Testimony, by Letter, of Surgeon William S. Ely, Executive Officer U. S. A. General Hospital Division, No. 1, Annapolis, Maryland, June 6th, 1864.
Dr.ELLERSLIE WALLACE, Philadelphia, Penn.
Doctor :— I am in receipt of your communication of the 2nd inst., and would reply as follows
I am an Assistant Surgeon of Volunteers in the service of the United States, and have been on duty in this hospital since October 3d, 1863, as executive officer and medical officer in charge of a ward. I have been present on the arrival of nearly every boatload of paroled prisoners since my connection with this hospital commenced.
I remember distinctly the arrival of the flag-of-truce steamer “New York,” November 18th, 1863, and was present and assisted in unloading the men. I went on board the boat and saw bodies of six (6) men who had died during the passage of the steamer from City Point, Va., to this place. No words can describe their appearance. In each case the sunken eye, the gaping mouth, the filthy skin, the clothes and head alive with vermin, the repelling, bony contour — all conspired to lead to the conclusion that we were looking upon the victims of starvation, cruelty and exposure, to a degree unparalleled in the history of humanity.
I have never seen more than the above number of dead in any single arrival; but at other dates, and on several occasions, I have seen two (2) and three (3) dead on board the boat, and have repeatedly known four (4) or six (6) to die within twelve (12) hours of their reception into hospital. The same condition evidenced in the cases of the six (6) referred to above, has characterized nearly every instance, and leads us irresistibly to the conclusion that death has been owing to a long series of exposure and hardships, with a deprivation of the barest necessities for existence.
I have known paroled prisoners of war to be admitted to this hospital with barely sufficient clothing to cover their nakedness. I cannot say that I have seen any single case where a patient was admitted without either hat, coat, shoes, shirt, or stockings, but I have repeatedly seen men without one (1), two (2), or three (8) of these articles, and think that I can say, that when they possessed all, it was an exceptional case. It is our rule to strip each patient to his skin, and provide all with entirely new clothing, because rags, filth and vermin preponderate so largely as to render any further use of the various articles of apparel upon the bodies of patients reaching this point from Richmond, Va., unhealthy, and in opposition to the simplest principles of hygiene.
Patients, when asked the manner in which they lost their clothing, reply that they were robbed of what they had when captured, or else that during their imprisonment, often-times extending over many months, their clothing, piece by piece, wore out, and that they had no opportunity to procure a change.
It is impossible for any, save those who have seen the condition of paroled men soon after their release from captivity, to have any idea of the state of the skin covering their bodies. In many cases that I have observed, the dirt incrustation has been so thick as to require months of constant ablution to recover the normal condition and function of the integument. Patients have repeatedly stated, in answer to my interrogations, “that they had been unable to wash their bodies once in six (6) months; "that all that time they had lain in the dirt, and, as might naturally be expected, the filth accumulation was constantly increasing. Frequently, the entire cuticle must die and be detached before any healthy action can be recovered.
I know not how to better compare the cutaneous condition of these men in its different morbid states, than to liken it, in feeling, to the effect produced upon the fingers by passing them over sand-paper, from the coarsest quality down to that moderately fine.
Diaphoretic action in many such cases, I have found almost unattainable. When we consider the importance of the cutaneous secretion, relative to a state of health, it cannot be denied that, in many instances under attention, this is the prime exciting cause of the diseases of the pulmonary and abdominal organs, which are so constantly found among our Richmond patients.
A great many post-mortem examinations of paroled prisoners who have died in our hospitals, have been made by myself and others. The thoracic organs are seldom found healthy. The pectoral muscles are so much wasted as to render the walls of the chest, to a certain extent, transparent. The lungs frequently are found filling but half the pulmonary cavities. Old pleuritic adhesions, in all degrees of extent, are generally seen; almost invariably there is a local stasis or congestion of blood, posteriorly and about the roots of the lungs; the heart is found flaccid, and often its walls are attenuated; when taken out and laid down, it flattens from its own weight, is seldom filled with a substantial clot, and generally contains but a very little dark, thin blood. Tubercular deposit is sometimes very extensive, and in cases where there is no external appearance favoring the scrofulous diathesis, leading me to the conclusion that it has been engendered ofttimes, in a previously healthy subject, by the deprivation of good, wholesome food, and the combination of unhealthy influences, to which so many of our prisoners of war succumb. The liver is unusually pale in color, and of anæmic aspect; the intestines are sometimes much diseased, but frequently healthy. I have known many instances of marked chronic diarrhœa, resulting filially, yet disclosing no organic intestinal changes or morbid appearances,— favoring the supposition that the diarrhœa is often only a symptom of a want of tonicity, not of organic disease.
I consider the frequency of pulmonary congestions among our patients from Richmond owing to the altered condition of the fluids of the system, especially the blood: its fibrinous portion becomes diminished, and stagnation takes place in the most depending portions of the lungs, giving us what we term a hypostatic pneumonia, depending on the want of tone in the vessels and consequent enfeebled circulation.
The treatment which I have found most effective in aiding the restoration to health of our reduced Richmond patients, is, very briefly, as follows: — Quinine, iron, and cod-liver oil, (in their different preparations and combinations), in small doses; liquid concentrated nourishment, a rigid enforcement of cleanliness, and regularity in eating and drinking, and, if possible, the hygienic advantages of a tent ward.
Our records exhibit a mortality among our patients from Richmond of 18 per cent.
I am, Doctor, very respectfully,
Your obedient servant,
WILLIAM S. ELY,
Assistant Surgeon U. S. Volunteers.
Personally appeared before me this sixth day of June, 1864, William S. Ely, Assistant Surgeon U. S. Volunteers, and took oath that the statements above made are true to the best of his knowledge and belief.
[SEAL.] HENRY P. LESLIE,
Notary Public, Anne Arundel Co., Md.