“MEDICAL TESTIMONY.”
(Transcript from the printed testimony at Wirz Trial, pages 618 to 639, inclusive).
“Dr. Joseph Jones for the prosecution.
By the Judge Advocate:
Question. Where do you reside?
Answer. In Augusta, Georgia.
Ques. Are you a graduate of any medical college?
Ans. Of the University of Pennsylvania.
Ques. How long have you been engaged in the practice of medicine?
Ans. Eight years.
Ques. Has your experience been as a practitioner, or rather as an investigator of medicine as a science?
Ans. Both.
Ques. What position do you hold now?
Ans. That of Medical Chemist in the Medical College of Georgia, at Augusta.
Ques. How long have you held your position in that college?
Ans. Since 1858.
Ques. How were you employed during the Rebellion?
Ans. I served six months in the early part of it as a private in the ranks, and the rest of the time in the medical department.
Ques. Under the direction of whom?
Ans. Under the direction of Dr. Moore, Surgeon General.
Ques. Did you, while acting under his direction, visit Andersonville, professionally?
Ans. Yes Sir.
Ques. For the purpose of making investigations there?
Ans. For the purpose of prosecuting investigations ordered by the Surgeon General.
Ques. You went there in obedience to a letter of instructions?
Ans. In obedience to orders which I received.
Ques. Did you reduce the results of your investigations to the shape of a report?
Ans. I was engaged at that work when General Johnston surrendered his army.
(A document being handed to witness.)
Ques. Have you examined this extract from your report and compared it with the original?
Ans. Yes sir, I have.
Ques. Is it accurate?
Ans. So far as my examination extended, it is accurate.
The document just examined by witness was offered in evidence, and is as follows:
Observations upon the diseases of the Federal prisoners, confined in Camp Sumter, Andersonville, in Sumter county, Georgia, instituted with a view to illustrate chiefly the origin and causes of hospital gangrene, the relations of continued and malarial fevers, and the pathology of camp diarrhea and dysentery, by Joseph Jones Surgeon P. A. C. S. Professor of Medical Chemistry in the Medical College of Georgia, at Augusta, Georgia.
Hearing of the unusual mortality among the Federal prisoners confined at Andersonville, Georgia, in the month of August, 1864, during a visit to Richmond, Va., I expressed to the Surgeon General, S. P. Moore, Confederate States of America, a desire to visit Camp Sumter, with the design of instituting a series of inquiries upon the nature and causes of the prevailing diseases. Small pox had appeared among the prisoners, and I believed that this would prove an admirable field for the establishment of its characteristic lesions. The condition of Peyer’s glands in this disease was considered as worthy of minute investigation. It was believed that a large body of men from the northern portion of the United States, suddenly transported to a warm Southern climate, and confined upon a small portion of land, would furnish an excellent field for the investigation of the relations of typhus, typhoid and malarial fevers.”
Then follows a letter of introduction to the Surgeon in charge at Andersonville, and a letter to Gen. Winder asking permission to visit the Inner Prison, and an order of Winder granting permission. The report then proceeds.
“Description of the Confederate States Military Prison Hospital at Andersonville, Number of prisoners, physical condition, food, clothing, habits, moral condition, diseases.
The Confederate Military Prison at Andersonville, Ga., consists of a strong Stockade, twenty feet in height, enclosing twenty-seven acres. The Stockade is formed of strong pine logs, firmly planted in the ground. The main Stockade is surrounded by two other similar rows of pine logs, the middle stockade being sixteen feet high, and the outer twelve feet. These are intended for offense and defense. If the inner stockade should at any time be forced by the prisoners, the second forms another line of defense; while in case of an attempt to deliver the prisoners by a force operating upon the exterior, the outer line forms an admirable protection to the Confederate troops, and a most formidable obstacle to cavalry or infantry.
The four angles of the outer line are strengthened by earth-works upon commanding eminences, from which the cannon, in case of an outbreak among the prisoners, may sweep the entire enclosure; and it was designed to connect these works by a line of rifle pits, running zigzag, around the outer stockade; those rifle pits have never been completed. The ground enclosed by the innermost stockade lies in the form of a parallelogram the larger diameter running almost due north and south. This space includes the northern and southern opposing sides of two hills, between which a stream of water runs from west to east. The surface soil of these hills is composed chiefly of sand with varying admixtures of clay and oxide of iron. The clay is sufficiently tenacious to give a considerable degree of consistency to the soil. The internal structure of the hills, as revealed by the deep wells, is similar to that already described. The alternate layers of clay and sand, as well as oxide of iron, which form, in its various combinations a cement to the sand, allow of extensive tunneling. The prisoners not only constructed numerous dirt huts with balls of clay and sand, taken from the wells which they have excavated all over those hills, but they have also, in some cases, tunneled extensively from these wells. The lower portion of these hills, bordering on the stream, are wet and boggy from the constant oozing of water. The stockade was built originally to accommodate only ten thousand prisoners, and included at first seventeen acres. Near the close of the month of June the area was enlarged by the addition of ten acres. The ground added was on the northern slope of the largest hill.
