SOME FEATURES OF THE MORTALITY--PERCENTAGE OF DEATHS TO THOSE LIVING
--AN AVERAGE MEAN ONLY STANDS THE MISERY THREE MONTHS--DESCRIPTION
OF THE PRISON AND THE CONDITION OF THE MEN THEREIN, BY A LEADING
SCIENTIFIC MAN OF THE SOUTH.
Speaking of the manner in which the Plymouth Pilgrims were now dying,
I am reminded of my theory that the ordinary man’s endurance of this
prison life did not average over three months. The Plymouth boys
arrived in May; the bulk of those who died passed away in July and
August. The great increase of prisoners from all sources was in May,
June and July. The greatest mortality among these was in August,
September and October.
Many came in who had been in good health during their service in the
field, but who seemed utterly overwhelmed by the appalling misery they
saw on every hand, and giving way to despondency, died in a few days
or weeks. I do not mean to include them in the above class, as their
sickness was more mental than physical. My idea is that, taking one
hundred ordinarily healthful young soldiers from a regiment in active
service, and putting them into Andersonville, by the end of the third
month at least thirty-three of those weakest and most vulnerable to
disease would have succumbed to the exposure, the pollution of ground
and air, and the insufficiency of the ration of coarse corn meal. After
this the mortality would be somewhat less, say at the end of six months
fifty of them would be dead. The remainder would hang on still more
tenaciously, and at the end of a year there would be fifteen or twenty
still alive. There were sixty-three of my company taken; thirteen
lived through. I believe this was about the usual proportion for those
who were in as long as we. In all there were forty-five thousand six
hundred and thirteen prisoners brought into Andersonville. Of these
twelve thousand nine hundred and twelve died there, to say nothing of
thousands that died in other prisons in Georgia and the Carolinas,
immediately after their removal from Andersonville. One of every
three and a-half men upon whom the gates of the Stockade closed never
repassed them alive. Twenty-nine per cent. of the boys who so much as
set foot in 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.