Evening star. [volume] (Washington, D.C.) 1854-1972, 1885-08-01

A REVIEW OF GEN. GRANTS CASE.
DR.. Shrady's History Of the Progress
OF the Disease-Due to Excessive SmO-
king.
DIR. George F. Shrady has prepared an article,
which appears In the Medical Record Of Satur-
day. 1t is entitled, "The Surgical and Patho-
logical Aspects OF General Grants Case" DR..
Shrady begins by stating:
mo case has excited greater interest from
a medical point OF view than that Of General
Grant Aside from the disease attacking pa
tient so widely known and so universally be-
loved II has shown some features v hich are
of surgical as we'll as Of pathological signifi-
canoe"
In the course Of the article DR.. Shrady says:
"The separation of the slough was anXiously
awaited, and when it occurred the patient, as
was expected, became much relieved of many
of his more distressing local symptoms ana OF
his depressed bodily condition. Then 1t was an.
nounced by the press that because the general
had rallied the physicians had erred IN dag
nOsing the case, and, consequently. the patients
chances of recovery were good. Much as this
happy result was to be hoped for, the stubborn
fact OF the existence of the original disease anu
OF its steady progress toward an inevitably
Ssaehns Lne ease fhe return Of the
TENTS strength was not surprise to his physl-
clans. 1t was what they aimed to bring about
by the treatment employed. The general ex-
haustion, which was In great measure 1nde.
pendent of the cancer, was at this time most
feared, and the treatment of that condition was
naturally of the first importance.
"But the gratifying change for the Detter
was believed to be simply OF a temporary char-
acter. DEATH directly or Indirectly, Que 10 tne
extension of the throat disease, was question
of few months at most. The surfaces OF the
throat covered by the inf1ammatory deposit
presented clean appearance after the deposit
was separated, but the primary cancerous ul-
ceratiOns of the palate and tongue never
changed for the better. The original disease
W "a lWa fhora. slowly but SURELY DrOPreSS-
ing, resisting every treatment, deiy1ng every
hope for cure, and grimly inviting the inevita-
bic issue.
THE TREATMENT SUMMARIZED.
Dr. Shrady closes his long article as follows:
"a brief summary of the treatment is all that
1t will be necessary to give now. Early in the
disease in order to eliminate every possible
chance of error In diagnosis, the patient was
placed under specific treatment, although the
clinical history of the case gave only negative
indications for its necessity. This treatment,
although continued for a sufficient period pro-
duced no effect in healing the alterations, or In
arresting the progress OF the disease. IOdoform
was used as a local application to the ulcer as
well as gargles composed of salt and water,
diluted carbOlic acid, solutions of permanga-
nate Of potash and yeast. A four per cent so
In ton of cocaine was occasionally applied to
the painful parts with happy results, but it was
never employed to any such excess as Is gen.
orally believed by the public, nor were there
any bad effects manifested from its administra-
ton at any time. The latter were carefully
guarded against with the full knowledge that
the drug was a new one, and that only its eau
tious use was admissible. Red clover was
given quite constantly, but produced no effect
whatsoever upon the local disease. 1t only
proved itself useful as a laxative and was SO
employed, as being the least harmful of med
icines of its sort for continuous administration.
His food consisted of beet extract, milk,
eggs and farinaceous materials, always in
his food, such appetite as he would occasionally
manifest was the guide for any change. The
rule was to deny him nothing he might crave.
l~y,
% he signifed his wish to be transferred to a
bed. This was the first time he had left his
easy chair for purposes of rest or sleep since
early In March. DR.. Sands and myself, who
had been previously summoned, at the final
consultation, agreed with DIR. Douglas that the
end was near, and that nothing more was to be
done than to make the patient as comfortable
as possible. The general had then lost his
ute and feeble and his respirations rs per min
ute and shallow. His consciousness gradually
left him at midnight. Continuing to sink, he
died without a struggle at sos a. m. Thursday,
July %, 1885.
THE CANCER DUE TO SMOKING.
1.-THE cause of the disease in this case is largely
conJectural. Epithelioma, as a rule, starts
from local irritation, and, unlike other forms of
disposition to the disease. There must, how
ever, aside from this, be q latent tendency
toward cancerOuS troubles, which Is more pro-
nOunced In some individuals than in others,
otherwise we should be unable to explain why
simple and continued irritation would induce
the disease in one case and not in another. 1t is,
however. quite probable that the Irritation Of
smoking was the active cause of the cancer In
Gen. Grants case or, at least, 1t Is fair to pre-
sumo that he would not have had the disease If
this habit had not been carried to excess. This
assumption is made in the face of the fact that
of the thousands who smoke but very small
proportion suffer from the disease.
"As far can be estimated, the cancer COM
menced only nine months before death. For
tunately the breathing was never affected by
tIS<s t<xft 4
pipe, nor was their any impeachment to swal-
lowing by the extension of the growth to the
esophagus. Both of these conditions might
have obtained, had the patient lived long
enough to give an opportunity for the local dis
ease to gain sufficient head way. The cancer pre-
sented an unusual feature in first invading the
side of the throat ratherthan that OF the tongue,
as the latter is most frequently the original
seat Of this disease. The appearance in the
lar progress of the cancer was a circumstance
worthy of note, and explained much of the ex-
haustion Of the patient during one of his critical
periods. If 1t had not been for this accidental
complication the epitheliOma would have
taken its usual course, and the public would
not have mistaken the extension of the inf1am-
not have been ready to believe that the original
disease was disappearing when the slOughy de-
was better of the complication, but not of the
cancer. The latter never changed but for the
worse.
ABSENCE OF PAIN.
"The occurrence of hemorrhage from the ero-
sion of the walls Of the larger vessels in the
neighborhoOd was believed to be eventually
possible, but was at no time seriously feared, as
nature had thrown out her safeguards in the
shape OF dense deposits around the branches of
the carotid artery and jugular veins.
although there was more or less constant
pain of gnawing character the patient was
happily spared that agony of suffering which is
often associated with the Invasion of the deeper
parts of the tongue by cancerous disease. Had
the latter occurred 1t was proposed to divide
the sensitive nerve Of the tongue (gustatOry)
through the mouth, which operation often
times gives absolute relief. Such pain as ex-
listed, however, was kept under control by co
caine and morphine, so that the last wish of the
patient, that his death should be peaceful one