The Dickinson press., 1885-03-28
GENERAL GRANTS ooHD1r1oH.

Ewo Leading Medical Journals Give Re.
Condition.
New York, March 19-After his visit to Gen.
Grant tonight DR.. Douglas said:
The general slept seven hours continuously
last night. He was very we'll through the day.
He asked for roast mutton, and ate it during
the afternoon and evening. The general revised
enough of his books to keep the printers busy
three days. When 1 left him to-nlghthe was in
cllned to sleep. The patients throat looks bet
ter this evening. Ithas not the angry appear
anceit has had. There was q catarrahal diff
Guilty in the morning that caused gagging, but
no bad results. Cocaine is not now being used,
and there is no pain. There is mental occupa-
ton that renders the general wakeful.
MORE MEDICAL LORE.
The following will appear in the Medical
Record on Saturday:
Gen. Grant has shown no marked tendency
toward progressing liberation. At the recent
weekly consultation DR.. Fordyce Barker was
nnayoidably absent Drs. j. H. Douglas,
Henry B. Sands and George F. Shrady, who
were present, made a thorough examination of
the generals throat with a view OF discussing
tho expediency Of a surgical operation for the
removal of the growth. Such u measure would
involve the division Of the lower jaw in tho
meaian line, the eXtirpation of the entire ton que
and the greater part of the soft palate, to.
gethcr with the removal of the liberated
and lntiltrated fauces and indurateu CLAN
Cular structures under the right anglo OF
the lower jaw. This was considered mechau-
ically possible, despite the close proximity
and probable involvement of tissues adjoining
the large arteries ana veins in the neighbour
hood of the liberation; but in the bestinterests
Of the distinguished patient the surgeons did
not feel inclined to recommend tho procedure.
Even by such means there could be no guarau-
tee: i'll view of the extensive surrounding in
filtration, that the limits Of the disease would
bo reached without immediate risk to the life
by q severe shock to tho constitution already
much enfeebled. His vital power is SO low
that for the present, at least. no kind
Of operation will be undertaken. Tho
liberation on the side of the tongue has not
progressed far enough to produce the usual
lntolerable pain reported with that condition;
but should the latter symptoms appear it may
be advised to divide the gustatory nerve. The
general tone of the patients system remains
about the sameas at lastleports, notwithstand-
ing he has suffered mueh from insomnia. Tie
latter, within the last day or two has been kept
under control 10y suitable anolynes. There is
no pain in swallowing, and sufficient food is
taken with reasonable relish.
A PHILADELPHIA CONTRIBUTION.
The Philadelphia Medical News this week
will say editorially, concerning the disease
from which Gen. Grant is suffering:
Lingual apithelioma, a. a rule, rapidly pro-
gresses toward fatal termination when left to
itself. The life OF tho patient, from the first
appearance ofthe disease, varies in accordance
with the estimates of different observers from
live to thirteen months, the average being sew
en- mouths. Death cnsues first from g~enersll-
cation OF the disease; secondly, from the in
halatlon OF putrid carnations, which result
from decomposition of the products of the ul-
cerated surface; third, from starvation through
the pressure of intiltrated Emphatic glands
and surrounding parts upon the nsophagus,
thereby interfering with deglut:ti, n; and
lastly from hemorrhage proceeding
from liberated lingual arteries or
vessels of the neck. The duration of the life
of those who survive all operation averages
nineteen months. Not only does operative in.
pro.ong life and relieve suffering,
but it effects a cure in ID per cent. of all cases.
In obtaining these results it must be remem-
bered that the incision of the tongue is attend
cd with a mortality of % per cent, the prin.
cipal dangers being the shock, hemorrhage.
gdlma of the CLOTHS, septic lung affections,
plcatumone, or orysipelas-some of which risks
can be avoided by taking careful precautions
during the operation and by pelfecting antisep-
NC measures during and after the procedure.
When in addition to disease Of the tongue it.
self, tho palate and tonsits arc involved, and
pro5nosis is far more grave-whether the dis
ease shall be permitted to pursue al unaided
or whether it shall be subjected to the
knife. In the latter event not only will the
tongue have to be extirpated, but disease OF
the palate and tonsils have to be reached. So
far as we can learn, there is no example of the
performance Of u double operation OH record,
andltls, IN our opinion, not justitiable.