The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1885-04-03

patient in waiting the issue of his own case as
in his military campaigns. and that by this
frame of mind he had, no doubt, done much to
retard the progress of his malady.
Criticism of the Attending Physicians.
Chicago News.
AS in President Garfeld's case, so also in Gen.
Grants, there has been much apparent room for
criticism of the physicians in charge. Although
an induration or hardening of the tongue-one
Of the distinctive symptoms of cancerous growths
was first noticed last fall, an official statement
was made even so late as Feb. q, in the New
York Medical Record to the effect "that all the
more serious and alarming symptoms have virs
tualy disappeared. We are gratified
to learn from his attending physician that all
these signs of epithelioma have passed away"
In its issue of March 7, two weeks later, was
published letter from DR.. Fordyce Barker re-
affirming the statement made by himself, and
upon which the foregoing announcement of the
Record was based, and adding that DR..
Douglas told him the evening before that
DR.. Barker's statement was exactly what
he (Douglas) should have said at the time. But
the Monday after / saw you, the action of Con-
gress had a most depressing effect on General
Grant, his vital powers suddenly broke down,
and the local malady speedily assumed new
aspect The newspaper accounts have been
greatly exaggerated, and we have never antici
pated any such speedy termination they
have indicated. l do not believe that Dr. Doug
las ever used the word cancer in connection with
the case. We have always spoken of it as
epthelioma of a malignant type, probably"
The newspaper eXaggeratlOnS have, unfor-
tunately proved to have had more foundation
than the anticpations of the doctors, based as
they may have been, it is charitable to believe,
on their wishes, hopes and personal affection
.nx n.1%@N g. {l1s.
dread of the word cancer. Until within few
years no other name would have been applied to
General Grants disease, Epitheoma is cancer,
as the non professional public understands the
latter term; but the specific disclaimer of Dr.
Barker created doubt and mental confusion
or inspired hopes which had no other than
mere verbal foundation. Whether the doctors
themselves were deluded by this jIggle of words
it would be profitless now to inquire. 1t seems
probable, at least, that they avaled themselves
distinction between cancer and epithelioma, and
| that this led to the postponement of the only
| procedure which offers any great probability of
permanent relief in these cases. To justly ap-
preciate this criticism 1t is necessary to premise
| that, in non-technical language, cancerous
| growths consist of changes in the natural form
| and structure of the cells which constitute
tissue, gland, or organ; that these altered cells
!! press upon, invade, and ultimately destroy the
| natural cells and structures which surround
| them (infiltration and ulceration); that when
| this stage is reached the cancer cells may
enter the circulation and be carried to other
parts of the body and there set up the same
| chain of processes. During the first stage-that
| of mere induraton-the disease is strictly local
one; it is not until liberation and breaking down
of tissues and structures begin that it assumes
| an infectious or constitutional character In
| this early stage it is obvious that prompt and
| thorough removal Of the cancer cells, as by a
surgical operation, would prevent their further
| multiplication and consequently fatal result
Statistics prove this to be the case. Not all
operations, it is true, invariably cure cancer A
certain proportion of failures is due TO incom-
plete removal of the cancer growth; another pro-
portion to the renewal of the formation either
upon the original site or elsewhere. But it is
equally true that the natural tendency of cancer
uninterfered with by surgical operation or
other procedure, is toward moro or less rapid
spread invasion of neighboring glands, organs
| and structures, destruction of functions, and
finally death.
This is, in brief, the modern theory of cancer
and one that harmoniZes much more fully with
the facts than did the older assumption that the
disease was caused by some pre-existing con-
stitutional taint, of which a cancerous growth or
tumor was only the local expression or develop
ment If this were true the removal of local
cancer by the knife, or caustic, or by burning
would never effect cure. since such removal
could not affect the constitutional taint which
remaining, would set up the local disease anew
at some other point. But cancers, demonstrated
10 Do SUCH Dy InlcrOScOplcdl examination. are
sometimes permanently cured by the complete
removal of the local growth; and one such proved
instance is entirely sufficient to upset theory
built upon the assumption of an indefnable,
mysterious, unknown constitutional taint-a
convenient scapegoat for want of exact knowl
edge.
Equally unsatisfactory, also, are other the
ories as, for example that non cancerous growths
or tpmors may, from local causes degenerate
into true cancers. There are no observed facts
to sustain such theory.
THE FACTS IN THE CASE.
With the foregoing definition and description,
what are the facts in the present easel
During the fall of 1884 the public was first ap-
prised Of the existence Of some serious trouble
affecting General Grants tongue, but apprehen-
sion was speedily allayed by the announcement
that the liberation of the tongue and per-
sistent earache had been relieved by the ex-
traction of tooth and ordinary local treatment
Not until the latter part of February or the be-
ginning of March last did it transpire that dur
ing the treatment of the liberated tongue sew
eral months previous, characteristic induration
or hardening of the side of the tongue had been
discovered. The term characteristic as i'm
plying an induration distinctive of cancer, is
here used advisediy, since the editor Of the
New York Medical Record, DIR. Snrady. whose
published statements form the basis Of this
article--admits that 1T was at one time feared,