240 NATURE AND LIFE. 



tissues, it gives an outlet to whatever must pass away, it 

 modifies the diseased surfaces; but there are cases in 

 which neither Nature nor art can avail further, and in which 

 the bone is so far gone that amputation becomes the only 

 chance of safety for the patient. In these desperate situa- 

 tions surgeons have recourse to methods which allow them 

 to effect a regeneration of the bone destroyed by the work- 

 ing of disease. The most useful of these methods, due to 

 Se"dillot, is that of scooping out. 



The operation of scooping, as it is practised since the 

 beautiful experiments of Sedillot, is very simple in itself. 

 The skin, flesh, and periosteum, are cut through, down to 

 the injured or diseased bone, and, when that is once laid 

 bare, it is attacked with the gouge, chisel, and mallet. It 

 is cut out and shaved away so as to remove the entire dis- 

 eased portion, and to spare all that has suffered no altera- 

 tion. Thus reduced to its sound parts and layers, the ex- 

 cavated bone by slow degrees repairs its losses. The de- 

 stroyed substance is renewed, a new bony tissue fills the 

 vacancies shaped by the operator's gouge, and after a few 

 months the organ, which has never lost its form, is again 

 restored to the conditions of common vitality. Sometimes, 

 no doubt, the scene, in which, to borrow Hippocrates's 

 thought, the surgeon himself, in the midst of another's 

 agon}^, endures his own tortures, becomes complicated in 

 an unforeseen way, and dangerous risks make it more tragic 

 still ; but art consists precisely in foreseeing and subdu- 

 ing these, and it is in this that the superior practitioner is 

 eminent above another. 



While Sedillot teaches and proves that it is necessary, 

 in the interest of the reproduction of bone and the restora- 

 tion of the limb, to get rid only of the diseased part of the 

 endangered bone, and to preserve its sound layer clinging 

 to the periosteum, some surgeons maintain rather that every 

 thing should be removed, except the periosteum, that is to 



