Part 8

Fifteen hundred cubic inches, or twenty-two quarts, of carbonic acid are expired from the lungs every hour, and thrown off into the surrounding atmosphere. Besides this, Sequin found that 18 grains of organized matter were thrown off per minute from the body in the form of insensible perspiration,--7 grains by the lungs, and 11 grains by the skin. Hence we may form some idea of the rapid corruption of the air in this stockade, where 30,000 men were breathing at one time. The foul and heavy vapors could not rise above the palisades unless a strong breeze prevailed; and even then they became so offensive as almost to extinguish life, like the deadly air of the Grotta del Cane. The exhalations from putrescent animal surfaces are always specifically heavier than the upper warm strata in the confined spaces where men are crowded together, such as the wards of hospitals. We find, according to Professor Graham, the vitiated air to be composed somewhat as follows: Phosphoretted hydrogen, sulphuretted hydrogen, carbonic acid, carburetted hydrogen, cyanogen with its compounds. The first gas is always recognized where the diseases of the internal organs are present, especially affections of the liver, stomach, bowels, and in fever and dysentery; and we observe the blackening of the lead plaster, &c., when the second is present. Stupor, headache, and sleepiness betray the presence of the other three gases. The diffusion of each gas is always inversely as the square root of the density of such gases.

The density is thus, air being regarded as 1000:--

Phosphuretted hydrogen, 1240 Sulphuretted " 1170 Carburetted " 559 Carbonic acid, 1524 Cyanogen, 1806

IX.

The report of the British Parliament Commission gives the following data in this important question: "The amount of carbonic acid in the air is about 1/2000 or .0005; the amount expired is about 1/12, or .083. Respired air contains 1/10 or 1 of carbonic acid, and this must be diluted ten times to make the air safe. Thus, 1/10 ÷ 10/1 = 1/100, or .01; and this again divided by 10, or 1/100 ÷ 10/1 = 1/1000 or .001, gives the amount of ventilation needed to reduce the air to that state of purity that only 1/1000 more of carbonic acid should be added to the air, when it would be represented by .0015 instead of .0005."

Observing this rule, and taking 300 cubic feet as the air respired for the 24 hours, to dilute it ten times it must be mixed with ten times the bulk, or 3000 cubic feet--the space to be allowed for each individual; but if it is wished to keep up a pure air, it must be mixed with ten times this bulk again, or 30,000 cubic feet, which shows the ventilation needed to maintain an atmosphere nearly pure; or there must be admitted into the space of 3000 cubic feet nearly 21 cubic feet per minute of fresh air by ventilation, if the man in it is to breathe an atmosphere which shall contain only three times more of carbonic acid than the air he breathes originally contained; or again, 300 cubic feet, 3000, and 30,000, mark the requirements of one individual, in 24 hours, for respiration, space, and ventilation. On a calm day, when there were no strong breezes to change the air of the stockade, the entire quantity of air in the old stockade, allowing the palisades to be on the average 20 feet high, could be exhausted in 20 minutes by the 30,000 men respiring 300 cubic inches per minute. This is not a proper estimate to offer; but it will give a just idea of the rapid and fearful vitiation of the air that took place within the enclosure.

Vierodt shows how rapidly carbonic acid increases when foul air is breathed, and Lehman proves the rapid disengagement of the gas in moist atmospheres.

Symptoms of uneasiness manifest themselves when the air contains from 6/1000 to 7/1000 carbonic acid, and when the proportion amounts to ten parts to 100 of air, death ensues. "This effect is visible upon vegetables also, and many of them are extremely susceptible of impurities in the air, and very slight modifications in the proportion of its constituents are more or less prejudicial to their growth." But plants, like animals, vary in regard to the delicacy of their constitutions, some being much more susceptible than others.

In warm climes the respiration becomes slower, and in consequence there is less of carbon burned and less oxygen absorbed; but on the other hand the functions of the skin become vastly increased, the bilious secretions become more active, and the excess of carbon is eliminated by this channel.

