166 CONTEMPORARY SCIENCE 



disarticulation at the hip-joint had a mortality of 100 

 per cent., i.e., every case died. It is instructive also to 

 compare the fate of those who had an amputation of the 

 thigh (1,666 French cases) with a mortality of 92 per 

 cent., and 487 cases treated conservatively, i.e., without 

 amputation, with a mortality of only 70 per cent. ! 



In our Civil War Duncan quotes the figures of Fox, 

 which are "the latest revised statistics and are all larger 

 than those of the Medical and Surgical History of the 

 War." The average strength of the Union Armies was 

 806,755, and the deaths 359,528, of whom 67,058 were 

 killed in battle and 43,012 died of wounds. This gives a 

 battle death rate of 33 per 1,000 per annum. The disease 

 death rate was 65 per 1,000 per annum. The case death 

 rate from disease was only 3.4 per cent., a very low figure. 



I can testify to the excellent condition of the Civil War 

 hospitals, of which I saw many, but only in the East. 

 When I say "excellent condition" it must be with the 

 reserve that we knew nothing as to bacteriology, which 

 did not exist, nor of infection, which was utterly un- 

 known as to its causes and prevention. The general sani- 

 tary conditions, and by this I mean shelter, ventilation, 

 cleanliness, good food, as good nursing as intelligent order- 

 lies could give, etc., were all excellent. But the surgical 

 conditions as we now know were simply dreadful. Prac- 

 tically every wound suppurated, and in summer I have 

 seen many wounds swarming with squirming maggots as 

 large as chestnut worms disgusting, but, fortunately, 

 not especially dangerous. 



In my "Surgical Reminiscences of the Civil War" 16 

 I have given many statistics taken from the official Medi- 

 cal and Surgical History of the War, a few of which I 

 will reproduce that you may see what blessed conditions 

 you "free born" men have inherited. Pyemia (blood- 

 poisoning) was one of our worst scourges. There were 

 2,818 cases, and of these only 71 recovered, a death rate 



18 Keen, Addresses and Other Papers, 1905, p. 420. 



