|SURNAME:||Nash||FORENAMES:||William||BORN:||c1806||AT:||.||OCCUPATION[S]:||.||RELIGION/DENOMINATION:||.||FATHER:||.||MOTHER:||.||SIBLINGS:||.||OTHER RELATIONS:||.||NOTES:||.||1st REGIMENT NO:||536||2nd REGIMENT NO:||.||ENLISTED:||16 08 1827 London||ATTESTED:||.||HEIGHT AT ENLISTMENT:||.||TROOP NO:||1828: Troop 2
1831: Troop 2
|TROOP CAPTAIN:||1831: Captain Harcourt Master||RANK:||1828: Private
|PROMOTIONS:||.||REDUCTIONS:||.||DESERTIONS:||.||COURT MARTIALS:||.||GIVEN UP TO:||.||GOOD CONDUCT BADGES:||.||MEDALS:||.||EMBARKATIONS:||18 02 1828 Duchess of Atholl England||DISEMBARKATIONS:||01 06 1828 Duchess of Atholl Bombay India||CAMPAIGNS:||.||OTHER DUTIES:||.||TRANSFERRED FROM:||.||TRANSFERRED TO:||.||DIED:||04 09 1832 Kirkee India aged 26 years. See autopsy report below||BURIED:||04 09 1832 Kirkee India||WILL:||.||BENEFICIARY:||.||NEXT OF KIN:||.||PRIZE MONEY:||.||NOTES:||.||AUTOPSY REPORT:|| CASE No. 3. Chronic dysentery, thickened state of the colon, papillous surface of the mucous coat, with probable hypertrophy:
WILLIAM NASH, Private, 4th Light Dragoons, AEt. 27. In 1830, had dysentery, and since that time had never been in perfect health. Admitted into Hospital 6th April, 1832, with febrile symptoms: was actively treated.
- 26th. Palpitation at the epigastrium, which he has occasionally observed since he was in Hospital with the first attack of dysentery. Abdomen full, slight uneasiness in the course of the colon on pressure.
- 27th, says that on pulling his belt tight he has generally pain in the course of the transverse colon.
May 22nd - Discharged convalescent.
May 28th - Re-admitted. Was on the previous day discharged from the convalescent ward. In the night time, purging returned with griping, and has continued very frequent since.
- 30th, strong pulsation at the epigastrium and below the umbilicus.
- July 30th, pain above the umbilicus, occasional hardness there; strong pulsation.
- 31st, there is a feeling of hardness in the course of the transverse colon, commencing on the right side of the umbilicus, and extending across the belly and upwards, and towards the left side of the diaphragm; feeling of soreness there. Died September 4th.
Throughout this long illness there were frequent amendments and relapses. Every variety of treatment was tried. The appearance of the evacuations throughout the disease varied. They are described as follows at different times in the reports: `Sometimes yellow, sometimes slimy; greenish and thin, with some lumps; dark green, watery; thin watery, bilious with white flocculi; thin yellow with some drops of blood; brown, watery, with some specks of blood; pretty consistent, with curdled appearance, tinged with bile; consist of bright yellow granules and flocculi floating in water: were also frequently feculent and natural.
Inspection, six hours after death:
Body emaciated; the omentum vascular, extended over all the bowels, but had not formed any adhesions, and was not thickened. No unnatural adhesions of the coecum; but not connected by unnatural adhesions to adjacent organs; the colon, after reaching the concavity of the liver, doubled down in a direction towards the umbilicus, not however extending so low, thence it doubled upwards, and followed the great arch of the stomach; the descending colon followed its natural course; there were some black patches on the peritoneal coat of the rectum. Parts of the meso-colon and meso-rectum fleshy and thickened, with enlarged glands. The small intestines much contracted; where most dependent, there more discoloured; were lying in the pelvic region, so that for the space of two or three inches diameter every way the lumbar vertebrae had interposed between them, and the anterior abdominal parietes, only the mesentery and the blood vessels, with their investing tissues: this space was in part opposed to the umbilicus, and the situation where the strong pulsation had been so long felt. This space was bounded superiorly by the transverse colon laid on the commencement of the jejunum, which latter intestine, after coursing along the right side of the descending colon, joined the rest of the small intestines, all of which were found on a plane below the last lumbar vertebra. The transverse colon had not lost its cells; they were however diminished. The mucous and intercellular tissues, throughout the whole course of the large bowels, much thickened, could easily be peeled from the muscular, the fibres of which latter were pale and healthy.
