The Abilene reflector. [volume] (Abilene, Kan.) 1883-1888, 1885-08-06
GENERAL GRANTS DISEASE.

Extracts From an Article by DIR. shrady On
the Surgical and Pathological Aspects Of
the Case-A Brief Review of the Treat
ment.
NEW YORK, July 31.-The subjoiucd
are extracts from an article by Or.
Shrady on the "Surgical and Pathc!1yicsi
Aspects of General Grants Case" which
will appear in the Medical Record OF next
Saturday. The treatment will be more
deliberately described hereafter. DR..
Shrady says:
at is not definitely known when the
throat trouble commenced, but probably
in June, 1884, as at that time General
Grant first complained of soreness in the
tonsillar regions.
"On March 7th, when l first saw the p2-
tient, in consultation with Drs. Barker,
Douglas and Sands, it was found that
the surfaces of the right tonsillar region,
and adjoining portion of the vault of the
pharynx were covered with thick yell
lowiSh emulation resembling sloughing
tissue. This deposit was evidently the
result of an acute procuSO enGraiteo
upon the original disease and partook OF
many of the characters of diphthe-
retic membrane. This viewi of the
complication explains many of tn grave
symptoms which We're subseque tly as
ISOLATED with the great prOStratioD, but
which were not directly traceable 20 the
progress of the epitheiiomatous degen-
Grafton. The progress of the local dis
ease was a steady one from the begin
ming. The loss of the palate and ada
cent soft parts, with the consequent lack
of perfect control of the tongue
occasioued great difficulty in
swallowing. Just before he
was transferred to Mt. McGregor, he
rather suddenly lost his voice never to
regain it. This was due partly to thick
ening of the vital chords by infiammatory
infiltration, sand partly to relaxation
of the parts from general weakness. A
brief summary of the treatment is all
that it will be necessary to give
now. Early in the disease in order
to eliminate every possible chance
of error in the diagnosis, the
patient was placed under specific treat
ment, although the clinical history of the
case gave only negative indications of its
necessity. This treatment, although con.
tinued for a sufficient period, produced
no effect in healing the ulceratiOns or in
arresting the progress of the disease.
Iodoform was used as a local application
to the ulcers, as we'll as gargles composed
of salt and water, diluted carbolic acid
and solutions of permanganate OF potash
and yeast. 4 four per cent. solution of
cocaine was occasionally applied to pain
full parts with happy results, but it was
urah
is generally thought by the public, nor
were there any bad effects manifested
from its administration. The latter were
carefully guarded against with the full
knowledge that the drug was new
one, and that only its cautious use was
admissible. Red clover was given quite
constantly, but produced no effect what
ever upon the local disease. 1t only
proved itself useful as a laxative, and
was so employed as being the least harm
full of medicines of its sort for con-
tinuouS administration.
1.-The diagnosis given early in the case
was proved to be correct by the micro
scope, by the clinical history of the pa
tient, and by the fat tissue. The dis
ease had much shorter course than US
ual, owing to the prOstration of the pa
measure, upon other causes
"The cause of the disease in this case
is largely conjectural. Epethiloma, as a
rule, starts from local circulation,
and unlike other forms of cancer is
not dependent upon hereditary predis-
position to the disease. There must,
however, aside from this, be a latent
tendency toward cancerous troubles
which = more nrOnOunced in some indi-
viduaIs than in others, otherwise
we should be unable to explain why
simple and continued circulation would
induce the disease in one case and not in
another. 1t is, however, quite probable
that excessive smoking was the ac-
tive cause of the cancer in General
Grants case, or at least it is fair to pre-
sumo he would not have had the disease
if his habit had not been carried to ex-
cess. This assumption is made in face of
III. fact that of the thousands who smoke
but very small proportion suffer from
the disease. Although there was more
or less constant pain OF a gnawing
the patient was happily spared
that agony of suffering which is often
associated with the invasion of the deep
er parts of the tongue by cancerous dis
case. Had the latter occurred, it
was proposed to divide the
"gustatory" through the mouth
which operation oftentimes gives abso-
lutte relief. Such pain as existed, how
ever, was kept under control by cocaine
and morphine, so that the last wish of
the patient that his death should be a
peaceful one was fully realized"