin from the rubbing of a shoe, or from the effects of the hot sun, or from the prick of a splinter, or from scratching a mosquito bite, in some cases, took on rapid and frightful ulceration and gangrene.

The long use of salt meat, ofttimes imperfectly cured, as well as the almost total deprivation of vegetables and fruit, appeared to be the chief causes of the scurvy.