Within the circumscribed area of the stockade the Federal prisoners were compelled to perform all the offices of life—cooking, washing, the calls of nature, exercise and sleeping.
During the month of March the prison was less crowded than at any subsequent time, and the average space of ground to each prisoner was only 98.7 feet, or less than seven square yards. The Federal prisoners were gathered from all parts of the Confederate States east of the Mississippi, and crowded into the confined space, until in the month of June, the average number of square feet of ground to each prisoner was only 33.2 or less than four square yards. These figures represent the condition of the stockade in a better light even than it really was; for a considerable breadth of land along the stream, flowing from west to east between the hills, was low and boggy, and was covered with the excrement of the men, and thus rendered wholly uninhabitable, and in fact useless for every purpose except that of defecation.
The pines and other small trees and shrubs, which originally were scattered sparsely over these hills, were, in a short time, cut down and consumed by the prisoners for firewood, and no shade tree was left in the entire enclosure of the stockade. With their characteristic industry and ingenuity, the Federals constructed for themselves small huts and caves, and attempted to shield themselves from the rain and sun and night damps and dew. But few tents were distributed to the prisoners, and those were in most cases torn and rotten. In the location and arrangement of these tents and huts no order appears to have been followed; in fact, regular streets appear to be out of the question in so crowded an area; especially too, as large bodies of prisoners were from time to time added suddenly without any previous preparations. The irregular arrangement of the huts and imperfect shelters were very unfavorable for the maintenance of a proper system of police.
The police and internal economy of the prison was left almost entirely in the hands of the prisoners themselves; the duties of the Confederate soldiers acting as guards being limited to the occupation of boxes or lookouts ranged around the stockade at regular intervals, and to the manning of the batteries at the angles of the prison. Even judicial matters pertaining to themselves, as the detection and punishment of such crimes as theft and murder appear to have been, in a great measure, abandoned to the prisoners.
A striking instance of this occurred in the month of July, when the Federal prisoners within the stockade tried, condemned, and hanged six (6) of their own number, who had been convicted of stealing, and of robbing and murdering their fellow prisoners. They were all hung upon the same day, and thousands of the prisoners gathered around to witness the execution. The Confederate authorities are said not to have interfered with these proceedings. In this collection of men from all parts of the world, every phase of human character was represented; the stronger preyed upon the weaker, and even the sick who were unable to defend themselves were robbed of their scanty supplies of food and clothing. Dark stories were afloat, of men, both sick and well, who were murdered at night, strangled to death by comrades for scant supplies of clothing or money.
I heard a sick and wounded Federal prisoner accuse his nurse, a fellow prisoner of the United States army, of having stealthily, during his sleep, inoculated his wounded arm with gangrene, that he might destroy his life and fall heir to his clothing.
The large number of men confined in the stockade soon, under a defective system of police, and with imperfect arrangements, covered the surface of the low grounds with excrements. The sinks over the lower portions of the stream were imperfect in their plan and structure, and the excrements were, in large measure, deposited so near the border of the stream as not to be washed away, or else accumulated upon the low boggy ground. The volume of water was not sufficient to wash away the feces, and they accumulated in such quantities in the lower portion of the stream as to form a mass of liquid excrement. Heavy rains caused the water of the stream to rise, and as the arrangements for passage of the increased amounts of water out of the stockade were insufficient, the liquid feces overflowed the low grounds and covered them several inches, after subsidence of the waters. The action of the sun upon this putrefying mass of excrements and fragments of bread and meat and bones excited most rapid fermentation and developed a horrible stench. Improvements were projected for the removal of the filth and for the prevention of its accumulation, but they were only partially and imperfectly carried out. As the forces of the prisoners were reduced by confinement, want of exercise, improper diet, and by scurvy, diarrhea, and dysentery, they were unable to evacuate their bowels within the stream or along its banks, and the excrements were deposited at the very doors of their tents. The vast majority appeared to lose all repulsion to filth, and both sick and well disregarded all the laws of hygiene and personal cleanliness. The accommodations for the sick were imperfect and insufficient.
