Andersonville, Volume 2
by
John McElroy
Part 3 out of 3
Andersonville died there. Let it be kept in mind all the time, that the
average stay of a prisoner there was not four months. The great majority
came in after the 1st of May, and left before the middle of September.
May 1, 1864, there were ten thousand four hundred and twenty-seven in the
Stockade. August 8 there were thirty-three thousand one hundred and
fourteen; September 30 all these were dead or gone, except eight thousand
two hundred and eighteen, of whom four thousand five hundred and ninety
died inside of the next thirty days. The records of the world can shove
no parallel to this astounding mortality.
Since the above matter was first published in the BLADE, a friend has
sent me a transcript of the evidence at the Wirz trial, of Professor
Joseph Jones, a Surgeon of high rank in the Rebel Army, and who stood at
the head of the medical profession in Georgia. He visited Andersonville
at the instance of the Surgeon-General of the Confederate States' Army,
to make a study, for the benefit of science, of the phenomena of disease
occurring there. His capacity and opportunities for observation, and for
clearly estimating the value of the facts coming under his notice were,
of course, vastly superior to mine, and as he states the case stronger
than I dare to, for fear of being accused of exaggeration and downright
untruth, I reproduce the major part of his testimony--embodying also his
official report to medical headquarters at Richmond--that my readers may
know how the prison appeared to the eyes of one who, though a bitter
Rebel, was still a humane man and a conscientious observer, striving to
learn the truth:
MEDICAL TESTIMONY.
[Transcript from the printed testimony at the Wirz Trial, pages 618 to
639, inclusive.]
OCTOBER 7, 1885.
Dr. Joseph Jones, for the prosecution:
By the Judge Advocate:
Question. Where do you reside
Answer. In Augusta, Georgia.
Q. Are you a graduate of any medical college?
A. Of the University of Pennsylvania.
Q. How long have you been engaged in the practice of medicine?
A. Eight years.
Q. Has your experience been as a practitioner, or rather as an
investigator of medicine as a science?
A. Both.
Q. What position do you hold now?
A. That of Medical Chemist in the Medical College of Georgia, at
Augusta.
Q. How long have you held your position in that college?
A. Since 1858.
Q. How were you employed during the Rebellion?
A. I served six months in the early part of it as a private in the
ranks, and the rest of the time in the medical department.
Q. Under the direction of whom?
A. Under the direction of Dr. Moore, Surgeon General.
Q. Did you, while acting under his direction, visit Andersonville,
professionally?
A. Yes, Sir.
Q. For the purpose of making investigations there?
A. For the purpose of prosecuting investigations ordered by the Surgeon
General.
Q. You went there in obedience to a letter of instructions?
A. In obedience to orders which I received.
Q. Did you reduce the results of your investigations to the shape of a
report?
A. I was engaged at that work when General Johnston surrendered his
army.
(A document being handed to witness.)
Q. Have you examined this extract from your report and compared it with
the original?
A. Yes, Sir; I have.
Q. Is it accurate?
A. So far as my examination extended, it is accurate.'
The document just examined by witness was offered in evidence, and is as
follows:
Observations upon the diseases of the Federal prisoners, confined to Camp
Sumter, Andersonville, in Sumter County, Georgia, instituted with a view
to illustrate chiefly the origin and causes of hospital gangrene, the
relations of continued and malarial fevers, and the pathology of camp
diarrhea and dysentery, by Joseph Jones; Surgeon P. A. C. S., Professor
of Medical Chemistry in the Medical College of Georgia, at Augusta,
Georgia.
Hearing of the unusual mortality among the Federal prisoners confined at
Andersonville; Georgia, in the month of August, 1864, during a visit to
Richmond, Va., I expressed to the Surgeon General, S. P. Moore,
Confederate States of America, a desire to visit Camp Sumter, with the
design of instituting a series of inquiries upon the nature and causes of
the prevailing diseases. Smallpox had appeared among the prisoners, and
I believed that this would prove an admirable field for the establishment
of its characteristic lesions. The condition of Peyer's glands in this
disease was considered as worthy of minute investigation. It was
believed that a large body of men from the Northern portion of the United
States, suddenly transported to a warm Southern climate, and confined
upon a small portion of land, would furnish an excellent field for the
investigation of the relations of typhus, typhoid, and malarial fevers.
The Surgeon General of the Confederate States of America furnished me
with the following letter of introduction to the Surgeon in charge of the
Confederate States Military Prison at Andersonville, Ga.:
CONFEDERATE STATES OF AMERICA,
SURGEON GENERAL'S OFFICE, RICHMOND, VA.,
August 6, 1864.
