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.