s.
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.

Scurvy and gangrene frequently existed in the same individual. In such
cases, vegetable diet with vegetable acids would remove the scorbutic
condition without curing the hospital gangrene. . . Scurvy consists
not only in an alteration in the constitution of the blood, which leads
to passive hemorrhages from the bowels, and the effusion into the various
tissues of a deeply-colored fibrinous exudation; but, as we have
conclusively shown by postmortem examination, this state is attended with
consistence of the muscles of the heart, and the mucous membrane of the
alimentary canal, and of solid parts generally. We have, according to
the extent of the deficiency of certain articles of food, every degree of
scorbutic derangement, from the most fearful depravation of the blood
and the perversion of every function subserved by the blood to those
slight derangements which 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. Su