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,' composed of linen threads cut of different lengths, which, on inquiry, it was found had been already used in the great hospitals in France, and had been subsequently washed and bleached, caused every ulcer to which it was applied to be affected by hospital gangrene.

Guthrie affirms in the same work, that the fact that this disease was readily communicated by the application of instruments, lint, or bandages which had been in contact with infected parts, was too firmly established by the experience of every one in Portugal and Spain to be a matter of doubt.