ich are scarcely distinguishable from a state of
health. We are as yet ignorant of the true nature of the changes of the
blood and tissues in scurvy, and wide field for investigation is open for
the determination the characteristic changes--physical, chemical, and
physiological--of the blood and tissues, and of the secretions and
excretions of scurvy. Such inquiries would be of great value in their
bearing upon the origin of hospital gangrene. Up to the present war,
the results of chemical investigations upon the pathology of the blood in
scurvy were not only contradictory, but meager, and wanting in that
careful detail of the cases from which the blood was abstracted which
would enable us to explain the cause of the apparent discrepancies in
different analyses. Thus it is not yet settled whether the fibrin is
increased or diminished in this disease; and the differences which exist
in the statements of different writers appear to be referable to the
neglect of a critical examination and record of all the symptoms of the
cases from which the blood was abstracted. The true nature of the
changes of the blood in scurvy can be established only by numerous
analyses during different stages of the disease, and followed up by
carefully performed and recorded postmortem examinations. With such data
we could settle such important questions as whether the increase of
fibrin in scurvy was invariably dependent upon some local inflammation.

XII. Gangrenous spots, followed by rapid destruction of tissue, appeared
in some cases in which there had been no previous or existing wound or
abrasion; and without such well established facts, it might be assumed
that the disease was propagated from one patient to another in every
case, either by exhalations from the gangrenous surface or by direct
contact.

In such a filthy and crowded hospital as that of the Confederate, States
Military Prison of Camp Sumter, Andersonville, it was impossible to
isolate the wounded from the sources of actual contact of the gangrenous
matter. The flies swarming over the wounds and over filth of every
description; the filthy, imperfectly washed, and scanty rags; the limited
number of sponges and wash-bowls (the same wash-bowl and sponge serving
for a score or more of patients), were one and all sources of such
constant circulation of the gangrenous matter, that the disease might
rapidly be propagated from a single gangrenous wound. While the fact
alread