We will first examine the consolidated report of the sick and wounded Federal prisoners. During six months, from the 1st of March to the 31st of August, forty-two thousand six hundred and eighty-six cases of sickness and wounds were reported. No classified record of the sick in the stockade was kept after the establishment of the hospital without the prison. This fact, in conjunction with those already presented relating to the insufficiency of medical officers and the extreme illness and even death of many prisoners in the tents in the stockade, without any medical attention or record beyond the bare number of the dead, demonstrates that these figures, large as they seem to be, are far below the truth.
As the number of prisoners varied greatly at different periods, the relations between those reported sick and well, as far as those statistics extend, can best be determined by a comparison of the statistics of each month.
During this period of six months no less than five hundred and sixty-five deaths are recorded under the head of morbi vanie. In other words, those men died without having received sufficient medical attention for the determination of even the name of the disease causing death.
During the month of August fifty-three cases and fifty-three deaths are recorded as due to marasmus. Surely this large number of deaths must have been due to some other morbid state than slow wasting. If they were due to improper and insufficient food, they should have been classed accordingly, and if to diarrhea or dysentary or scurvy, the classification in like manner should have been explicit.
We observe a progressive increase of the rate of mortality, from 3.11 per cent. in March to 9.09 per cent. of mean strength, sick and well, in August. The ratio of mortality continued to increase during September, for notwithstanding the removal of one-half the entire number of prisoners during the early portion of the month, one thousand seven hundred and sixty-seven (1,767) deaths are registered from September 1 to 21, and the largest number of deaths upon any one day occurred during this month, on the 16th, viz: one hundred and nineteen.
The entire number of Federal prisoners confined at Andersonville was about forty thousand six hundred and eleven; and during the period of near seven months, from February 24 to September 21, nine thousand four hundred and seventy-nine (9,479) deaths were recorded; that is, during this period near one-fourth, or more, exactly one in 4.2, or 23.3 per cent. terminated fatally. This increase of mortality was due in great measure to the accumulation of the sources of disease, as the increase of excrements and filth of all kinds, and the concentration of noxious effluvia, and also to the progressive effects of salt diet, crowding, and the hot climate.
CONCLUSIONS.
1st. The great mortality among the Federal prisoners confined in the military prison at Andersonville was not referable to climatic causes, or to the nature of the soil and waters.
2d. The chief causes of death were scurvy and its results and bowel affections—chronic and acute diarrhea and dysentery. The bowel affections appear to have been due to the diet, and the habits of the patients, the depressed, dejected state of the nervous system and moral and intellectual powers, and to the effluvia arising from the decomposing animal and vegetable filth. The effects of salt meat, and the unvarying diet of corn-meal, with but few vegetables, and imperfect supplies of vinegar and sirup, were manifested in the great prevalence of scurvy. This disease, without doubt, was also influenced to an important extent in its origin and course by the foul animal emanations.