82 FISTULA AND POLL-EVIL 
pus. Necrotic ends sooner or later, without in- 
terference, separate from the viable bone, and 
then leave it carpeted with granulations which 
now cicatrize with the rest of the wound. We 
are, therefore, unequivocally opposed to the 
removal of bone tissue other than the already 
well-loosened sequestra, which are sometimes 
found floating in the cavity or feebly attached 
im situ. 
The fourth step is the insertion of the drain- 
age tube. This is done with the drainage tube 
inserter. (Fig. 3.) 
«srmed with the tube the point of the inserter 
is placed at the bottom of the cavity and then 
pushed out laterally in the downward direction 
through the splenius and serratus cervicis mus- 
cles to the surface. The skin must be incised 
as the point of the inserter bulges it out as its 
point is not sharp enough to penetrate it un- 
assisted by an incision. When inserted on the 
one side the inserter is passed into the other 
end of the tube and pushed through the same 
place on the opposite side. This places the 
tube across the bottom of the cavity and out to 
each side of the neck. (Fig. 4.) 
When the operation is prolonged for any 
cause and the blood loss has been great, we 
postpone the insertion of the tube until the 
