by John McElroy
While we readily admit that famine induces that state of the system which is the most susceptible to the action of fever poisons, and thus induces the state of the entire population which is most favorable for the rapid and destructive spread of all contagious fevers, at the same time we are forced by the facts established by the present war, as well as by a host of others, both old and new, to admit that we are still ignorant of the causes necessary for the origin of typhus fever. Added to the imperfect nature of the rations issued to the Federal prisoners, the difficulties of their situation were at times greatly increased by the sudden and desolating Federal raids in Virginia, Georgia, and other States, which necessitated the sudden transportation from Richmond and other points threatened of large bodies of prisoners, without the possibility of much previous preparation; and not only did these men suffer in transition upon the dilapidated and overburdened line of railroad communication, but after arriving at Andersonville, the rations were frequently insufficient to supply the sudden addition of several thousand men. And as the Confederacy became more and more pressed, and when powerful hostile armies were plunging through her bosom, the Federal prisoners of Andersonville suffered incredibly during the hasty removal to Millen, Savannah, Charleston, and other points, supposed at the time to be secure from the enemy. Each one of these causes must be weighed when an attempt is made to estimate the unusual mortality among these prisoners of war.
Scurvy, arising from sameness of food and imperfect nutrition, caused, either directly or indirectly, nine-tenths of the deaths among the Federal prisoners at Andersonville.
Not only were the deaths referred to unknown causes, to apoplexy, to anasarca, and to debility, traceable to scurvy and its effects; and not only was the mortality in small-pox, pneumonia, and typhoid fever, and in all acute diseases, more than doubled by the scorbutic taint, but even those all but universal and deadly bowel affections arose from the same causes, and derived their fatal character from the same conditions which produced the scurvy. In truth, these men at Andersonville were in the condition of a crew at sea, confined in a foul ship upon salt meat and unvarying food, and without fresh vegetables. Not only so, but these unfortunate prisoners were men forcibly confined and crowded upon a ship tossed about on a stormy ocean, without a rudder, without a compass, without a guiding-star, and without any apparent boundary or to their voyage; and they reflected in their steadily increasing miseries the distressed condition and waning fortunes of devastated and bleeding country, which was compelled, in justice to her own unfortunate sons, to hold these men in the most distressing captivity.
I saw nothing in the scurvy which prevailed so universally at Andersonville, at all different from this disease as described by various standard writers. The mortality was no greater than that which has afflicted a hundred ships upon long voyages, and it did not exceed the mortality which has, upon me than one occasion, and in a much shorter period of time, annihilated large armies and desolated beleaguered cities. The general results of my investigations upon the chronic diarrhea and dysentery of the Federal prisoners of Andersonville were similar to those of the English surgeons during the war against Russia.
IX. Drugs exercised but little influence over the progress and fatal termination of chronic diarrhea and dysentery in the Military Prison and Hospital at Andersonville, chiefly because the proper form of nourishment (milk, rice, vegetables, anti-scorbutics, and nourishing animal and vegetable soups) was not issued, and could not be procured in sufficient quantities for the sick prisoners.
Opium allayed pain and checked the bowels temporarily, but the frail dam was soon swept away, and the patient appears to be but little better, if not the worse, for this merely palliative treatment. The root of the difficulty could not be reached by drugs; nothing short of the wanting elements of nutrition would have tended in any manner to restore the tone of the digestive system, and of all the wasted and degenerated organs and tissues. My opinion to this effect was expressed most decidedly to the medical officers in charge of these unfortunate men. The correctness of this view was sustained by the healthy and robust condition of the paroled prisoners, who received an extra ration, and who were able to make considerable sums by trading, and who supplied themselves with a liberal and varied diet.
X. 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 gangrene among these prisoners appeared clearly to depend in great measure upon the state of the general system, induced by diet, exposure, neglect of personal cleanliness; and by 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 this form of gangrene, 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 Prison Hospital; and in the depressed, depraved condition of the system of these Federal prisoners, death ensued very rapidly after the gangrenous state of the intestines was established.
XI. A scorbutic condition of the system appeared to favor the origin of foul ulcers, which frequently took on true hospital gangrene.