SIR:--The field of pathological investigations afforded by the large
collection of Federal prisoners in Georgia, is of great extant and
importance, and it is believed that results of value to the profession
may be obtained by careful investigation of the effects of disease upon
the large body of men subjected to a decided change of climate and those
circumstances peculiar to prison life. The Surgeon in charge of the
hospital for Federal prisoners, together with his assistants, will afford
every facility to Surgeon Joseph Jones, in the prosecution of the labors
ordered by the Surgeon General. Efficient assistance must be rendered
Surgeon Jones by the medical officers, not only in his examinations into
the causes and symptoms of the various diseases, but especially in the
arduous labors of post mortem examinations.
The medical officers will assist in the performance of such post-mortems
as Surgeon Jones may indicate, in order that this great field for
pathological investigation may be explored for the benefit of the Medical
Department of the Confederate Army.
S. P. MOORE, Surgeon General.
Surgeon ISAIAH H. WHITE,
In charge of Hospital for Federal prisoners, Andersonville, Ga.
In compliance with this letter of the Surgeon General, Isaiah H. White,
Chief Surgeon of the post, and R. R. Stevenson, Surgeon in charge of the
Prison Hospital, afforded the necessary facilities for the prosecution of
my investigations among the sick outside of the Stockade. After the
completion of my labors in the military prison hospital, the following
communication was addressed to Brigadier General John H. Winder, in
consequence of the refusal on the part of the commandant of the interior
of the Confederate States Military Prison to admit me within the Stockade
upon the order of the Surgeon General:
CAMP SUMTER, ANDERSONVILLE GA.,
September 16, 1864.
GENERAL:--I respectfully request the commandant of the post of
Andersonville to grant me permission and to furnish the necessary pass
to visit the sick and medical officers within the Stockade of the
Confederate States Prison. I desire to institute certain inquiries
ordered by the Surgeon General. Surgeon Isaiah H. White, Chief Surgeon
of the post, and Surgeon R. R. Stevenson, in charge of the Prison
Hospital, have afforded me every facility for the prosecution of my
labors among the sick outside of the Stockade.
Very respectfully, your obedient servant,
JOSEPH JONES, Surgeon P. A. C. S.
Brigadier General JOHN H. WINDER,
Commandant, Post Andersonville.
In the absence of General Winder from the post, Captain Winder furnished
the following order:
CAMP SUMTER, ANDERSONVILLE;
September 17, 1864.
CAPTAIN:--You will permit Surgeon Joseph Jones, who has orders from the
Surgeon General, to visit the sick within the Stockade that are under
medical treatment. Surgeon Jones is ordered to make certain
investigations which may prove useful to his profession. By direction of
General Winder.
Very respectfully,
W. S. WINDER, A. A. G.
Captain H. WIRZ, Commanding Prison.
Description of the Confederate States Military Prison Hospital at
Andersonville. Number of prisoners, physical condition, food,
clothing, habits, moral condition, diseases.
The Confederate Military Prison at Andersonville, Ga., consists of a
strong Stockade, twenty feet in height, enclosing twenty-seven acres.
The Stockade is formed of strong pine logs, firmly planted in the ground.
The main Stockade is surrounded by two other similar rows of pine logs,
the middle Stockade being sixteen feet high, and the outer twelve feet.
These are intended for offense and defense. If the inner Stockade should
at any time be forced by the prisoners, the second forms another line of
defense; while in case of an attempt to deliver the prisoners by a force
operating upon the exterior, the outer line forms an admirable protection
to the Confederate troops, and a most formidable obstacle to cavalry or
infantry. The four angles of the outer line are strengthened by
earthworks upon commanding eminences, from which the cannon, in case of
an outbreak among the prisoners, may sweep the entire enclosure; and it
was designed to connect these works by a line of rifle pits, running
zig-zag, around the outer Stockade; those rifle pits have never been
completed. The ground enclosed by the innermost Stockade lies in the
form of a parallelogram, the larger diameter running almost due north and
south. This space includes the northern and southern opposing sides of
two hills, between which a stream of water runs from west to east.
The surface soil of these hills is composed chiefly of sand with varying
admixtures of clay and oxide of iron. The clay is sufficiently tenacious
to give a considerable degree of consistency to the soil. The internal
structure of the hills, as revealed by the deep wells, is similar to that
already described. The alternate layers of clay and sand, as well as the
oxide of iron, which forms in its various combinations a cement to the
sand, allow of extensive tunneling. The prisoners not only constructed
numerous dirt huts with balls of clay and sand, taken from the wells
which they have excavated all over those hills, but they have also, in
some cases, tunneled extensively from these wells. The lower portions of
these hills, bordering on the stream, are wet and boggy from the constant
oozing of water. The Stockade was built originally to accommodate only
ten thousand prisoners, and included at first seventeen acres. Near the
close of the month of June the area was enlarged by the addition of ten
acres. The ground added was situated on the northern slope of the
largest hill.
