sameness of the food, and from 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 fibrinous element was
deficient. In cases of ulceration of the mucous membrane of the
intestinal canal, the fibrinous element of the blood appeared to be
increased; while in simple diarrhea, uncomplicated with ulceration, and
dependent upon the character of the food and the existence of scurvy,
it was either diminished or remained stationary. Heart-clots were very
common, if not universally present, in the 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 fibrinous concretions were almost universally absent.
From the watery condition of the blood there resulted various serous
effusions into the pericardium, into the ventricles of the brain, and
into the abdominal cavity.

In almost all cases which I examined after death, even in 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 firm coagula were
universally present. The presence of these clots in the cases of
hospital gangrene, whilst they were absent in the cases in which there
were no inflammatory symptoms, appears to sustain the conclusion that
hospital gangrene is a species of inflammation (imperfect and irregular
though it may be in its progress), in which the fibrinous element and
coagulability 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 fibrinous constituent.

VI. The impoverished condition of the blood, which led to serous
effusions within the ventricles of the brain, and around the brain and
spinal cord, and into the pericardial and abdominal cavities, was
gradually induced by the action of several causes, but chiefly by the
character of the food.

The Federal prisoners, as a general rule, had been reared upon wheat
bread and Irish potatos; and the Indian corn so extensively used at the
South, was almost unknown to