Scurvy and 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. . . Scurvy consists not only in an alteration in the constitution of the blood, which leads to passive hemorrhages from the bowels, and the effusion into the various tissues of a deeply-colored fibrinous exudation; but, as we have conclusively shown by postmortem examination, this state is attended with consistence of the muscles of the heart, and the mucous membrane of the alimentary canal, and of solid parts generally. We have, according to the extent of the deficiency of certain articles of food, every degree of scorbutic derangement, from the most fearful depravation of the blood and the perversion of every function subserved by the blood to those slight derangements which are scarcely distinguishable from a state of health. We are as yet ignorant of the true nature of the changes of the blood and tissues in scurvy, and wide field for investigation is open for the determination the characteristic changes—physical, chemical, and physiological—of the blood and tissues, and of the secretions and excretions of scurvy. Such inquiries would be of great value in their bearing upon the origin of hospital gangrene. Up to the present war, the results of chemical investigations upon the pathology of the blood in scurvy were not only contradictory, but meager, and wanting in that careful detail of the cases from which the blood was abstracted which would enable us to explain the cause of the apparent discrepancies in different analyses. Thus it is not yet settled whether the fibrin is increased or diminished in this disease; and the differences which exist in the statements of different writers appear to be referable to the neglect of a critical examination and record of all the symptoms of the cases from which the blood was abstracted. The true nature of the changes of the blood in scurvy can be established only by numerous analyses during different stages of the disease, and followed up by carefully performed and recorded postmortem examinations. With such data we could settle such important questions as whether the increase of fibrin in scurvy was invariably dependent upon some local inflammation.
XII. Gangrenous spots, followed by rapid destruction of tissue, appeared in some cases in which there had bee
n no previous or existing wound or abrasion; and without such well established facts, it might be assumed that the disease was propagated from one patient to another in every case, either by exhalations from the gangrenous surface or by direct contact.
In such a filthy and crowded hospital as that of the Confederate, States Military Prison of Camp Sumter, 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 description; the filthy, imperfectly washed, and scanty rags; the limited number of sponges and wash-bowls (the same wash-bowl and sponge serving for a score or more of patients), were one and all sources of such constant circulation of the gangrenous matter, that the disease might rapidly be propagated from a single gangrenous wound. While the fact already considered, 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 hospital gangrene upon the surface, demonstrates the dependence of the disease upon the state of the constitution, and proves in a clear manner that neither the contact of the poisonous matter of gangrene, nor the direct action of the poisoned atmosphere upon the ulcerated surface, is necessary to the development of the disease; on the other hand, it is equally well-established that the disease may be communicated by the various ways just mentioned. It is impossible to determine the length of time which rags and clothing saturated with gangrenous matter will retain the power of reproducing the disease when applied to healthy wounds. Professor Brugmans, as quoted by Guthrie in his commentaries on the surgery of the war in Portugal, Spain, France, and the Netherlands, says that in 1797, in Holland, 'charpie,' composed of linen threads cut of different lengths, which, on inquiry, it was found had been already used in the great hospitals in France, and had been subsequently washed and bleached, caused every ulcer to which it was applied to be affected by hospital gangrene. Guthrie affirms in the same work, that the fact that this disease was readily communicated by the application of instruments, lint, or bandages which had been in contact with infected parts, was too firmly established by the experience of every one in Portugal and Spain to be a matter of doubt. There are facts to show that flies may be the means of communicating malignant pustules. Dr. Wagner, who has related several cases of malignant pustule produced in man and beasts, both by contact and by eating the flesh of diseased animals, which happened in the village of Striessa in Saxony, in 1834, gives two very remarkable cases which occurred eight days after any beast had been affected with the disease. Both were women, one of twenty-six and the other of fifty years, and in them the pustules were well marked, and the general symptoms similar to the other cases. The latter patient said she had been bitten by a fly upon the back d the neck, at which part the carbuncle appeared; and the former, that she had also been bitten upon the right upper arm by a gnat. Upon inquiry, Wagner found that the skin of one of the infected beasts had been hung on a neighboring wall, and thought it very possible that the insects might have been attracted to them by the smell, and had thence conveyed the poison.
[End of Dr. Stevenson's Statement]
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The old adage says that "Hunger is the best sauce for poor food," but hunger failed to render this detestable stuff palatable, and it became so loathsome that very many actually starved to death because unable to force their organs of deglutition to receive the nauseous dose and pass it to the stomach. I was always much healthier than the average of the boys, and my appetite consequently much better, yet for the last month that I was in Andersonville, it required all my determination to crowd the bread down my throat, and, as I have stated before, I could only do this by breaking off small bits at a time, and forcing each down as I would a pill.
A large part of this repulsiveness was due to the coarseness and foulness of the meal, the wretched cooking, and the lack of salt, but there was a still more potent reason than all these. Nature does not intend that man shall live by bread alone, nor by any one kind of food. She indicates this by the varying tastes and longings that she gives him. If his body needs one kind of constituents, his tastes lead him to desire the food that is richest in those constituents. When he has taken as much as his system requires, the sense of satiety supervenes, and he "becomes tired" of that particular food. If tastes are not perverted, but allowed a free but temperate exercise, they are the surest indicators of the way to preserve health and strength by a judicious selection of alimentation.