That we expire more carbonic acid in a warm, moist atmosphere, and less in a cold, dry climate, is shown by the exhilaration of our spirits on a fine frosty morning.

No wonder that men lost their reason in this prison, for the blood no longer reddened from the imperfect arterialization, and burdened the brain with its effete matter, paralyzing and clogging up the delicate filaments and the narrow channels of thought and life.

We have seen that the blood is subject to incessant variations in its precise chemical constitution; a free atmosphere, well supplied, oxygenates and destroys the numerous impurities that tend to lurk in the system and develop disease.

Bichat shows, in his researches on life and death, how the black and carbonized blood disturbs the functions of the brain and acts like a narcotic poison, causing the heart finally to cease its throbbings.

These miasms and poisons floated about the enclosure where there was not the least sign of vegetable organism to absorb and convert them. As they passed into the systems of the prisoners they became the cause of disease, decrepitude, and death.

X.

Vitiated air is one of the most subtile and powerful of poisons, and it seems to affect soldiers more than any other class of persons, and its consequences have been commented upon by most of the military writers,--from Xenophon among the Greeks, Vegetius among the Romans, down to those of the present time. Cavalry horses have been observed to suffer deterioration and death from the same cause.

Ague and fever, states Dr. Johnson, "two of the most prominent features of the malarious influences, are as a drop of water in the ocean when compared with the other, but less obtrusive, but more dangerous maladies that silently disorganize the vital structure of the human fabric under the influence of this deleterious and invisible poison."

One fourth of the sailors of the English navy are sent home invalided every year, and one tenth of them die from the effects of foul air of their cabins. "Two thirds of the pulmonary diseases which desolate England are induced by this cause." Baudelocque long ago pointed out its influences in the etiology of scrofula.

It is really the same influence observed by Magendie, and not contradicted to the present day, that putrid blood, brain, bile, or pus, when laid on flesh wounds, produce in animals, after a longer or shorter interval, vomiting, languor, and death. The same results and phenomena are observed in the inspiration of bad air; the most terrible forms of fever arise from the overcrowding of people in confined and limited spaces. Most of the zymotic diseases enter by the lungs, which are the principal absorbing agents.

The breathing in of foul air, loaded with perceptible and putrid animal and vegetable emanations, gives rise to those zymotici, the ideas of which originated with Hippocrates, and to which the distinguished Liebig has since given form and prominence.

Not only is animal life disturbed and destroyed, but we observe that vegetables even are affected by the same or similar causes; that they are extremely susceptible of impurities in the air, and that the rapidity and vigorous appearance of their growth are affected whenever there is very slight modification in the healthy proportions of the atmosphere. Again, we see how seeds, when placed in elementary oxygen, germinate with extreme rapidity, and soon decay, thus indicating how the presence of nitrogen in the natural air restrains the force of the other element.

XI.

There was another serious defect in the management of the prison, and that was, the neglect to provide the means for entire ablution, which, in warm climes, becomes an imperative necessity. "Animals perspire, that they may live;" and this function is as necessary to a healthy life as either breathing or digestion: the skin, like the lungs, gives off carbonic acid and absorbs oxygen. But it differs from the lungs in giving off a much larger bulk of the former gas than it absorbs of the latter. The quantity of carbonic acid which escapes varies with circumstances. It is sometimes equal to one thirtieth, and sometimes amounts to only a ninetieth part of that which is thrown off from the lungs, but generally it amounts to 100 grains daily. But exercise and hard labor increase the evolution of carbon from the skin, as it does from the lungs. A large quantity of nitrogen also escapes by the skin.

Hence we may infer the effect upon the prisoners, from the want of ablution, and the means of removing the accumulating filth of their bodies. The functions of the skin, and their influence in the practical feeding of animals, have been carefully studied by the experimentalists, and they have observed that the difference in washed and unwashed animals, during the process of fattening, amounts to one fifth.

