rse 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