In this case Nature was protesting by a rebellion of the tastes against any further use of that species of food. She was saying, as plainly as she ever spoke, that death could only be averted by a change of diet, which would supply our bodies with the constituents they so sadly needed, and which could not be supplied by corn meal.
How needless was this confinement of our rations to corn meal, and especially to such wretchedly prepared meal, is conclusively shown by the Rebel testimony heretofore given. It would have been very little extra trouble to the Rebels to have had our meal sifted; we would gladly have done it ourselves if allowed the utensils and opportunity. It would have been as little trouble to have varied our rations with green corn and sweet potatos, of which the country was then full.
A few wagon loads of roasting ears and sweet potatos would have banished every trace of scurvy from the camp, healed up the wasting dysentery, and saved thousands of lives. Any day that the Rebels had chosen they could have gotten a thousand volunteers who would have given their solemn parole not to escape, and gone any distance into the country, to gather the potatos and corn, and such other vegetables as were readily obtainable, and bring, them into the camp.
Whatever else may be said in defense of the Southern management of military prisons, the permitting seven thousand men to die of the scurvy in the Summer time, in the midst of an agricultural region, filled with all manner of green vegetation, must forever remain impossible of explanation.
CHAPTER LI
SOLICITUDE AS TO THE FATE OF ATLANTA AND SHERMAN'S ARMY—PAUCITY OF NEWS —HOW WE HEARD THAT ATLANTA HAD FALLEN—ANNOUNCEMENT OF A GENERAL EXCHANGE—WE LEAVE ANDERSONVILLE.
We again began to be exceedingly solicitous over the fate of Atlanta and Sherman's Army: we had heard but little directly from that front for several weeks. Few prisoners had come in since those captured in the bloody engagements of the 20th, 22d, and 28th of July. In spite of their confident tones, and our own sanguine hopes, the outlook admitted of very grave doubts. The battles of the last week of July had been looked at it in the best light possible—indecisive. Our men had held their own, it is true, but an invading army can not afford to simply hold its own. Anything short of an absolute success is to it disguised defeat. Then we knew that the cavalry column sent out under Stoneman had been so badly handled by that inefficient commander that it had failed ridiculously in its object, being beaten in detail, and suffering the loss of its commander and a considerable portion of its numbers. This had been followed by a defeat of our infantry at Etowah Creek, and then came a long interval in which we received no news save what the Rebel papers contained, and they pretended no doubt that Sherman's failure was already demonstrated. Next came well-authenticated news that Sherman had raised the siege and fallen back to the Chattahoochee, and we felt something of the bitterness of despair. For days thereafter we heard nothing, though the hot, close Summer air seemed surcharged with the premonitions of a war storm about to burst, even as nature heralds in the same way a concentration of the mighty force of the elements for the grand crash of the thunderstorm. We waited in tense expectancy for the decision of the fates whether final victory or defeat should end the long and arduous campaign.
At night the guards in the perches around the Stockade called out every half hour, so as to show the officers that they were awake and attending to their duty. The formula for this ran thus:
"Post numbah 1; half-past eight o'clock, and a-l-l 's w-e-l-l!"
Post No. 2 repeate
d this cry, and so it went around.
One evening when our anxiety as to Atlanta was wrought to the highest pitch, one of the guards sang out:
"Post numbah foah—half past eight o'clock—and Atlanta's—gone—t-o —hell."
The heart of every man within hearing leaped to his mouth. We looked toward each other, almost speechless with glad surprise, and then gasped out:
"Did 'you hear THAT?"
The next instant such a ringing cheer burst out as wells spontaneously from the throats and hearts of men, in the first ecstatic moments of victory—a cheer to which our saddened hearts and enfeebled lungs had long been strangers. It was the genuine, honest, manly Northern cheer, as different from the shrill Rebel yell as the honest mastiff's deep-voiced welcome is from the howl of the prowling wolf.
The shout was taken up all over the prison. Even those who had not heard the guard understood that it meant that "Atlanta was ours and fairly won," and they took up the acclamation with as much enthusiasm as we had begun it. All thoughts of sleep were put to flight: we would have a season of rejoicing. Little knots gathered together, debated the news, and indulged in the most sanguine hopes as to the effect upon the Rebels. In some parts of the Stockade stump speeches were made. I believe that Boston Corbett and his party organized a prayer and praise meeting. In our corner we stirred up our tuneful friend "Nosey," who sang again the grand old patriotic hymns that set our thin blood to bounding, and made us remember that we were still Union soldiers, with higher hopes than that of starving and dying in Andersonville. He sang the ever-glorious Star Spangled Banner, as he used to sing it around the camp fire in happier days, when we were in the field. He sang the rousing "Rally Round the Flag," with its wealth of patriotic fire and martial vigor, and we, with throats hoarse from shouting; joined in the chorus until the welkin rang again.