Pure air and the enforcement of daily ablutions having been introduced into some of the English schools, the sick rate was reduced two thirds. A general of a beleaguered city in Spain was obliged to put his soldiers on short allowance, and compelled them to bathe daily in order to amuse them, when he found, to his surprise, that they became in better condition than when on full rations.

Chadwick states, in his papers on Economy, that "amongst soldiers of the line who have only hands and face washing provided for, the death-rate is upwards of 17 per 1000."

When sent into prisons where there is a far lower diet, sometimes exclusively vegetable, and without beer or spirits, but where regular head to foot ablutions and cleanliness of clothes, as well as of persons, are enforced, their health is vastly increased, and the death-rate is reduced to 2-1/2 per 1000.

XII.

It appears from the mortuary records of the prison that 13,000 men were registered and buried during the year of its occupation. It also appears from the same hospital lists that 17,873 men received medical treatment, or were known to be sick, and their names entered in the books. Of these, 825 men were exchanged, leaving 17,048 to be accounted for; thus giving a mortality of more than 76 per cent., or 760 men out of every thousand.

It is said, and stated with confidence, that the names of the 4000 soldiers who died in their mud-holes within the pen, and who did not generally receive any medical treatment whatever, were placed upon the hospital register, and their diseases diagnosed after death and removal from the stockade. But of this the writer is not positive, although he has seen tables of statistics of certain periods of the prison, where it is shown that every patient who was treated for disease perished.

XIII.

To form an idea of the awful mortality which reigned here, let us review the records of the hospital prisons, and the casualties of armies of foreign as well as our own country. These comparisons must, however, be received with much allowance, for the circumstances which led to death are very different.

* * * * *

In the prisons of Switzerland, before they were improved, the mortality was 25 to 35 per 1000. In the county jails of England it is reckoned at 10 per 1000; in the terrible hulks (Les Bagnes) of France it is 39 to 55 per 1000, including epidemics of cholera.

The average mortality of the London hospitals, where only the severer cases of disease and accident are received and treated, is nine per cent.

In the hospitals of Dublin it is less than 5 per cent.; in the civil hospitals of France it is from 5 to 9 per cent.; in the military hospitals of the same country it is much less; at Val de Grace it was 4 per cent. for a period of forty years; at Vincennes it was 2 per cent. for a long period; at the Gros Caillou, for a term of eleven years, it was less than 3 per cent. out of 55,000 patients.

The mortality at Moyamensing Prison for many years was 1 per cent., and in the New York Penitentiary less than that for seven years. The average deaths in the prisons of Massachusetts, Michigan, New York, and Maryland, was about 2 per cent. The death-rate of the rebels confined in our military prisons was small, comparatively: at Fort Delaware it was 2 per cent, for eleven months; at Johnson's Island it was 2 per cent., or 134 deaths out of 6000 prisoners, for the period of twenty-one months.

The loss at the rebel prison at Elmira is not known for the entire term; but it was much less than the rebel "Vinculis" desires to make it.

His own statements make but 4 per cent. during the worst month for instance: "Now out of less than nine thousand five hundred prisoners on the first of September, 386 died that month."

"At Andersonville the mortality averaged 1000 per month out of 36,000 prisoners, 1/36. At Elmira it was 386 per month, out of 9500, or 1/25 of the whole. At Elmira it was 4 per cent.; at Andersonville less than 3 per cent.

"If the mortality at Andersonville had been as great as at Elmira, the deaths should have been fourteen hundred and forty per month, or fifty per cent. more than they were."

The official records of Andersonville show that Vinculis is greatly in error; for, instead of fourteen hundred and forty, the great number he imagines, they were even more; for the figures show two thousand six hundred and seventy-eight for September, or more than fifteen per cent., and in October fifteen hundred and ninety-five, or more than twenty-seven per cent., and in the month of August three thousand men died, and on the twenty-third of that month one hundred and twenty-seven perished, or one every eleven minutes out of the number present.