From the organization of the prison, February 24th, 1864, to May 22d, the sick were treated within the stockade. In the crowded condition of the stockade, and with the tents and huts clustered thickly around the hospital, it was impossible to secure proper ventilation or to maintain the necessary police. The Federal prisoners also made frequent forays upon the hospital stores and carried off the food and clothing of the sick. The hospital was on the 22d of May removed to its present site without the stockade, and five acres of ground covered with oaks and pines appropriated to the use of the sick.
The supply of medical officers has been insufficient from the foundation of the prison.
The nurses and attendants upon the sick have been most generally Federal prisoners, who in too many cases appear to have been devoid of moral principle, and who not only neglected their duties, but were also engaged in extensive robbing of the sick.
From the want of proper police and hygienic regulations alone it is not wonderful that from February 24th to September 21st, 1864, nine thousand four hundred and seventy-nine deaths nearly one third of the entire number of prisoners, should have been recorded. I found the stockade and hospital in the following condition during my pathological investigations, instituted in the month of September, 1864:
Stockade, Confederate States Military Prison.
At the time of my visit to Andersonville a large number of Federal prisoners had been removed to Millen, Savannah, Charleston and other parts of the Confederacy, in anticipation of an advance of General Sherman’s forces from Atlanta, with the design of liberating their captive brethren: however, about fifteen thousand prisoners remained confined within the limits of the stockade and Confederate States Military Prison Hospital.
In the stockade, with the exception of the damp low lands bordering the small stream, the surface was covered with huts, and small ragged tents and parts of blankets and fragments of oil-cloth, coats, and blankets stretched upon sticks. The tents and huts were not arranged according to any order, and there was in most parts of the enclosure scarcely room for two men to walk abreast between the tents and huts.
Each day the dead from the stockade were carried out by their fellow prisoners and deposited upon the ground under a bush arbor just outside the southwestern gate. From thence they were carried in carts to the burying ground, one quarter of a mile northwest of the prison. The dead were buried without coffins, side by side, in trenches four feet deep.
The low grounds bordering the stream were covered with human excrements and filth of all kinds, which in many places appeared to be alive with working maggots. An indescribable sickening stench arose from these fermenting masses of human filth.
There were near five thousand seriously ill Federals in the stockade and Confederate States Military Prison Hospital, and the deaths exceeded one hundred per day, and large numbers of the prisoners who were walking about, and who had not been entered upon the sick reports, were suffering from severe and incurable diarrhea, dysentery and scurvy. The sick were attended almost entirely by their fellow prisoners, appointed as nurses, and as they received but little attention, they were compelled to exert themselves at all times to attend to the calls of nature, and hence, they retained the power of moving about to within a comparatively short period of the close of life. Owing to the slow progress of the diseases most prevalent, diarrhea and chronic dysentery, the corpses were as a general rule emaciated.
I visited two thousand sick within the stockade, lying under some long sheds which had been built at the northern portion for themselves. At this time only one medical officer was in attendance, whereas at least twenty medical officers should have been employed.
Scurvy, diarrhea, dysentery, and hospital gangrene were the prevailing diseases. I was surprised to find but few cases of malarial fever, and no well marked cases either of typhus or typhoid fever. The absence of the different forms of malarial fever may be accounted for on the supposition that the artificial atmosphere of the stockade, crowded densely with human beings and loaded with animal exhalations, was unfavorable to the existence and action of malarial poison. The absence of typhoid and typhus fevers amongst all the causes which are supposed to generate these diseases, appeared to be due to the fact that the great majority of these prisoners had been in captivity in Virginia, at Belle Island, and in other parts of the Confederacy for months, and even as long as two years, and during this time they had been subjected to the same bad influences, and those who had not had these fevers before either had them during their confinement in Confederate prisons or else their systems, from long exposure were proof against their action.
