|SURNAME:||Garness also recorded as Garnish, Garrets and Garnets||FORENAMES:||John||BORN:||c1808||AT:||.||OCCUPATION[S]:||.||RELIGION/DENOMINATION:||.||FATHER:||.||MOTHER:||.||SIBLINGS:||.||OTHER RELATIONS:||.||NOTES:||.||1st REGIMENT NO:||609||2nd REGIMENT NO:||.||ENLISTED:||03 03 1829 London||ATTESTED:||.||HEIGHT AT ENLISTMENT:||.||TROOP NO:||1831: Troop 4||TROOP CAPTAIN:||1831: Captain John Baker Spooner||RANK:||1829-1832: Private||PROMOTIONS:||.||REDUCTIONS:||.||DESERTIONS:||.||COURT MARTIALS:||.||GIVEN UP TO:||.||GOOD CONDUCT BADGES:||.||MEDALS:||.||EMBARKATIONS:||02 01 1830 Duchess of Atholl England||DISEMBARKATIONS:||17 04 1830 Duchess of Atholl Bombay India||CAMPAIGNS:||.||OTHER DUTIES:||.||TRANSFERRED FROM:||.||TRANSFERRED TO:||.||DIED:||23 09 1832 Kirkee India aged 24 years. See autopsy report below||BURIED:||23 09 1832 Kirkee India||WILL:||.||BENEFICIARY:||.||NEXT OF KIN:||.||PRIZE MONEY:||.||NOTES:||.||AUTOPSY REPORT:|| CASE No. 4. Dysentery with puckered fungoid internal surface of part of the colon:
JOHN GARNESS, Private, 4th Light Dragoons, AEt. 24. About two years in India. January 17th, 1831, admitted into Hospital, with head-ache and pain of right shoulder.
- 19th, pain of right side increased by full inspiration, and by lying on the back; skin cool. This man was cupped, and the side rubbed in with mercurial ointment.
- 26th, easy; slight cough.
- 29th, no pain; mouth sore. Discharged February 11th.
Re-admitted with catarrh, November, 1831. In May, 1832, he had common continued fever for a few days.
September 9th, 1832. admitted from the surgical ward, [where he had been long confined and much reduced from numerous Guinea worms,] with dysenteric symptoms of two days standing; there was little pain of belly and not much pyrexia; blood and mucus were observed in the evacuations, and latterly, membranous shreds; cold clammy skin for some days before death. Died September 23rd. Bled, leeched, blistered, mercury in the form of calomel, blue pill, and friction; no ptyalism.
Inspection, seven hours after death. Omentum vascular, in parts fleshy; few adhesions here, none of the coecum. The top of the ascending colon adhered firmly to the gall-bladder and under surface of the liver. The ascending colon and commencement of the transverse distended, the latter forming the common duplicature towards the umbilicus. At the middle of the transverse colon, the gut became contracted and thickened; the descending colon was similiarly contracted, its natural connections were vascular; no new ones had formed. The sigmoid not so much contracted, it felt also firm and thickened; the greater part of the S. flexure was lying in the pelvis, its peritoneum here and there vascular. Rectum thickened and firm.
In the coecum and ascending colon the mucous membrane had that irregular papillous surface which I have described before - an appearance as if an unequal exudation of tenacious adherent mucous had taken place. Where this appearance existed the membrane could be distinctly raised from the subjacent tunics. In the intercellular tissue there was no thickening, its filaments were distinctly seen on the stretch under the raised mucous membrane. The muscular coat was healthy; here the disease was solely in the mucous tunic. Approaching the contracted portions, the irregularity of surface increased; and round, small, defined, superficial ulcers like small-pox pits began to appear here and there, they seemed to be in the situation of what had been large papillae; throughout the contracted portion, the sigmoid, and rectum, the irregularity of surface was so increased as to present a puckered fungoid aspect: here the bottom of the depressed interstices was evidently in most instances the cellular tissue. Sometimes the elevations coursed in distinct transverse ridges round the bowel, still presenting a mucous surface, sometimes like red currant jelly. The more elevated ridges when cut into were hard and cartilaginous. In the sigmoid and rectum there were large isolated patches of the elevated portions, often surrounded by depressed portions, the bottom of which latter was formed by muscular fibre, discoloured, probably thickened. There was a greyish tint throughout the greatest part of the mucous membrane of the great bowels.
Small intestines healthy; contents of ileum and jejenun green, tenacious, not foetid. Higher up in the jejenun and in the duodenum there was a tenacious yellowish mucus. In the stomach there were here and there some dotted red patches of softer structure than the rest of the tunic. Liver healthy; bile in the gall-bladder; spleen healthy. The cortical part of the right kidney was somewhat lighter in colour than natural. The lungs were healthy, but many old adhesions, principally on the right side, and to the diaphragm of same side. Heart sound.
Remarks. This patient was treated in January, 1831, for pain of right shoulder, and right side, which were plainly considered to be dependant on the liver. It is however much more probable that the liver at that time was not affected, but that the adhesions took place between the diaphragm and base of the lungs. It was in fact pleuritis, not hepatitis.
In a paper in No. CXI of the Edinburgh Medical and Surgical Journal, I have stated that adhesions between the convex surface of the liver and diaphragm are very generally attended with adhesions of the base of the right lung to the thoracic surface of the diaphragm.
My observation since, leads me to qualify this statement, and to say, that when adhesions of the convexity of the liver to the diaphragm are consequent on abscess, then there is the corresponding adhesion of the lung. It is plainly a prospective remedy, similar to those adhesions which patch up perforated bowels; it prevent effusion into the chest by anticipating an egress for the pus.
There is one interesting observation connected with these remedial adhesions, it is that they are not attended with the distressing symptoms which severally mark their idiopathic production. Inflammation of the pleura of the diaphragm is generally an urgent disease. In none of the cases reported by me in the Edinburgh Journal could we have divined its existence. Inflammation of the peritoneum is generally marked by acute tenderness: in case No. 2 [John Ryan] where it took place in anticipation of an abscess bursting into the colon, it was relieved by a tight bandage. The same fact may be observed in case No. 7 [Henry Green]. In the coecum the mucous coat presented the papillous surface; it was in a condition similar to No. 2 [John Ryan] with the exception, that there was less softening, and no implication of the sub-cellular tissue. Throughout the contracted part of the bowel there was a more irregular, rugous appearance. I account for this in part on the principle alluded to at the commencement of this paper; the inflammatory action found the bowel contracted, the mucous tunic consequently rugous; it fixed it in that condition, by altering the nature and relations of the connecting cellular tissue. This will account for the irregular surface of the contracted portions; but it is expressly stated, that the sigmoid was not contracted, yet the mucous surface was irregular with transverse ridges coursing round it. In the two situations there was however a difference. It was principally in the contracted part that the puckered rugous surface was general. It was principally towards the sigmoid that the cartilaginous ridges existed.
I consider the lesions to have been different. Int he contracted part the eminences were not the result of any actual increment to their molecules, but the result of the anatomical condition in which the mucous tunic was, when first attacked. In the other sites the inequalities were produced by a thickening of the mucous and sub-cellular tissues. The want of redness of the mucous membrane, and yet the undoubted proofs of inflammatory action, may be remarked, not however as anything unusual; it is to be observed in several of the other cases.
|TNA SOURCES:||WO/12/639-642||BL SOURCES:||IOR/N/3/10||OTHER SOURCES:||FIBIS
Transactions of the Medical and Physical Society of Calcutta, Vol. 7, 1835
4th Light Dragoons Index