CARIES—SUPPURATIVE OSTEOMYELITIS, 459 
V. 
CARIES—SUPPURATIVE OSTEOMYELITIS. 
This affection, known in veterinary practice under the name of cazies, is 
essentially characterized by the interstitial suppuration of the bony sub- 
‘stance, accompanied with necrobiotic manifestations and terminating with 
‘the complete destruction of the invaded bony structure. 
Promoted by pyogeneous microbes, specially the staphylococcus aureus 
nd albus, it corresponds to the traumatic osteomyelitis of human surgery 
~-the term cazzes being applied specially to bony tuberculosis by surgeons. 
Peri-osseous suppurations may be complicated with caries. Bony 
‘wounds made by soiled instruments generally bring on the same result. 
In animals, as well as in man, caries may be related to a general 
morbid state; it then may appear without apparent producing cause. 
Anyhow it is possible for the micro-organisms to be carried in bones by 
the circulation: Rodet and Jacoulay have produced osteomyelitis and 
bony suppuration by injecting cultures of staphylococci in the veins of 
rabbits. But, in the majority of cases, caries is due to local causes. The 
‘superficiality and the porosity of bones predispose them to it. In horses, 
the last phalanx, on account of its structure, the frequency of the trauma- 
tisms which affect it and the infectious processes that follow, furnishes the 
‘very great majority of the cases of caries met with in our practice. The 
navicular bone, the spinous processes of the withers, the maxillaries, are 
also frequently affected. 
The treatment must have for object the rapid and complete elimination 
of the invaded bony structure, and the transformation of the morbid 
enter in a simple bony wound, whose repair will go on rapidly in the 
vrdinary way. There are two methods to choose: in one, exclusively 
surgical, the éntire carious part is excised with the sharp instrument; the 
-other, more conservative, consists in transforming the carious part into a 
‘true chemical scar analogous to the splinter of necrosis, likely to promote 
-as it does, on its periphery, a moderate inflammatory process sufficient for 
‘its elimination. By this second mode, one, as Ollier says, attempts to 
“‘necrotize”? the carious bone—to give it artificially the physical and 
chemical characters of the bone, necrosed spontaneously. 
The use of either of these processes is dependent on various circum- 
‘stances, specially the seat of the caries and the disorders it. has given 
tise to. In all cases, however, it is indicated to interfere as soon as 
possible. 