The average number of square feet of ground to each prisoner in August
1864: 35.7
Within the circumscribed area of the Stockade the Federal prisoners were
compelled to perform all the offices of life--cooking, washing, the calls
of nature, exercise, and sleeping. During the month of March the prison
was less crowded than at any subsequent time, and then the average space
of ground to each prisoner was only 98.7 feet, or less than seven square
yards. The Federal prisoners were gathered from all parts of the
Confederate States east of the Mississippi, and crowded into the confined
space, until in the month of June the average number of square feet of
ground to each prisoner was only 33.2 or less than four square yards.
These figures represent the condition of the Stockade in a better light
even than it really was; for a considerable breadth of land along the
stream, flowing from west to east between the hills, was low and boggy,
and was covered with the excrement of the men, and thus rendered wholly
uninhabitable, and in fact useless for every purpose except that of
defecation. The pines and other small trees and shrubs, which originally
were scattered sparsely over these hills, were in a short time cut down
and consumed by the prisoners for firewood, and no shade tree was left in
the entire enclosure of the stockade. With their characteristic industry
and ingenuity, the Federals constructed for themselves small huts and
caves, and attempted to shield themselves from the rain and sun and night
damps and dew. But few tents were distributed to the prisoners,
and those were in most cases torn and rotten. In the location and
arrangement of these tents and huts no order appears to have been
followed; in fact, regular streets appear to be out of the question in so
crowded an area; especially too, as large bodies of prisoners were from
time to time added suddenly without any previous preparations.
The irregular arrangement of the huts and imperfect shelters was very
unfavorable for the maintenance of a proper system of police.
The police and internal economy of the prison was left almost entirely in
the hands of the prisoners themselves; the duties of the Confederate
soldiers acting as guards being limited to the occupation of the boxes
or lookouts ranged around the stockade at regular intervals, and to the
manning of the batteries at the angles of the prison. Even judicial
matters pertaining to themselves, as the detection and punishment of such
crimes as theft and murder appear to have been in a great measure
abandoned to the prisoners. A striking instance of this occurred in the
month of July, when the Federal prisoners within the Stockade tried,
condemned, and hanged six (6) of their own number, who had been convicted
of stealing and of robbing and murdering their fellow-prisoners. They
were all hung upon the same day, and thousands of the prisoners gathered
around to witness the execution. The Confederate authorities are said
not to have interfered with these proceedings. In this collection of men
from all parts of the world, every phase of human character was
represented; the stronger preyed upon the weaker, and even the sick who
were unable to defend themselves were robbed of their scanty supplies of
food and clothing. Dark stories were afloat, of men, both sick and well,
who were murdered at night, strangled to death by their comrades for
scant supplies of clothing or money. I heard a sick and wounded Federal
prisoner accuse his nurse, a fellow-prisoner of the United States Army,
of having stealthily, during his sleep inoculated his wounded arm with
gangrene, that he might destroy his life and fall heir to his clothing.
....................................
The large number of men confined within the Stockade soon, under a
defective system of police, and with imperfect arrangements, covered the
surface of the low grounds with excrements. The sinks over the lower
portions of the stream were imperfect in their plan and structure, and
the excrements were in large measure deposited so near the borders of the
stream as not to be washed away, or else accumulated upon the low boggy
ground. The volume of water was not sufficient to wash away the feces,
and they accumulated in such quantities in the lower portion of the
stream as to form a mass of liquid excrement heavy rains caused the water
of the stream to rise, and as the arrangements for the passage of the
increased amounts of water out of the Stockade were insufficient, the
liquid feces overflowed the low grounds and covered them several inches,
after the subsidence of the waters. The action of the sun upon this
putrefying mass of excrements and fragments of bread and meat and bones
excited most rapid fermentation and developed a horrible stench.
Improvements were projected for the removal of the filth and for the
prevention of its accumulation, but they were only partially and
imperfectly carried out. As the forces of the prisoners were reduced by
confinement, want of exercise, improper diet, and by scurvy, diarrhea,
and dysentery, they were unable to evacuate their bowels within the
stream or along its banks, and the excrements were deposited at the very
doors of their tents. The vast majority appeared to lose all repulsion
to filth, and both sick and well disregarded all the laws of hygiene and
personal cleanliness. The accommodations for the sick were imperfect and
insufficient. From the organization of the prison, February 24, 1864, to
May 22, the sick were treated within the Stockade. In the crowded
condition of the Stockade, and with the tents and huts clustered thickly
around the hospital, it was impossible to secure proper ventilation or to
maintain the necessary police. The Federal prisoners also made frequent
forays upon the hospital stores and carried off the food and clothing of
the sick. The hospital was, on the 22d of May, removed to its present
site without the Stockade, and five acres of ground covered with oaks and
pines appropriated to the use of the sick.
