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