The Iola register. [volume] (Iola, Allen County, Kansas) 1875-1902, 1885-08-07
GENERAL GRANTS DISEASE.

Extracts From an Article by DIR. Shrady On
the Surgical and Pathological Aspects Of
the Case-A Brief Review of the Trea.-
ment.
NEW YORK, July 3l.-The subjoircd
are extracts from an article by Or.
Sbrady on the "Surgical and Pa tbc,a sicai
Aspects of General Grants Case" which
will appear In the Medical Record OF next
Saturday. The treatment will be more
deliberately described hereafter. DIR.
Shrady says:
cit is not definitely known when the
throat trouble commenced, but probably
in June, 1884. as at that time General
Grant first complained of soreness in the
tonsillar regions.
"On March It'll, when first saw the pi-
tient, in consultation with Drs. Barker,
Douglas aud Sands, 1t was found that
the surfaces of the right tonsillar region,
and adjoining portion of the vault of tie
pharynx were covered with a thick yell
lowish oxidation resembling sloughing
tissue. This deposit was evidently the
result of an acute procuso engrafted
upon the orig inal disease and partook OF
many of the characters of diphthe-
retic membrane. This viewi of the
complication explains many of tn e grave
symptoms which were subsequently as.
sociated with the great prostration, but
which were not directly traceable 20 the
progress of the epitheliomatous degen-
GRAFTON. The progress of the local dis
ease was steady one from the begin
ming. The loss of the palate and ada
cent soft parts, with the consequent lack
of perfect control of the tongue
occasioDed great difficulty In
swallowing. Just before he
was transferred to Mt. McGregor, he
rather suddenly lost his voice never to
regain it. This was due partly to thick.
ening of the vital chords by inflammatory
inf!tration, sand partly to a relaxation
of the parts from general weakness. A
brief summary of the treatment is all
that it will be necessary to give
now. Early in the disease in order
to eliminate every possible chance
of error in the diagnosis, the
patient was placed under specific treat
ment, although the clinical history of the
case gave only negative indications of its
necessity. This treatment, although con.
tinued for sufficient period, produced
no effect in healing the ulceratiOns or in
arresting the progress of the disease.
Iodoform was used as a local application
to the ulcers, as we'll "a gargles composed
of salt and water, diluted carbolic acid
and solutions of permanganate of potash
and yeast. A four per cent. solution of
cocaine was occasionally applied to pain
full parts with happy results, but it was
never employed to any such excess as
is generally thought by the public, nor
were there any bad effects manifested
from its administration. The latter were
carefully guarded against with the full
knowledge that the drug was a new
one, and that only its cautious use was
admissible. Red clover was given quite
constantly, but produced no effect what
ever upon the local disease. 1t only
proved itself useful as laxative, and
was so employed as being the least harm
fui of medicines of its sort Tor con-
tinuous administration.
1.-The diagnosis given early in the case
was proved to be correct by the micro
scope, by the clinical history of the pa
tient, and by the fat tissue. The dis
ease had a much shorter course than u.s.
ual, owing to the prostration of the pa
TENTS system, dependent, in a great
measure, upon other causes
''The cause of the disease in this case
is largely conjectural. Epethiloma, as a
rule, starts from local circulation,
and unlike other forms of cancer Is
not dependent upon hereditary predis-
position to the disease. There must,
however, aside from this. be latent
toward cancerous troubles
which Is more pronounced in some indi-
viduals than in others, otherwise
we should be unable to explain why
simple and continued circulation would
induce the disease in one case and not in
another. 1t is, however, quite probable
that excessive smoking was the ac-
tive cause of the cancer in General |
case, or at least it is fair to pre-
sumo he would not have had the disease |
If his habit had not been carried to ex- |
cess. This assumption Is made in face of |
he fact that of the thousands who smoke |
but a very small proportion suffer from |
the disease. Although there was more |
Dr. less constant pain OF a gnawing |
the patient was happily spared |
hat agony of suffering which is often |
with the invasion of the deep
,r parts of the tongue by cancerous dis
ease. Had the latter occurred, il
was proposed to divide the
sensitive nerve of the tongue
'gustitory" through the mouth
which operation oftentimes gives abso-
ute relief. Such pain as existed. how
,ver, was kept under control by cocaine
md morphine, SO that the last wish of
he patient that his death should be
peaceful one was fully realized"
STORM.BEATEN.