ermed the _sequestrum_. If, however, it be superficial, and separate
from the parts beneath, it is called an _exfoliation_. This healing
process, by which the involucrum is formed, cannot be completed while
the dead portion remains. Hence, numerous openings are made through the
involucrum, to permit the escape of the sequestrum. When a surgical
operation is performed for the removal of the necrosed bone it is called
_sequestrotomy_. The instruments which our specialists usually employ
for this practice are represented in Figs. 3, 4, and 5.

[Illustration: Fig. 3.
Hand drill for boring bone. ]

[Illustration: Fig. 4.
The osteotrite, for enlarging openings and cutting carious bone.]

[Illustration: Fig. 5.
Gouge forceps for excavating bone.]

CAUSES. Fever-sore may be due to inflammation, injuries, working in
phosphorus, or from the inordinate and protracted use of mercury.

SYMPTOMS. The pain frequently commences in the night, and all the
different stages succeed, until, finally, the result is frequently
mortification or death. The entire bone, or only a part of it, may be
affected; the parts become swollen, "matter" forms, and unless it be
artificially evacuated, it will in time work its way out through a
fistulous opening. As the disease progresses, the adjacent tissues
become thickened and numerous openings are formed, which communicate
with the bone, and often with each other, so that a probe may be passed
from one to another, as represented in Fig. 6, copied from a drawing by
Dr. Howe. The discharge from fever-sores varies in character, and
usually has a fetid odor. The surgeon can readily distinguish between
healthy and unhealthy bone by the use of a probe. The pus discharged in
necrosis contains minute particles of bone, which may be felt by rubbing
it between the fingers. Sometimes large pieces present themselves at the
openings. The general health is seriously impaired, and the patient
becomes debilitated, anaemic, and hectic.

[Illustration: Fig. 6.
Necrosis of the tibia. A common
probe is passed through the sinuses, or openings.]

TREATMENT. The process of repair is necessarily tedious, and nature
should be assisted to remove the old bone and promote the formation of
the new. An alterative course of treatment is indicated and must be
persistently followed. Give Dr. Pierce's Golden Medical Discovery and
Pleasant Pellets in sufficient doses to keep the bowels regular.
However, all efforts to heal the s