XIV.

In the hospitals of the allied forces, during the campaign of the Crimea, which were established along the banks of the Bosphorus and at Constantinople, there were admitted, during the twenty-two months of the war, one hundred and thirty-nine thousand patients, and of these nineteen per cent. were lost during the entire period, or at the rate of ten per cent. per annum.

One hundred and ninety-three thousand patients were admitted into the French hospitals during the same period, and but fourteen per cent. were lost, or less than eight per cent. per annum.

The mortality of the military hospitals of the army of occupation of Spain in 1824 was less than five per cent.

The extemporized and regular hospitals of Milan, says Baron Larrey, received during the Italian campaign thirty-four thousand sick and wounded; of whom fourteen hundred died, or four per cent., or forty men out of every one thousand. The temporary hospitals of Nashville received during the year 1864 sixty-five thousand sick and wounded, of whom twenty-six hundred died, or four per cent. The numerous hospitals of Washington treated in 1863 sixty-eight thousand patients, and lost twenty-six hundred, or less than four per cent.; and, in 1864, the same hospitals treated ninety-six thousand patients (forty-nine thousand sick and forty-seven thousand wounded), and lost six thousand, or six per cent. The department of Pennsylvania received fifty-six thousand patients in its various hospitals, and lost but two per cent. Twenty-nine thousand nine hundred patients were cared for in the medical and surgical wards of the fourteen great civil hospitals of London in 1861, and but twenty-seven hundred of these died, or nine per cent. The diary of the rebel War Clerk says, that in the hospitals of the rebel service sixteen hundred thousand patients were treated, with a loss of four per cent.; yet it appears from a surreptitious copy of the quarterly report ending 1864, relating to the prisoners in hospital at Richmond, that twenty-seven hundred patients were treated, and thirteen hundred and ninety-six died, or fifty per cent.; more than half of these cases were those of diarrhoea and dysentery, and only seventy deaths from fever. It appears from the official data of the Surgeon-General's office, published in November, 1865, that eight hundred and seventy thousand cases of wounds and disease were treated by the medical staff of the United States army in 1862, and but two per cent. were lost; also, that in 1863, seventeen hundred thousand cases were cared for, with a loss of three per cent. only.

XV.

The statistics of the great armies of Austria, Sardinia, and France during the Italian war, when half a million of men met in conflict at Magenta and Solferino, show, according to Boudin, that but six thousand four hundred and ten men lost their lives--of the French, three thousand five hundred and five; of the Sardinians, one thousand and forty-five; of the Austrians, one thousand eight hundred and sixty. It is shown by the records of the British army, that, out of the aggregate number of four hundred and thirty-eight thousand British soldiers who were engaged in the twenty-two great battles of the British empire from 1801 to 1854, but fourteen thousand men were killed, or died of their wounds, or three per cent. These battles embrace those of Egypt, Spain, France, Waterloo, and the Crimea.

Contrast these blood-stained records with this one instance of rebel cruelty at Andersonville. Of the number of the Federal soldiers who have been held in captivity during the rebellion by the rebels, more than thirty thousand of them are now dead. We know from official records that twenty-three thousand are buried at Andersonville and Salisbury alone.

XVI.

Up to the month of September, 1864, forty-two thousand four hundred prisoners had been received, and out of this number seven thousand five hundred and eighty-seven, or eighteen per cent., had died since the occupation of the prison--a period of about six months. During August the manoeuvres of Sherman alarmed them so much that they thought best to remove many of the prisoners to other stockades in Alabama and in North and South Carolina; but yet the mortality for the remainder of the year was for the month of September seventeen per cent. out of the number present; October, twenty-seven per cent.; November, twenty-four per cent.; and seven per cent. in December, when there were but five thousand inmates. This gives nineteen per cent. average for each of those four months, and indicates that out of the thirty-two thousand present on the first of August, but few thousand would have been living at the close of the year, had not Sherman compelled a reduction in the number of inmates. Out of this number present in August, and distributed afterwards, I believe that but few thousand survived the system of treatment at the other prisons, and ever lived to reach home. Of these few thousand men who were finally exchanged, a great many have since perished; which statement will be admitted by all who have watched the phases of disease since the termination of the war.