The supply of medical officers has been insufficient from the foundation
of the prison.
The nurses and attendants upon the sick have been most generally Federal
prisoners, who in too many cases appear to have been devoid of moral
principle, and who not only neglected their duties, but were also engaged
in extensive robbing of the sick.
From the want of proper police and hygienic regulations alone it is not
wonderful that from February 24 to September 21, 1864, nine thousand four
hundred and seventy-nine deaths, nearly one-third the entire number of
prisoners, should have been recorded. I found the Stockade and hospital
in the following condition during my pathological investigations,
instituted in the month of September, 1864:
STOCKADE, CONFEDERATE STATES MILITARY PRISON.
At the time of my visit to Andersonville a large number of Federal
prisoners had been removed to Millen, Savannah; Charleston, and other
parts of, the Confederacy, in anticipation of an advance of General
Sherman's forces from Atlanta, with the design of liberating their
captive brethren; however, about fifteen thousand prisoners remained
confined within the limits of the Stockade and Confederate States
Military Prison Hospital.
In the Stockade, with the exception of the damp lowlands bordering the
small stream, the surface was covered with huts, and small ragged tents
and parts of blankets and fragments of oil-cloth, coats, and blankets
stretched upon stacks. The tents and huts were not arranged according to
any order, and there was in most parts of the enclosure scarcely room for
two men to walk abreast between the tents and huts.
If one might judge from the large pieces of corn-bread scattered about in
every direction on the ground the prisoners were either very lavishly
supplied with this article of diet, or else this kind of food was not
relished by them.
Each day the dead from the Stockade were carried out by their
fellow-prisoners and deposited upon the ground under a bush arbor, just
outside of the Southwestern Gate. From thence they were carried in
carts to the burying ground, one-quarter of a mile northwest, of the
Prison. The dead were buried without coffins, side by side, in trenches
four feet deep.
The low grounds bordering the stream were covered with human excrements
and filth of all kinds, which in many places appeared to be alive with
working maggots. An indescribable sickening stench arose from these
fermenting masses of human filth.
There were near five thousand seriously ill Federals in the Stockade and
Confederate States Military Prison Hospital, and the deaths exceeded one
hundred per day, and large numbers of the prisoners who were walking
about, and who had not been entered upon the sick reports, were suffering
from severe and incurable diarrhea, dysentery, and scurvy. The sick were
attended almost entirely by their fellow-prisoners, appointed as nurses,
and as they received but little attention, they were compelled to exert
themselves at all times to attend to the calls of nature, and hence they
retained the power of moving about to within a comparatively short period
of the close of life. Owing to the slow progress of the diseases most
prevalent, diarrhea, and chronic dysentery, the corpses were as a general
rule emaciated.
I visited two thousand sick within the Stockade, lying under some long
sheds which had been built at the northern portion for themselves. At
this time only one medical officer was in attendance, whereas at least
twenty medical officers should have been employed.
Died in the Stockade from its organization, February 24, 186l to
September 2l ....................................................3,254
Died in Hospital during same time ...............................6,225
Total deaths in Hospital and Stockade ...........................9,479
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 either of typhus or typhoid fever. The absence of
the different forms of malarial fever may be accounted for in 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 malarial 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 manifested 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, oedematous limbs, covered with livid
vibices, and petechiae spasmodically flexed, painful and hardened
extremities, spontaneous hemorrhages from mucous canals, and large,
ill-conditioned, spreading ulcers covered with a dark purplish fungus
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
apeneuroses, 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 water 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 sun, or from
the prick of a splinter, or from scratching, or a musketo 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 most total
deprivation of vegetables and fruit, appeared to be the chief causes of
the scurvy. I carefully examined the bakery and the bread furnished the
prisoners, and found that they were supplied almost entirely with
corn-bread from which the husk had not been separated. This husk acted
as an irritant to the alimentary canal, without adding any nutriment to
the bread. As far as my examination extended no fault could be found
with the mode in which the bread was baked; the difficulty lay in the
failure to separate the husk from the corn-meal. I strongly urged the
preparation of large quantities of soup made from the cow and calves'
heads with the brains and tongues, to which a liberal supply of sweet
potatos and vegetables might have been advantageously added. The
material existed in abundance for the preparation of such soup in large
quantities with but little additional expense. Such aliment would have
been not only highly nutritious, but it would also have acted as an
efficient remedial agent for the removal of the scorbutic condition. The
sick within the Stockade lay under several long sheds which were
originally built for barracks. These sheds covered two floors which
were open on all sides. The sick lay upon the bare boards, or upon such
ragged blankets as they possessed, without, as far as I observed, any
bedding or even straw.
