The principles of surgery . Fig. 126. Caries of the vertebra; macerated; the bodies extensively destroyed; marked incurvationforwards. Fig. 127. The same during life. of the vertebrae more especially. In these, the main reliance for curemust be placed in Nature ; the surgeon is qualified only to assist. Butas, under such circumstances, ordinary indications of cure cannot becarried out—or at least can only be slowly and imperfectly fulfilled—prognosis is unfavorable. It is still essential that the carious surfaceshafl be thrown off, and a healthy foundation for repair can only be
The principles of surgery . Fig. 126. Caries of the vertebra; macerated; the bodies extensively destroyed; marked incurvationforwards. Fig. 127. The same during life. of the vertebrae more especially. In these, the main reliance for curemust be placed in Nature ; the surgeon is qualified only to assist. Butas, under such circumstances, ordinary indications of cure cannot becarried out—or at least can only be slowly and imperfectly fulfilled—prognosis is unfavorable. It is still essential that the carious surfaceshafl be thrown off, and a healthy foundation for repair can only be accomplished by an effort of the part itself; by ul-ceration crumbling down the carious and unnaturally cancellated part, 388 TREATMENT OF Caries of die vertebrae; pre-to maceration. The aorta overlays the cyst of the and leaving the surrounding normal texture unattacked; ceasing when it comes there, its task having been accomplished, and giving place tothe reparative effort already there begun. Or ulceration may be acce-lerated, or at all events mixed up with more con-tinuous death of the unprofitable part— destructive process, especially that bysimple ulceration, may advance leisurely andquietly; without any communication with theexternal atmosphere. One of two events maythen occur. The skin may continue unbroken ;the purulent matter becoming absorbed, as wellas the molecular debris of the bone which is thencommingled with it; and this, it is plain, canonly happen when the disease is of limited ex-tent, and the process altogether chronic in its na-ture. Or the abscess with its contained debris,and perhaps sequestra finds its way to the sur-face in the usual manner; and is thence dis-charged. It is in the
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