The whole surface of the mucous tunic had an irregular aspect, produced by the elevation of little, variously-sized superficial eminences, closely grouped. It resembled nearly the posterior part of the tongue, where the papillae are broad and flattish, or it might be likened to a surface of closely grouped superficial warts; the effect was to make the mucous tunic at first sight look ulcerated, but on nearer inspection, the absence of ulceration and the continuity of the mucous surface were apparent. This surface resisted washing or rubbing with the flat part of the finger, but the papillae peeled off with the nail in the form of thick gelatinous mucus, containing some opaque granules: there was little change of colour, it was greyish throughout the greater part of the membrane. Here and there, more especially at the sigmoid flexure internally, were black patches, half an inch or more in diameter; in parts of some of these there was a breach of continuity: these patches were gangrened portions, very tender, peeling off in the form of a thin pellicle, leaving underneath a reddish ulcerated-looking surface; in some the gangrened pellicle had been altogether thrown off, and left a superficial ulcer with reddish bottom and ragged edgde; but this was not in many instances the case. In the rectum there was more of this gangrenous appearance: the patches however were less defined. The greater part of the under tunic of the lower portion of the rectum was occupied by a thin tender pellicle, easily separating, in some portions black, in others less remarkably so. The coats of the small intestines thinned; the bowel contracted. In parts however of the lower portion of the ileum there were partial distensions, sometimes only of one-half of the diameter of the gut; there was redness of part of the mucous lining of the ileum, but no proof that it was the result of inflammation; contents green tenacious. The stomach, distended with air, seemed sufficiently healthy; the liver had formed no unnatural adhesions, it was somewhat darker in its colour, and internally somewhat more mottled than natural. The gall-bladder contained dark bile.
The cortical part of both kidnies had partially undergone the yellow degeneration first described by Dr. Bright. Lungs on both sides adhered firmly, but their structure was sufficiently healthy; heart sound.
Remarks. it is probable, that the tunics never recovered their normal condition after the first attack in 1830; the disease at that time may have consisted of softening of the mucous coat, followed by thickening of the sub-cellular: the former may have been recovered from; the latter, probably remained. My reasons for thinking so are, the pulsation at the umbilicus complained of from the time of the first attack, the explanation of that pulsation, the uncomfortable feeling on tighening the belt, the frequent relapses of diarrhoea and dysentery.
How well the report of July 31st is explained by the state and position of the transverse colon, as found on dissection. The actual condition of the colon was thickening of the sub-cellular tissue. Softening with hypertrophy of the mucous coat.
The plausible explanation of the appearances in this case is, that during the long illness, the succession of amendments and relapses, the mucous lining became the seat of different actions. It may have been reduced to the state in the colon of No. 2 [John Ryan], then the action of softening may have ceased, and the anormal nutrition which I have supposed to have pre-existed in the cellular tissue may have extended to the mucous linging, and increased its molecules; this action of hypertrophy would have found the surface of the membrane irregular; its effect must have been to exaggerate that irregularity. The white granules intermixed with the secretion is another reason for supposing that there must have been some action in addition to the softening. These white opaque granules I shall subsequently notice: I have seen them in several instances in the small intestines, and all under different circumstances.
|BL SOURCES:||IOR/N/3/10||OTHER SOURCES:||Transactions of the Medical and Physical Society of Calcutta, Vol. 7, 1835||LINKS:||.|
4th Light Dragoons Index