The clarion. [volume] (Jackson, Miss.) 1883-1888, 1885-08-05
GENERAL GRANTS DISEASE
Extracts from m Article by Dr.. shrady
the Dead Hero,s Case

60TA0Y
the Dead Hero's Case
NEW YoRK, July 3l-The subjoined are
extracts from an article by DR.. Shrady. IN
The Surgical and Pathological Aspect OF
Gen Grants Case. = which viii appear in The
Medical Record Of Saturday The treat
ment win be more deliberately described
hereafter. DIR. Shrady says:
1T is not definitely known when the
throat trouble commenced, but probably in
june, 1884, as at that time Gen Grant first
complained Of soreness in the tonsiIlar
region On March z, when first saw the
patient in consultation with Drs Barker.
Douglas and Sands, it was found that ths
surfaces of the right tonsillar region and
adjoining portion of the vault OF the phar-
ynx Were covered with q thick, yellowish
exudation resembling sloughing tissue.
This deposit was evidently the result OF
an acute process, engrafted upon the origi-
nal disease, and partook of many of the
characters of a diphtheratic membrane.
This view of the complication explains
many Of the grave symptoms which were
subsequently, associated with great prostra-
ton, but which were not directly traceable
20 the progress of the epitheliomatous de-
generation.
s'The progress of the local disease was a
steady one from the beginning. The less
of the palate and ad jacent soft parts, with
the consequent lack Of perfect control of the
tongue, occasioned great difficulty in swal-
lowing. Just before he was transferred to
Mount McGregor he rather suddenly lost his
voice, never TO regain it,
This was due partly to thickening of tbs
vocal chords by the infiammatory infltra-
ton, and partly to a relaxation of the parts
fr-afr A
of the treatment is all that viii 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 treat
ment, although the clinical history Of the
case gave only negative indications of its
necessity. This treatment, although con-
nnued for a sufficient period, produced no
effect IN healing the alterations, OF in ar
resting the progress of the disease Iodoform
was used as a local application to the
ulcers, as well as gargles composed of salt
and water diluted cal bolic acid solutions OF
permanaganate of potash and yeast. A foul.
per cent solution of cocaine was OCCASION
ally applied TO the painful parts with happy
results, but it was never employed To any
such excess as IS gener ally believed by the
public, nor were there any bad effects mani
Tested from its administration. The latter
We're carefully guarded against, with the
full knowledge that the drug was new one,
and that only its cautious use was adniissa-
Bile
Red clover was given quite constantly,
but produced no effect whatever upon the
local disease. 1t only proved itself useful as
a laxative, and was so employed as being
the least harmful of medicines of its sort
fol continuous administration
The diagnosis given early in the case was
proved to be correct by the microscope, by
the clinical history of the patient, and by the
fatal issue. The disease had a much shorter
course than usual, owing to the prostration
of the patients system dependent in a great
measure upon the causes. The cause of the
disease in this case is largely conjectural
Epithehoma as rule, starts from local
irritation, and unlike other forms
of cancer, is not dependent upon
hereditary predisposition to the disease
There must, however, aside from this, be
latent tendency toward caneerous trou bles
which is more pronounced in some indiyidu-
ais 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 smok-
ing was the active cause OF
the cancer in ecu Grants case,
or at least it is fair to presume that he
would not have had the disease if his habit
had not been carried to excess. This as
sumption is made in the face of the fact that
OF thousands who smoke but very small
proportion suffer from the disease.
Although there was more or less con.
slant pain of a gnawing character the pa
tient was happily spared that agony of suf-
fering, which is often associated with the
invasion of the deeper parts of the tongue
by cancerous disease Had the latter oc.
CURED, it was proposed to divide the sensi-
tive nerve of the tongue tguslatory)
through the mouth, which operation often
times gives absolute 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 a
peaceful one was fully realized