What we ought to consider in the suture, and so win∣ge of a wounde. Chap. 2.
WE must not at anye time sovve vp a vvounde, least in the first shee be vvell purifyed, & cle∣ansed, as vvell externallye, as internallye, if at the least vvith out any great daunger or per∣rill it may be effected: extractinge and takinge therout all that is contrarie vnto the sayed vvounde, as is congealed bloode, vvhich com∣minge to corruptione, might cause greate in∣flāmatione, & oftē times alsoe a convulsione in that parte, throughe vvhich the sovvinge breaketh, & teareth, & soe conseqventlye hin∣derethe the vnitinge & healinge of the vvoū∣de: vvherfore in the resovvinge of a vvoūde, vve must deligentlye note, that vve doe not contracte & dravve together on all sydes) the lippes or edges of the forsayed vvounde (ex∣cept it vveare in the haremouth, & in the cle∣aved or severed lippes of the mouth) but must leave some distance betvveene the one & the other lippe or in anye place some or other a∣pertione, because the matter which gathe∣reth it selfe together, in the bottome of the vvounde, may issue therout, and by that mea∣nes the medicamentes may be therone appli∣ed. In like sorte the Chirurgiane must in sovv¦inge consider, & vse medicoritye, and not ta∣ke to great a qvantitye, ether in the length, or in the depthe of the fleshe, and of the skine, throughe the vvhich there might ensue and follovve great payne, vvhich vve ought not to esteeme for smalle, & therof allsoe vvoulde remayne an illfavored & vnseemlye cicatrice or scarre: As to the contrarye the not deepe sovvinge of the vvounde, myght easylye brea∣ke and burst agayne, & then in vayne it vvea∣re sovvede. For if soe be, that the needle, be to neere thrust throughe the edges of the vvoū∣de, thē the threde because of his tenuitye tea∣reth throughe the skinne or fleshe, & vvhen as vve thruste the needle to deepe and farre, from the lippes or edges of the vvounde, then there resteth and remayneth a greate parte of the skinne, vvhich vvill not be vnited: vvher∣fore indifferentlye vve ought to pearce toge∣ther as much of the skin as of the fleshe, be∣cause the fleshe farre sooner and easyer com∣meth to heale and cure, vvith the fleshe then the skinne vvith the skinne, and that is consi∣deringe the naturall temperatenes of the fo∣resayed fleshe, vvhich is vvarme, and moyste. And as touchinge the distance of the stitches, and soovvinge, vve ought not to laye them to close one by the other, nether to farre separa∣te & sequestred one frō the other, as thē they can not retayne the vvounde: And vvhen all to nye the other they are layed, cause payne, through all the stitches, and dravvinge to∣gether of the same, through the vvhich payne is caused a concursione of Humors vnto that place: vve must therfore vse a meane therine vvell consideringe, the largenes, and length of the vvounde: but above all vve must marke, that vve thrust not, throughe or in anye syn∣nues or tendones, consideringe the payne, the Spasmus and manye other fearfull accidentes, vvhich therof might ensue, as allreadye vve have sayed. Sovving of a vvounde may not be effected vvith anye violence, in those partes vvhich vve endevoure to vnite and bringe to¦gether, but thē is sovvinge laudable, vvhen as the skinne stretcheth it allmost together, of it ovvne accorde, & vvheras in this sorte it vvill not be effected or brought to passe easylye, & that the lippes of the vvound vvith violence must be ioyned, it is as then most convenient, that vve relay the stitches some distāce one frō the other, & lettinge them be somvvhat loos∣lye sovved: for if it chaunced vve drevve them somvvhat stiflye together, the skinne might then easylye rente or teare, & soe burst a sun∣der throughe the tumefactione vvhich therof ensueth: If that therefore, vve disire perfectlye to cure a vvounde, vve ought as thē soe to dis∣pose of the sovvinge, because that in thus doin¦ge, the humors, bloode, matter, and the exter∣nall ayre might be repelled, from the lippes, or edges of the vvoūde, because such thinges, may hinder, or at the leaste deferre, the curin∣ge of the same: and in soe much, as the lippes of the vvounde are not vvell vnited the one vvith the other, and kept in that stature, & vni∣tinge, the vvound can verve badlye & hardlye be cured.
And alsoe if the lippes of the vvounde, doe greatlye chaunce to svvell, & inflame, & theye shrinck in themselves, or els if they be to much brused or plettered, vve must not thē in anye sorte resovve it agayne: for the suture vvould strayght vvaye breake, and soe conse∣quentlye the inflammatione increased, but must delay it soe longe vntill the foresayed in∣flammatione be seaced & the vvounde be co∣me to goode suppuratione and matter, and is prepared and readye, to be vnited & brought together.