The effects of scurvy were manifested on every hand, and in all its various stages, from the muddy pale complexion, pale gums, feeble, languid muscular motions, lowness of spirits, and fetid breath, to the dusky, dirty leaden complexion, swollen features, spongy purple, livid, fungoid, bleeding gums, loose teeth, œdematous limbs, covered with livid vibices and petechiae, spasmodically flexed, painful and hardened extremities, spontaneous hemorrhages from mucous canals, and large, ill conditioned, spreading ulcers covered with a dark purplish fungus growth. I observed that in some cases of scurvy the parotid glands were greatly swollen, and in some instances to such an extent as to preclude entirely the power to articulate. In several cases of dropsy of the abdomen and lower extremities supervening upon scurvy, the patients affirmed that previously to the appearance of the dropsy they had suffered with profuse and obstinate diarrhea, and that when this was checked by a change of diet, from Indian corn bread baked with the husk, to boiled rice, the dropsy appeared. The severe pains and livid patches were frequently associated with swellings in various parts, and especially in the lower extremities, accompanied with stiffness and contractions of the knee joints and ankles, and often with a burning feel of the parts, as if lymph had been effused between the integuments and apeneuroses, preventing the motion of the skin over the swollen parts. Many of the prisoners believed that the scurvy was contagious, and I saw men guarding their wells and springs, fearing lest some man suffering with scurvy might use the water and thus poison them. I observed also numerous cases of hospital gangrene and of spreading scorbutic ulcers, which had supervened upon slight injuries. The scorbutic ulcers presented a dark purple fungoid, elevated surface, with livid swollen edges, exuded a thin, fetid sanious fluid, instead of pus. Many ulcers which originated from the sorbutic condition of the system appeared to become truly gangrenous, assuming all the characteristics of hospital gangrene.
From the crowded condition, filthy habits, bad diet, and dejected depressed condition of the prisoners, their systems had become so disordered that the smallest abrasion of the skin from the rubbing of a shoe, or from the effects of the sun, or from the prick of a splinter, or from scratching or a mosquito bite, in some cases took on rapid and frightful ulceration and gangrene. The long use of salt meat, ofttimes imperfectly cured, as well as the most total deprivation of vegetables and fruit, appeared to be the chief cause of scurvy. I carefully examined the bakery and the bread furnished the prisoners, and found that they were supplied almost entirely with corn bread from which the husk had not been separated. This husk acted as an irritant to the alimentary canal, without adding any nutriment to the bread. As far as my examination extended no fault could be found with the mode in which the bread was baked; the difficulty lay in the failure to separate the husk from the corn meal. I strongly urged the preparation of large quantities of soup made from the cow and calves heads with the brains and tongues to which a liberal supply of sweet potatoes and vegetables might have been advantageously added. The material existed in abundance for the preparation of such soup in large quantities with but little additional expense. Such aliment would have been not only highly nutritious, but it would also have acted as an efficient remedial agent for the removal of the scorbutic condition. The sick within the stockade lay under several long sheds which were originally built for barracks. These sheds covered two floors which were open on all sides. The sick lay upon the bare boards, or upon such ragged blankets as they possessed, without, as far as I observed, any bedding or even straw.
The haggard, distressed countenances of these miserable, complaining dejected, living skeletons, crying for medical aid and food, and cursing their Government for its refusal to exchange prisoners, and the ghastly corpses with their glazed eyeballs staring up into vacant space, with the flies swarming down their open grinning mouths, and over their ragged clothes infested with numerous lice, as they lay amongst the sick and dying formed a picture of helpless, hopeless misery which it would be impossible to portray by words or by the brush. A feeling of disappointment and even resentment on account of the action of the United States Government upon the subject of exchange of prisoners, appeared to be widespread, and the apparent hopeless, nature of the negotiations for some general exchange of prisoners appeared to be a cause of universal regret and deep and injurious despondency. I heard some of the prisoners go so far as to exonerate the Confederate Government from any charge of intentionally subjecting them to a protracted confinement, with its necessary and unavoidable sufferings in a country cut off from all intercourse with foreign nations, and sorely pressed on all sides, whilst on the other hand they charged their prolonged captivity upon their own Government, which was attempting to make the negro equal to the white man. Some hundreds or more of the prisoners had been released from confinement in the stockade on parole, and filled various offices as clerks, druggists, carpenters, etc., in the various departments. These men were well clothed and presented a stout and healthy appearance, and as a general rule, they presented a much more robust and healthy appearance than the Confederate troops guarding the prisoners.
The entire grounds are surrounded by a frail board fence, and are strictly guarded by Confederate soldiers, and no prisoner, except the paroled attendants, is allowed to leave the grounds except by a special permit from the commandant of the interior of the prison.
The patients and attendants, near two thousand in number, are crowded into this confined space and are but poorly supplied with old and ragged tents. Large numbers of them were without any bunks in the tents, and lay upon the ground, ofttimes without even a blanket. No beds or straw appeared to have been furnished. The tents extend to within a few yards of the small stream, the eastern portion of which, as we have before said, is used as a privy and is loaded with excrements; and I observed a large pile of corn bread, bones, and filth of all kinds, thirty feet in diameter and several feet in height, swarming with myriads of flies, in a vacant space near the pots used for cooking. Millions of flies swarmed over everything and covered the faces of the sleeping patients, and crawled down their open mouths and deposited their maggots in the gangrenous wounds of the living and in the mouths of the dead.
