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.