XII. Gangrenous spots, followed by rapid destruction of tissue, appeared
in some cases in which there had been no previous or existing wound or
abrasion; and without such well established facts, it might be assumed
that the disease was propagated from one patient to another in every
case, either by exhalations from the gangrenous surface or by direct
contact.

In such a filthy and crowded hospital as that of the Confederate, States
Military Prison of Camp Sumter, Andersonville, it was impossible to
isolate the wounded from the sources of actual contact of the gangrenous
matter. The flies swarming over the wounds and over filth of every
description; the filthy, imperfectly washed, and scanty rags; the limited
number of sponges and wash-bowls (the same wash-bowl and sponge serving
for a score or more of patients), were one and all sources of such
constant circulation of the gangrenous matter, that the disease might
rapidly be propagated from a single gangrenous wound. While the fact
already considered, that a form of moist gangrene, resembling hospital
gangrene, was quite common in this foul atmosphere in cases of dysentery,
both with and without the existence of hospital gangrene upon the
surface, demonstrates the dependence of the disease upon the state of the
constitution, and proves in a clear manner that neither the contact of
the poisonous matter of gangrene, nor the direct action of the poisoned
atmosphere upon the ulcerated surface, is necessary to the development of
the disease; on the other hand, it is equally well-established that the
disease may be communicated by the various ways just mentioned. It is
impossible to determine the length of time which rags and clothing
saturated with gangrenous matter will retain the power of reproducing the
disease when applied to healthy wounds. Professor Brugmans, as quoted by
Guthrie in his commentaries on the surgery of the war in Portugal, Spain,
France, and the Netherlands, says that in 1797, in Holland, 'charpie,'