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.