Savannah morning news. [volume] (Savannah) 1868-1887, 1885-03-25
THAT MALIGNANT CANCER.
The Chances for Gen. Grant Recovery
NJ he Submits to an Oneratinn

The Chances for Gen. Grant Recovery
N no Submits to an Operation.
Although scirrhOus carcinoma of the
tongue is occasionally met with, says the
Philadelphia Medical Nelrs, the most i'm
portant Of the neOplasms of that organ is
epithelioma, the natural history of which
has a special interest at this time, in con-
nection with the case of a distinguished
citizen, in which minute examination has
disclosed that the disease is a cancer of
that type.
Lingual epitheliOma, as a rule, rapidly
progresses toward a fatal termination.
When left to itself, the life of the patient
from the first appearance of the disease
varies, IN accordance with the estima ates
OF different observers, from 1O.5 to l3
months, the average being III months.
Death ensues, first, from the generaliEa-
ton OF the disease; secondly, from septic
pneumonia, from the inhalation of the
putrid emanatiOns which result from the
decomposition Of the products of the ul-
cerated surface; thirdly, from starvation,
through the pressure of the infected lym-
phatic glands and surrounding parts
upon the RsOphagus, thereby interfering
with deglutitiOn; and, lastly, from hem
Orrhage proceeding from the liberated
nnguaI arteries. or the vessels OF the neck. A..
The duration Of life of those who sur.
viVe an operation averages 10 months.
Not only does operative interference pro-
long life and relieve suffering but it
ELECTS a nnal cure in IA per cent. of all
cases. In attaining these results it must.
however. be remembered that excision of
the tongue is attended with a mortality OF
- per cent, the principal dangers being
shock, hemOrrhage, edema of the CLOTHS,
septic lung affections, py9mia and erysip.
elias, some of which risks can be avoided
by taking careful precautions during the
/ operation. AID by the perfecting OF anti
septic measures during and alter the pro-
cedure.
When in addition TO disease of the
tongue itself the palate and the tOnsil are
/ involved, the prOgnOsis is far more grave.
I whether the disease is permitted to puI.
D sue an unaided course, or whether il be
I subjected 20 the knife. In the latter event
not only will the tongue have to be extir-
I pated, but the disease of the palate and
I t0nsll VIII have TO be reached either by
Z Langenpeck's or Mikulicz's method OF
I operation In the former the iawbone is
/ divided just in front of the masseter mus.
/ Gle. while In the latter the ramus Of the
I jaw Is resected. For carcinoma Of the
I tonsil alone temporary section Of the in.
I ieTlOr maXllla has been practiced by Chee.
D yer, Gensmer, and Won Bergman. In
/ NneeNers case the disease continued To
I progress; in Gensmer's there was freedom
Y from recurrence for 33 months: while we
I are not aware Of the fate of Won Berg
maun's patient. In Mikulicz's case of re.
section Of the ramus, the patient was well
I at the expiration OF six months.
I 80 tar as we can learn, there is no eX-
I ample Of the performance of the double
operation on record; and it is. in our
/ opinion, not justifiable. The only avail
Z able measures are those directed toward
I the relief OF suffering, the prevention OF
I septic complications, and supporting the
Z powers of the system. Should degIutition
I be greatly inteTfered with, gastrOstOmy
might be resOrted to; but this procedure,
under the circumstances, is of such a
questionable nature that the prudent sur
geOn would doubtless not take it into con-
/ sideraiiOn.
Although an operation for the removal
I Of the disease in Gen. Grants case is not
contemplated, the association with the
case Of such eminent surgeons as PTOfs.
MarkOe and Sands is an ample guarantee
to the profession that the question has not
/ been overlooked, and that, if any opera
/ tiOn should be deemed advisable, it would
be performed with the utmost skill and
sOundest Judgment.