General Diseases of Bones, Joints and Muscles. 391 



vary in different cases. "When the irritation from the hot 

 L'on has passed off, Misters may be applied if necessary. 



In all cases the use of counter-irritants must be stopped 

 and soothing measures resorted to when it becomes evident 

 that active inflammation has been set up anew in the bone. 

 A long period of rest is essential to allow of the hardening 

 of the newly formed bony tissue or of the old bone which 

 has been softened or otherwise altered by disease. 



Matter forming in the interior of a bone is to be evacu- 

 ated by boring down to it with a circular saw (trephine). 

 Matter forming between the bone and its investing mem- 

 brane must be promptly evacuated with a sharp knife or 

 lancet. 



Simple tdceretion is to be treated hke an ordinary wound, 

 the pressure or other cause of its existence having been 

 first removed. A nourishing diet and a course of tonics 

 (cinchona, gentian, etc.,) are usually demanded. 



A dead bone should be removed. If a simple scale or 

 film on the surface, it may be taken off with a sharp knife 

 or chisel. If larger the bone-forceps or saw may be 

 necessary. It may sometimes be needful to remove a 

 piece of live bone with the circular saw, to make way for 

 the extraction of a dead portion imprisoned within. 

 Should the outer fibrous covering of the bone be preserved 

 intact, new bone may be formed in place of the old, but 

 never so perfect in form, and, as a rule, the extensive loss 

 of an important bone, in one of the lower animals, renders 

 it useless and should warrant its destruction. 



In no case should a cutting operation on a bone be 

 undertaken while the soft parts around it are in a state oi 

 acute inflammation, as, although the diseased or dead 

 parts should be removed, the adjacent bone is likely to 

 take on unliealthy action and to prove worse than at 

 first. 



In case of new bony deposits and tumors, it is rarely 

 desirable to resort to cutting instruments, unless when 

 they ha'-e a broad mass and narrow neck, connecting 