............................
The haggard, distressed countenances of these miserable, complaining,
dejected, living skeletons, crying for medical aid and food, and cursing
their Government for its refusal to exchange prisoners, and the ghastly
corpses, with their glazed eye balls staring up into vacant space, with
the flies swarming down their open and grinning mouths, and over their
ragged clothes, infested with numerous lice, as they lay amongst the sick
and dying, formed a picture of helpless, hopeless misery which it would
be impossible to portray bywords or by the brush. A feeling of
disappointment and even resentment on account of the United States
Government upon the subject of the exchange of prisoners, appeared to be
widespread, and the apparent hopeless nature of the negotiations for some
general exchange of prisoners appeared to be a cause of universal regret
and deep and injurious despondency. I heard some of the prisoners go so
far as to exonerate the Confederate Government from any charge of
intentionally subjecting them to a protracted confinement, with its
necessary and unavoidable sufferings, in a country cut off from all
intercourse with foreign nations, and sorely pressed on all sides, whilst
on the other hand they charged their prolonged captivity upon their own
Government, which was attempting to make the negro equal to the white
man. Some hundred or more of the prisoners had been released from
confinement in the Stockade on parole, and filled various offices as
clerks, druggists, and carpenters, etc., in the various departments.
These men were well clothed, and presented a stout and healthy
appearance, and as a general rule they presented a much more robust and
healthy appearance than the Confederate troops guarding the prisoners.
The entire grounds are surrounded by a frail board fence, and are
strictly guarded by Confederate soldiers, and no prisoner except the
paroled attendants is allowed to leave the grounds except by a special
permit from the Commandant of the Interior of the Prison.
The patients and attendants, near two thousand in number, are crowded
into this confined space and are but poorly supplied with old and ragged
tents. Large numbers of them were without any bunks in the tents, and
lay upon the ground, oft-times without even a blanket. No beds or straw
appeared to have been furnished. The tents extend to within a few yards
of the small stream, the eastern portion of which, as we have before
said, is used as a privy and is loaded with excrements; and I observed a
large pile of corn-bread, bones, and filth of all kinds, thirty feet in
diameter and several feet in hight, swarming with myriads of flies, in a
vacant space near the pots used for cooking. Millions of flies swarmed
over everything, and covered the faces of the sleeping patients, and
crawled down their open mouths, and deposited their maggots in the
gangrenous wounds of the living, and in the mouths of the dead. Musketos
in great numbers also infested the tents, and many of the patients were
so stung by these pestiferous insects, that they resembled those
suffering from a slight attack of the measles.
The police and hygiene of the hospital were defective in the extreme;
the attendants, who appeared in almost every instance to have been
selected from the prisoners, seemed to have in many cases but little
interest in the welfare of their fellow-captives. The accusation was
made that the nurses in many cases robbed the sick of their clothing,
money, and rations, and carried on a clandestine trade with the paroled
prisoners and Confederate guards without the hospital enclosure, in the
clothing, effects of the sick, dying, and dead Federals. They certainly
appeared to neglect the comfort and cleanliness of the sick intrusted to
their care in a most shameful manner, even after making due allowances
for the difficulties of the situation. Many of the sick were literally
encrusted with dirt and filth and covered with vermin. When a gangrenous
wound needed washing, the limb was thrust out a little from the blanket,
or board, or rags upon which the patient was lying, and water poured over
it, and all the putrescent matter allowed to soak into the ground floor
of the tent. The supply of rags for dressing wounds was said to be very
scant, and I saw the most filthy rags which had been applied several
times, and imperfectly washed, used in dressing wounds. Where hospital
gangrene was prevailing, it was impossible for any wound to escape
contagion under these circumstances. The results of the treatment of
wounds in the hospital were of the most unsatisfactory character, from
this neglect of cleanliness, in the dressings and wounds themselves, as
well as from various other causes which will be more fully considered.
