The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1885-08-01

as comfortable as possible The success attend.
ing these efforts was manifested in many wavs
He, however, possessed in a remarkable degree
the faculty of repressng his feelings bearing
his pain and maintaining his mental composure
all of which was calculated to deceive a casual
observer as to the real extent of suffering in
the midst of this and with a constant reminder
of approaching death, he stoicaly gave himself
up to the composition of his life story anxious
only that he should live long enough to finish it
The progress of the local disease was steady
one from the beginning. The loss of the palate
and adjacent soft parts, with the consequent
lack OF perfect control of the tongue, occasioned
great difficulty in swallowing
Just before he was transferred to Mt Nc
Gregor he rather suddenly lost his voice, never
to regain it. This was due partly to thickening
of the vocal cords by the intlammatory infiltra-
ton and partly to relaxation of the parts from
general weakness.
A brief summary of the treatment is all that
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 the specific treatment, although
the clinical history of the case gave only mega
tive indications for its necessity This treat
ment, although continued for a sufficient period,
produced no effect in healing the alterations or
IN arrestlng the progress of the disease.
The cause OF the disease in this case is largely
con]ecturai. Epithelioma, as rule, starts from
local irritation and, unlike other forms of cancer
Is not dependent upon hereditary predisposition
this, be o latent tendency toward cancerous
troubles, which is more pronounced in some
individuals than in others, otherwise we should be
unable to explain why simple and continued irri-
tat1on would induce the disease in one and
not In another. Ii is, however, quite probable
that the irritation of smoking was the active
cause of cancer in General Grants case at
least it is fair to presume that he would not have
had the disease ii this habit had not been carried
to excess This assumption is madein the face Of
Of nIC who prol-a but
very small proportion suffer from the disease.
AS far as can be estimated the COM
menced only nine months before death. The
appearance in the throat of a sloughing process
during the regular process of the cancer was
circumstance worthy of note, and explained
much of the exhaustion of the patient during
one of his critical periods. If it had not been
for this accidental complication the epithelioma
would have taken its usual course and the pub
lie would not have mistaken the extension of
the indmmatory process for that of cancer, and
would not have been ready to believe that the
original disease was disappearing when the
sloughy deposit was discharged.
The patient at the time was better Of the COM
piication, but not of the cancer. The latter
never changed but for the worse Tie occur-
renee of hemorrhage from the erosion 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 shane Of dense
deposits around the branches Of the carotid
artery and lugular vein
Although there was more or less constant pain
of growing character, the patient was happily
spared that agony of suffering which is often
sociated with invasion OF the deeper parts of the
tongue by cancerous disease. Had the latter
occurred it was proposed to divide the sensitive
nerve of the tongue (gustatory) through the
mouth, which operation oftentmes gives abso-
Lutte relief. Such pain as existed, however, was
kept under control by cocaine and morphine,
so that the last wish of the patient that his
death should be peaceful one was fully real
ized