XVII.

The records state that eight thousand died from diarrhoea and scurvy, and that three thousand more died from dysentery and unknown causes. Two hundred and fifteen thousand cases of diarrhoea were treated in the United States army in 1862, and but one thousand one hundred died; and of thirty-seven thousand cases of dysentery, but three hundred and forty-seven died; and but one death from scurvy per thirty-five thousand of mean strength. In 1863, according to the official records by Surgeon Woodward, five hundred thousand cases of diarrhoea and dysentery were treated, and but two per cent. died. According to the same authority there were but eight thousand six hundred cases of scurvy during the first two years of the war, and but one per cent. of these died. Fever was almost unknown, although the foul atmospheres and malarial miasms are generally so eager in their attacks, and so rapid in their effects; the autopsies of the dead men revealed to the astonished pathologist the utter absence of all the usual lesions of these diseases.

Boudin, of the French army, in 1843, in his "Essai de Geographie Medicale," observes that phthisis and typhoid fever are very rare in the marshy districts where intermittent fevers of a certain gravity prevail. It does not appear that either of these diseases declared itself to any perceptible degree.

The effect of starvation was so strong that miasmatic disease could not gain a lodgment in the system, although every other condition was favorable to its production. Scurvy seems to be prominent in the alleged diseases. The combined influence of all the vicious conditions could readily have produced this form of malady in its worst shape; but it is one of those diseases which are clearly within the control of man, and for the existence of which, in this case, there is no excuse whatever. They required the treatment, practised with success in India, for those fluxes which are marked by a scorbutic state of the system--potatoes and lime juice.

The neighboring plantations produced the potatoes in great quantities. In the everglades of Florida the lime tree, which furnishes a positive antidote, grows in wild luxuriance; and the woods everywhere, the corn and potatoes of their fields, furnish vinegar by distillation. If the plantations failed in their supplies of vegetables, the forests furnished, with trifling labor, an excellent substitute.

Vinegar, in the early history of war, was the chief and the sure reliance against the attacks of scurvy and malaria. To this drink chiefly, Marshal Saxe ascribes the amazing success of the Roman campaigns in the varied climates of Europe, Asia, and Africa. Scientific men, from Dioscorides to Orfila, have extolled its virtues in this respect. It is idle to say that they did not know how to make it, for the merest tyro in chemistry understands the method of fermentation and distillation.

XVIII.

It has been stated that the mortality was caused by epidemics; by dysentery or camp distempers; but the testimony of nature, as revealed by the scalpel of the dissector, does not admit of such statement. There was neither epidemic nor pestilence. There was starvation instead.

That a vast amount of this mortality was caused by the unfavorable, the needless, the cruel circumstances in which the prisoners were placed, no one acquainted with the phenomena of life and death will deny.

But as to how much more than the normal rate, no man has sufficient generosity and impartiality to determine.

This we know, however, that it is an axiom with all hygienists and military men, that the health of the soldier is always in direct ratio of the care taken of him. To give a just estimate of the normal degree of the mortality that was caused by diarrhoea, will indeed form a complex problem, since it is not only the last stage of starvation, but it is often produced by the decomposition of the blood by the dyscrasia peculiar to camp life. We observe it in all armies during the summer months, and that it seems to result from manifold causes. Although the predisposing cause is the dyscrasiac condition of the soldier, the determining cause is most always the quality of the food consumed, and the purity of the water used for potable purposes. Surface water mixed with confervoids and decomposed vegetable matter, and the deeper currents of water which pass through the rotten limestones, are, during the summer, the fruitful sources of intestinal disorders.