I saw several gangrenous wounds filled with maggots. I have frequently
seen neglected wounds amongst the Confederate soldiers similarly
affected; and as far as my experience extends, these worms destroy only
the dead tissues and do not injure specially the well parts. I have even
heard surgeons affirm that a gangrenous wound which had been thoroughly
cleansed by maggots, healed more rapidly than if it had been left to
itself. This want of cleanliness on the part of the nurses appeared to
be the result of carelessness and inattention, rather than of malignant
design, and the whole trouble can be traced to the want of the proper
police and sanitary regulations, and to the absence of intelligent
organization and division of labor. The abuses were in a large measure
due to the almost total absence of system, government, and rigid, but
wholesome sanitary regulations. In extenuation of these abuses it was
alleged by the medical officers that the Confederate troops were barely
sufficient to guard the prisoners, and that it was impossible to obtain
any number of experienced nurses from the Confederate forces. In fact
the guard appeared to be too small, even for the regulation of the
internal hygiene and police of the hospital.
The manner of disposing of the dead was also calculated to depress the
already desponding spirits of these men, many of whom have been confined
for months, and even for nearly two years in Richmond and other places,
and whose strength had been wasted by bad air, bad food, and neglect of
personal cleanliness. The dead-house is merely a frame covered with old
tent cloth and a few bushes, situated in the southwestern corner of the
hospital grounds. When a patient dies, he is simply laid in the narrow
street in front of his tent, until he is removed by Federal negros
detailed to carry off the dead; if a patient dies during the night, he
lies there until the morning, and during the day even the dead were
frequently allowed to remain for hours in these walks. In the dead-house
the corpses lie upon the bare ground, and were in most cases covered with
filth and vermin.
............................
The cooking arrangements are of the most defective character. Five large
iron pots similar to those used for boiling sugar cane, appeared to be
the only cooking utensils furnished by the hospital for the cooking of
nearly two thousand men; and the patients were dependent in great measure
upon their own miserable utensils. They were allowed to cook in the tent
doors and in the lanes, and this was another source of filth, and another
favorable condition for the generation and multiplication of flies and
other vermin.
The air of the tents was foul and disagreeable in the extreme, and in
fact the entire grounds emitted a most nauseous and disgusting smell.
I entered nearly all the tents and carefully examined the cases of
interest, and especially the cases of gangrene, upon numerous occasions,
during the prosecution of my pathological inquiries at Andersonville, and
therefore enjoyed every opportunity to judge correctly of the hygiene and
police of the hospital.
There appeared to be almost absolute indifference and neglect on the part
of the patients of personal cleanliness; their persons and clothing
inmost instances, and especially of those suffering with gangrene and
scorbutic ulcers, were filthy in the extreme and covered with vermin.
It was too often the case that patients were received from the Stockade
in a most deplorable condition. I have seen men brought in from the
Stockade in a dying condition, begrimed from head to foot with their own
excrements, and so black from smoke and filth that they, resembled negros
rather than white men. That this description of the Stockade and
hospital has not been overdrawn, will appear from the reports of the
surgeons in charge, appended to this report.
.........................
We will examine first the consolidated report of the sick and wounded
Federal prisoners. During six months, from the 1st of March to the 31st
of August, forty-two thousand six hundred and eighty-six cases of
diseases and wounds were reported. No classified record of the sick in
the Stockade was kept after the establishment of the hospital without the
Prison. This fact, in conjunction with those already presented relating
to the insufficiency of medical officers and the extreme illness and even
death of many prisoners in the tents in the Stockade, without any medical
attention or record beyond the bare number of the dead, demonstrate that
these figures, large as they, appear to be, are far below the truth.
As the number of prisoners varied greatly at different periods, the
relations between those reported sick and well, as far as those
statistics extend, can best be determined by a comparison of the
statistics of each month.
During this period of six months no less than five hundred and sixty-five
deaths are recorded under the head of 'morbi vanie.' In other words,
those men died without having received sufficient medical attention for
the determination of even the name of the disease causing death.
During the month of August fifty-three cases and fifty-three deaths are
recorded as due to marasmus. Surely this large number of deaths must
have been due to some other morbid state than slow wasting. If they were
due to improper and insufficient food, they should have been classed
accordingly, and if to diarrhea or dysentery or scurvy, the
classification should in like manner have been explicit.
We observe a progressive increase of the rate of mortality, from 3.11 per
cent. in March to 9.09 per cent. of mean strength, sick and well, in
August. The ratio of mortality continued to increase during September,
for notwithstanding the removal of one-half of the entire number of
prisoners during the early portion of the month, one thousand seven
hundred and sixty-seven (1,767) deaths are registered from September 1 to
21, and the largest number of deaths upon any one day occurred during
this month, on the 16th, viz. one hundred and nineteen.
