104 THE GERM THEORY OF DISEASE. 



NECROSED BONE. 



Take the case of necrosed bone. How is a sequestrum 

 formed, but by the digestion and removal of that portion 

 which connects it with the living bone. Can this be accom- 

 plished by any of the more ordinary fluids found in the 

 tissues ? certainly not. Then a special menstruum is formed 

 for the purpose of this solution. Formed where, and by what ? 

 Not in some distant part and sent here, but by the tissues in 

 immediate contact, acting by virtue of their natural endow- 

 ments and the stimulus of juxtaposition with an undesirable 

 substance. If the tissue could act without undue irritation, 

 the act of digestion of the part should occur, and its place 

 be supplied, without the formation of pus. However, this 

 probably never occurs, except in cases of the death of very 

 small portions of bone. In some cases, however, we believe it 

 does occur to a considerable extent. We have witnessed cases 

 of healing of wounds involving bone, which we can explain in 

 no other way. In most cases, however, the inflammation runs 

 so high, and continues so long, that pus forms, and prevents the 

 physiological action of the cells. These cells cannot perform 

 this function from a distance. The ferment substance, if 

 formed, is dissipated in the fluids; they must be in juxtaposition 

 with the substance to be digested, or at least, no dissipating men- 

 struum must intervene, in order that the integrity of the soluble 

 ferment may be preserved and applied directly to its work. 



If this condition can be attained, dead bone will be digested 

 and removed. As a matter of fact, we generally find sequestra 

 eaten into, here and there, sometimes more, sometimes less. 

 These burrowings represent points where the granulations, in 

 a state closely approximating healthy action, have come in 

 contact with and invaded the dead bone. If this condition 

 could be maintained at all points, the sequestrum would be 

 completely removed. 



