Wheeling register. [volume] (Wheeling, W. Va.) 1878-1935, 1885-03-20
GRANTS CASE VERY SERIOUS.
Tho Report of the Medical Record and the
Opinion of the Medical News.

szNEW YoRK, March l9.-The following
will appear in the Medical Record March
2lst: During the past week the local disease
of General Grant has shown no marked ten
dency toward progressive liberation. At
the,recent weekly consultation, DR.. Fordyce
Barker was unavoidably absent. Doctors
j. 81. Douglas, Henry B. Sands and George
F. Shrady, who were present, made thor
ough examination Of the Generals throat,
with . view of discussing the expe-
diency of a radical surgical opera.
ton for the removal of the growth.
Such measure would involve division Of
the lower jaw in the medal line, extirpa.
tion Of the entire tongue and the greater
part of the soft palate, together with the re-
mogal of the liberated and inflterated
fauces and indurated glandular structures
under the right angle Of the lower jaw.
This was considered mechanically posi-
ble, despite the close proximity and proJa-
BILE involvement of tissues adjoining the
large arteries and veins in the neighborhood
of the alterations, but in the best
interests of the distinguished patient, the
surgeons did not feel inclined to recommend
the procedure. Even by such means there
could be no guarantee in view Of the exten.
sive surrounding in6lteration that the limits
of the disease could be reached without an
immediate risk by a severe shock to the
constitution already much enfeebled. The
low vital power is such strong element in
the disease that for the present, at least no
kind of operation can be undertaken. The
liberation on the side of the tongue has
not, progressed far enough to
provi6e the usual intolerable
pain associated with that condition, but
should the latter symptoms appear, it may
be deemed advisable to divide the gusta-
tory nerve. The general tone of the pa:
tents system remains about the same as at
the last report, notwithstanding he has
suffered much from insomnia. The latter
within the last day or two has been kept under
control by suitable anodynes. There is no
pain in swallowing, and sufficient TODD is
taken with reasonable relish.
The Opinion of the Medical News.
PHILADELPHIA, March l9.-The Phila-
delphia Medical News this week will say
editorially concerning the disease from
which Gen. Grant is suffering: "Lingual
epitbelioma, as q rule, rapidly progresses
towards fatal termination, when left to
itself, of the life of the patient. From its
first appearance the disease varies in &C
corGance with estimates of different obsery-
ers from 10 to L. months, the average be-
ing IL months. Death ensues, first from
generalization Of the disease; secondly,
from septic pneumonia, from the
inhalation of putrid emanation which
results from the decomposition of the
products of the lacerated surface; thirdly,
from starvation through pressure on the in
fected lympathelic glands, and surrounding
parts under the esophagus, thereby inter
fering with deglutition; and lastly, from
hemorrhage proceeding from the liberated
lipgual arteries or vessels of the neck. The
duration of the life Of those who survive
the operation averages nineteen months.
Not only does operative interference prolong
life and relieve suffering, but it effects final
cure in fourteen per cent Of all cases. In
attaining these results it must, however, be
remembered that the incision of the tongue
is attended with mortality of twenty three
per cent. The principal dangers being
udena of glottis, septic lung affections, py-
anna, and erys,pelas, some of which risks
can be avoided by taking careful pre-
cautions during the operation
snd by perfecting antiseptlc
measures during snl after procedure.
When, in addition to the disease, the tongue
itself, palate and tonsil are involved, the
prognosis is far more grave, whether the dis,
ease be permitted to pursue an unaided
cour e. or whether it be subjected to the
kni.e. In the latter event not only will the
tongue have to be extirpated but disease OF
the palate and tonsil have to be reached.
So far as we can learn there is no example
of the performance OF the double operation
on record, and it is, in our opinion, not JUS
Ii61 le