The entire number of Federal prisoners confined at Andersonville was
about forty thousand six hundred and eleven; and during the period of
near seven months, from February 24 to September 21, nine thousand four
hundred and seventy-nine (9,479) deaths were recorded; that is, during
this period near one-fourth, or more, exactly one in 4.2, or 13.3 per
cent., terminated fatally. This increase of mortality was due in great
measure to the accumulation of the sources of disease, as the increase of
excrements and filth of all kinds, and the concentration of noxious
effluvia, and also to the progressive effects of salt diet, crowding, and
the hot climate.
CONCLUSIONS.
1st. The great mortality among the Federal prisoners confined in the
military prison at Andersonville was not referable to climatic causes, or
to the nature of the soil and waters.
2d. The chief causes of death were scurvy and its results and bowel
affections-chronic and acute diarrhea and dysentery. The bowel
affections appear to have been due to the diet, the habits of the
patients, the depressed, dejected state of the nervous system and moral
and intellectual powers, and to the effluvia arising from the decomposing
animal and vegetable filth. The effects of salt meat, and an unvarying
diet of cornmeal, with but few vegetables, and imperfect supplies of
vinegar and syrup, were manifested in the great prevalence of scurvy.
This disease, without doubt, was also influenced to an important extent
in its origin and course by the foul animal emanations.
3d. From the sameness of the food and form, the action of the poisonous
gases in the densely crowded and filthy Stockade and hospital, the blood
was altered in its constitution, even before the manifestation of actual
disease. In both the well and the sick the red corpuscles were
diminished; and in all diseases uncomplicated with inflammation,
the fibrous element was deficient. In cases of ulceration of the mucous
membrane of the intestinal canal, the fibrous element of the blood was
increased; while in simple diarrhea, uncomplicated with ulceration,
it was either diminished or else remained stationary. Heart clots were
very common, if not universally present, in cases of ulceration of the
intestinal mucous membrane, while in the uncomplicated cases of diarrhea
and scurvy, the blood was fluid and did not coagulate readily, and the
heart clots and fibrous concretions were almost universally absent.
From the watery condition of the blood, there resulted various serous
effusions into the pericardium, ventricles of the brain, and into the
abdomen. In almost all the cases which I examined after death, even the
most emaciated, there was more or less serous effusion into the abdominal
cavity. In cases of hospital gangrene of the extremities, and in cases
of gangrene of the intestines, heart clots and fibrous coagula were
universally present. The presence of those clots in the cases of
hospital gangrene, while they were absent in the cases in which there was
no inflammatory symptoms, sustains the conclusion that hospital gangrene
is a species of inflammation, imperfect and irregular though it may be in
its progress, in which the fibrous element and coagulation of the blood
are increased, even in those who are suffering from such a condition of
the blood, and from such diseases as are naturally accompanied with a
decrease in the fibrous constituent.
4th. The fact that hospital Gangrene appeared in the Stockade first, and
originated spontaneously without any previous contagion, and occurred
sporadically all over the Stockade and prison hospital, was proof
positive that this disease will arise whenever the conditions of
crowding, filth, foul air, and bad diet are present. The exhalations
from the hospital and Stockade appeared to exert their effects to a
considerable distance outside of these localities. The origin of
hospital gangrene among these prisoners appeared clearly to depend in
great measure upon the state of the general system induced by diet, and
various external noxious influences. The rapidity of the appearance and
action of the 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 it in all essential respects,
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 Hospital, in the depressed, depraved condition of the system of
these Federal prisoners.
5th. A scorbutic condition of the system appeared to favor the origin of
foul ulcers, which frequently took on true hospital gangrene. Scurvy and
hospital 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. From the results of the
existing war for the establishment of the independence of the Confederate
States, as well as from the published observations of Dr. Trotter, Sir
Gilbert Blane, and others of the English navy and army, it is evident
that the scorbutic condition of the system, especially in crowded ships
and camps, is most favorable to the origin and spread of foul ulcers and
hospital gangrene. As in the present case of Andersonville, so also in
past times when medical hygiene was almost entirely neglected, those two
diseases were almost universally associated in crowded ships. In many
cases it was very difficult to decide at first whether the ulcer was a
simple result of scurvy or of the action of the prison or hospital
gangrene, for there was great similarity in the appearance of the ulcers
in the two diseases. So commonly have those two diseases been combined
in their origin and action, that the description of scorbutic ulcers, by
many authors, evidently includes also many of the prominent
characteristics of hospital gangrene. This will be rendered evident by
an examination of the observations of Dr. Lind and Sir Gilbert Blane upon
scorbutic ulcers.