Mosquitoes in great numbers also infested the tents, and many of the patients were so stung by these pestiferous insects, that they resembled those suffering from a slight attack of the measles.
The police and hygiene of the hospital were defective in the extreme; the attendants, who appeared in almost every instance to have been selected from the prisoners, seemed to have, in many cases, but little interest in the welfare of their fellow captives. The accusation was made that the nurses, in many cases, robbed the sick of their clothing, money, and rations, and carried on a clandestine trade with the paroled prisoners and confederate guards without the hospital enclosure, in the clothing, effects of the sick, dying, and dead Federals. They certainly appeared to neglect the comfort and cleanliness of the sick intrusted to their care in a most shameful manner, even after making due allowances for the difficulties of the situation. Many of the sick were literally encrusted with dirt and filth and covered with vermin.
When a gangrenous wound needed washing, the limb was thrust out a little from the blanket, or board, or rags upon which the patient was laying, and water poured over it, and all the putrescent matter allowed to soak into the ground floor of the tent. The supply of rags for dressing wounds was said to be very scant, and I saw the most filthy rags which had been applied several times, and imperfectly washed, used in dressing wounds. Where hospital gangrene was prevailing, it was impossible for any wound to escape contagion under these circumstances. The result of the treatment of wounds in the hospital were of the most unsatisfactory character, from this neglect of cleanliness, in the dressings and wounds themselves, as well as from various other causes which will be more fully considered. I saw several gangrenous wounds filled with maggots. I have frequently seen neglected wounds among Confederate soldiers similarly affected; and as far as my experience extends these worms destroy only the dead tissues and do not injure specially the well parts. I have even heard surgeons affirm that a gangrenous wound which had been thoroughly cleansed by maggots, healed more rapidly than if it had been left to itself. This want of cleanliness on the part of the nurses appeared to be the result of carelessness and inattention, rather than of malignant design, and the whole trouble can be traced to the want of proper police and sanitary regulations and to the absence of intelligent organization and division of labor.
The abuses were in large measure due to the almost total absence of system, government, and rigid, but wholesome sanitary regulations. In extenuation of these abuses it was alleged by the medical officers that the Confederate troops were barely sufficient to guard the prisoners, and that it was impossible to obtain any number of experienced nurses from the Confederate forces. In fact the guard appeared to be too small, even for the regulation of the internal hygiene and police of the hospital.
The manner of disposing of the dead was also calculated to depress the already desponding spirits of these men, many of whom have been confined for months, and even for nearly two years in Richmond and other places, and whose strength had been wasted by bad air, bad food, and neglect of personal cleanliness.
The dead-house is merely a frame covered with old tent cloth and a few brushes, situated in the south-western corner of the hospital grounds. When a patient dies, he is simply laid in the narrow street in front of his tent, until he is removed by Federal negroes detailed to carry off the dead; if a patient dies during the night he lies there until morning, and during the day, even the dead were frequently allowed to remain for hours in these walks. In the dead-house the corpses lie upon the bare ground, and were in most cases covered with filth and vermin.
The cooking arrangements are of the most defective character. Five large iron pots similar to those used for boiling sugar cane, appeared to be the only cooking utensils furnished by the hospital for the cooking of nearly two thousand men; and the patients were dependent in great measure upon their own miserable utensils. They were allowed to cook in the tent doors and in the lanes, and this was another source of filth, and another favorable condition for the generation and multiplication of flies and other vermin.
The air of the tents was foul and disagreeable in the extreme, and in fact the entire grounds emitted a most nauseous and disgusting smell. I entered nearly all the tents and carefully examined all the cases of interest, and especially the cases of gangrene, upon numerous occasions, during the prosecution of my pathological inquiries at Andersonville, and therefore enjoyed every opportunity to judge correctly of the hygiene and police of the hospital.
There appeared to be absolute indifference and neglect on the part of the patients of personal cleanliness; their persons and clothing, in most instances, and especially of those suffering with gangrene and scorbutic ulcers, were filthy in the extreme and covered with vermin. It was too often the case that patients were received from the Stockade in a most deplorable condition. I have seen men brought in from the stockade in a dying condition, begrimed from head to foot with their own excrements, and so black from smoke and filth that they resembled negroes rather than white men. That this description of the stockade and hospital has not been overdrawn, will appear from the reports of the surgeons in charge, appended to this report.