Guide Voodoo Doll

The Guide Voodoo Doll is an accessory that can be dropped by a Voodoo Demon in the Underworld. It has a resemblance to the Guide.

When this item is equipped as an accessory, it becomes possible to kill the Guide with weapons. If the item is destroyed by Lava in the Underworld, it will kill the guide and summon the Wall of Flesh. If the item is destroyed while there is no living Guide, the Wall of Flesh will not appear.

Before the Wall of Flesh is defeated, the Arms Dealer may say, among his dialogue lines, "I heard there is a doll that looks very similar to [Name of Guide] somewhere in the underworld. I'd like to put a few rounds in it.", hinting at the fact the doll has to be destroyed to continue progression.

Their is also the nurse who will also say how many times will [name of guide] come in with severe lava burns

Regardless if the Wall of Flesh is killed or not, the Guide will always respawn after being killed.