6th. Gangrenous spots followed by rapid destruction of tissue appeared
in some cases where there had been no known wound. Without such
well-established facts, it might be assumed that the disease was
propagated from one patient to another. In such a filthy and crowded
hospital as that of the Confederate States Military Prison at
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 kind, the filthy, imperfectly washed and
scanty supplies of rags, and the limited supply of washing utensils, the
same wash-bowl serving for scores of patients, were sources of such
constant circulation of the gangrenous matter that the disease might
rapidly spread from a single gangrenous wound. The fact already stated,
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 the disease upon the entire surface, not only
demonstrates the dependence of the disease upon the state of the
constitution, but proves in the clearest manner that neither the contact
of the poisonous matter of gangrene, nor the direct action of the
poisonous atmosphere upon the ulcerated surfaces is necessary to the
development of the disease.
7th. In this foul atmosphere amputation did not arrest hospital
gangrene; the disease almost invariably returned. Almost every
amputation was followed finally by death, either from the effects of
gangrene or from the prevailing diarrhea and dysentery. Nitric acid and
escharotics generally in this crowded atmosphere, loaded with noxious
effluvia, exerted only temporary effects; after their application to the
diseased surfaces, the gangrene would frequently return with redoubled
energy; and even after the gangrene had been completely removed by local
and constitutional treatment, it would frequently return and destroy the
patient. As far as my observation extended, very few of the cases of
amputation for gangrene recovered. The progress of these cases was
frequently very deceptive. I have observed after death the most
extensive disorganization of the structures of the stump, when during
life there was but little swelling of the part, and the patient was
apparently doing well. I endeavored to impress upon the medical officers
the view that in this disease treatment was almost useless, without an
abundant supply of pure, fresh air, nutritious food, and tonics and
stimulants. Such changes, however, as would allow of the isolation of
the cases of hospital gangrene appeared to be out of the power of the
medical officers.
8th. The gangrenous mass was without true pus, and consisted chiefly of
broken-down, disorganized structures. The reaction of the gangrenous
matter in certain stages was alkaline.
9th. The best, and in truth the only means of protecting large armies
and navies, as well as prisoners, from the ravages of hospital gangrene,
is to furnish liberal supplies of well-cured meat, together with fresh
beef and vegetables, and to enforce a rigid system of hygiene.
10th. Finally, this gigantic mass of human misery calls loudly for
relief, not only for the sake of suffering humanity, but also on account
of our own brave soldiers now captives in the hands of the Federal
Government. Strict justice to the gallant men of the Confederate Armies,
who have been or who may be, so unfortunate as to be compelled to
surrender in battle, demands that the Confederate Government should adopt
that course which will best secure their health and comfort in captivity;
or at least leave their enemies without a shadow of an excuse for any
violation of the rules of civilized warfare in the treatment of
prisoners.
[End of the Witness's Testimony.]
The variation--from month to month--of the proportion of deaths to the
whole number living is singular and interesting. It supports the theory
I have advanced above, as the following facts, taken from the official
report, will show:
In April one in every sixteen died.
In May one in every twenty-six died.
In June one in every twenty-two died.
In July one in every eighteen died.
In August one in every eleven died.
In September one in every three died.
In October one in every two died.
In November one in every three died.
Does the reader fully understand that in September one-third of those in
the pen died, that in October one-half of the remainder perished, and in
November one-third of those who still survived, died? Let him pause for
a moment and read this over carefully again; because its startling
magnitude will hardly dawn upon him at first reading. It is true that
the fearfully disproportionate mortality of those months was largely due
to the fact that it was mostly the sick that remained behind, but even
this diminishes but little the frightfulness of the showing. Did any one
ever hear of an epidemic so fatal that one-third of those attacked by it
in one month died; one-half of the remnant the next month, and one-third
of the feeble remainder the next month? If he did, his reading has been
much more extensive than mine.
The greatest number of deaths in one day is reported to have occurred on
the 23d of August, when one hundred and twenty-seven died, or one man
every eleven minutes.
The greatest number of prisoners in the Stockade is stated to have been
August 8, when there were thirty-three thousand one hundred and fourteen.
I have always imagined both these statements to be short of the truth,
because my remembrance is that one day in August I counted over two
hundred dead lying in a row. As for the greatest number of prisoners,
I remember quite distinctly standing by the ration wagon during the whole
time of the delivery of rations, to see how many prisoners there really
were inside. That day the One Hundred and Thirty-Third Detachment was
called, and its Sergeant came up and drew rations for a full detachment.
All the other detachments were habitually kept full by replacing those
who died with new comers. As each detachment consisted of two hundred
and seventy men, one hundred and thirty-three detachments would make
thirty-five thousand nine hundred and ten, exclusive of those in the
hospital, and those detailed outside as cooks, clerks, hospital
attendants and various other employments--say from one to two thousand
more.
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