Excerpt from The Boston Medical and Surgical Journal, Vol. 12: Wednesday, February 11, 1835
After dissecting away the tumor, the kali was rubbed over the raw surface of the base. The adjacent sound parts being carefully protected with dossils of lint, the kali was repeatedly applied to the surface, which was again and again cleared by rubbing of}' the dead portions after each application of the kali. This process, which occupied a considerable time, was daily repeated. Finally, the bone was laid completely bare, and in a few weeks a bone exfoliated, consisting of a thin lamella of considerable breadth.
The vacuity which remained, and which was large, from three of the teeth having been removed, rapidly granulated and cicatrized, arid when I saw this patient a few years afterwards, I was astonished to find that the contiguous teeth had coalesced, filling up the deficiency in the jaw in a most extraordinary manner.
Case II. - A gentleman, forty-five years of age, had a tumor of the upper maxilla, which completely filled up the space between the four incisors and lip, and was so large as to elevate the lip and deform the countenance. It was of a dark purple color, had a firm fleshy feel, and adhered immoveably by a broad base to the subjacent bone.
I dissected back the lip, to expose the whole tumor, and then removed all that portion which the knife could reach, and afterwards freely rubbed the kali purum on the raw surface. The application of the kali was repeated every day for some lime, and subsequently every other day. Ultimately the alveolar processes were completely exposed, and exfoliating portions of the thin external lamin? daily separated, so that in a few weeks the whole dead bone had exfoliated, and the surface which it exposed was afterwards speedily covered with granulations, which cicatrized, and left little deformity.
Remarks. - These cases will suffice to show the advantages to be derived from this mode of treatment, for it is evident that by the knife alone it is impossible to destroy such tumors, as they grow in situations where it is often not practicable to saw off, or otherwise remove, the diseased portions of the bone from which they grow. Nor can the actual cautery answer the intended purpose, unless by such frequent repetitions of a painful operation as few would allow.
The common lunar caustic is quite useless in such cases; as the length of time occupied by the formation and separation of an eschar renders it too inert a remedy, the growth of the tumor being more rapid than the destruction effected by the caustic; whereas the kali purum possesses all the advantages of the actual cautery in the rapidity of its action, and of the lunar caustic in the nicety of its application. The kali destroys the life even of skin, almost as quickly as the cautery, so that slough after slough may be produced, and a large portion of the diseased growth thus daily destroyed. Besides, it has the advantage of being applied with great precision to any particular part, by which only the diseased portion is destroyed, and the necessary quantity of bone denuded. With regard to the pain produced, this mode is decidedly preferable.
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