The Frenche chirurgerye, or all the manualle operations of chirurgerye , vvith divers, & sundrye figures, and amongst the rest, certayne nuefovvnde instrumentes, verye necessarye to all the operationes of chirurgerye. Through Iaques Guillemeau, of Orleans ordinarye chirurgiane to the Kinge, and sworen in the citye of Paris. And novv truelye translated out of Dutch into Englishe by A.M.

❧ Of the stitchinge of the bellye which we call, Gastroraphia Chapter. 6.

* 1.1THe guttes or entralles, and the nett, beinge brought into ther severall places, vve must as thē sovve, & stitch vp the vvoun∣de: but because such suture, accordinge vnto the opinions & sayinges of divers, may not be done in that sorte, as other stitchinges, or sovvinges, to vvit the ioyninge together of that, vvhich is of one nature and dispositione, the one vvith the other, as the Peritoneum, vvith the Peritoneo, (& soe forth of the skinne and the muscles) but vve are vvilled and councelled that vve ioyne and stitch the Peritoneum, vvhich is a membra∣ne, vvith the muscles, and vvith the skinne E∣pigastri, because the same beinge verye synuis∣he, vvill verye difficultlye be cured or healed, vvith the other parte Peritonei, vvhich opposi∣telye is situated agaynst it vvhich is allsoe of the same synnuishe substance. In fine vve are councelled, to sovve vp the edges of the vvoū∣de vvhich is in the right syde Peritonei, vvith the muscles, vvhich are in the left lippe of the vvounde, soe that one this manner the muscu¦lous fleshe, of the right lippe Peritonei, vvhich healeth vvith the left lippe of the foresayed Peritoneum, vvith the musculous fleshe one the one syde, and the muscvlous fleshe vvith the Peritoneo on the other syde. Because that Peri∣toneum, vvith the Peritoneo, can not be healed, vvherthroughe the vvounde onlye above in the fleshye parte might chaunce to heale, out of the vvhich might ensue a tumefactione, as if it vveare a roushing, or issuinge forth of the navel, consideringe the foresayed Peritoneum, vvhich throughe erectione & heavinge vp of the guttes, could not in anye sorte conioyne together: and such a meaninge muste be done one this manner. The vvounde beinge grea∣te, vve must have a convenient minister or servāt, vvhich must vvith his hand one the ex∣terior parte of the vvoūde depresse it dovvne, because as then shee may be shutt & closed, & nether the guttes, nor the nett, roush therout sufferinge only a small portione of the vvoū∣de vncovered for the Chyrurgian, vvho vvith his threded needle, must begīne his first stitch in the end of the one lippe of the vvounde, thrustinge through the externall skinne, and the musculous fleshe of the vvounde, vvith∣out touchinge the Peritoneum, vvhich is there vnder situated, dravvinge the needle frō out∣vvardes, invvardes vvith her threde, & thrust the secōde stitche, cleane throughe the vvho∣le lippe of the vvounde, vvhich oppositelye is situated agaynst the first stiche, to vvitte, the Peritoneum, the muscles and the skinne, first bringinge the stitch cleane through the Peri∣toneum, and dravvinge the foresayed needle, from invvarded, outvvardes: And the same beinge dravvē out, vvith her threde, he must then lay his thirde stitche, as he did the first, beginninge the stitch in the skinne, & in the musculous fleshe, of the first lippe, vvithout touchinge the musculous fleshe, of the first lippe, vvithout touchinge the Peritoneum, dra∣vvinge the needle from out vvardes, invvar∣des, thē he must bringe his fourth stitch, as he hath done the seconde, thrustinge cleane throughe the Peritoneum, all the musculous fleshe, & the skinne, dravvinge out the need∣le from invvardes, outvvardes, & in this sorte he must proceede, and goe forvvardes, vntill the vvhole vvounde from end to ende be cle∣ane sovved vp, thrustinge throughe on the

one syde, onlye the skinne & the musculous fleshe, and one the other syde the Peritoneum, the musculous fleshe, & the skinne: because the sovvinge of the Peritoneum onlye, vvith the other part Peritonei, is not sufficiente, nether the suture of the fleshe onlye, but this suture must as vvell be done in the one as in the o∣ther, endevouringe allvvayes to vnite the Peri¦toneum vvith the musculous flesh.

* 1.2Some there are vvhich effect this suture on this manner, follovvīge, beinge of opinione, that those partes, vvhich are of one nature & propertye, verye easylye vnite them selves the one, vvith the other, as the skinne vvith the skinne, the fleshe vvith the fleshe, and the membranes vvith the membranes, vvherfore they bringe ther first stitch, quite, and cleane throughe the skinne and the musculous fles∣he, from the first lipp, vvithout touchinge the Peritoneum, vvhich is thervnder situated, dra∣vvinge there needle from outvvardes, invvar∣des, vvith her thred, layinge ther seconde stit∣che, in the lipp right opposite agaynst that, thrustinge then onlye throughe the Peritone∣um, & throughe a little fleshe, dravvinge the needle, from invvardes, outvvardes, thē they bringe there thirde stitch, in the first lippe of the vvounde, thrustinge throughe the Perito∣neum, & a little fleshe, vvithout ether thrustin∣ge through the muscles, or the skinne, dra∣vvinge there needle from invvardes, outvvar∣des, & then they bringe there fourth stitch in the opposite lyinge lippe, & thrust throughe the skinne, and throughe the musculous fles∣he, vvithout touchinge the Peritoneum, and in that sort proceede forevvardes, vntill the vvhole vvounde be sovved, soe that throughe one edge of the lippe, but yet at divers times they thrust throughe the skinne and the mus∣ous fleshe, and allsoe the Peritoneum.

* 1.3Amonge all other sortes of sovvinge the vvoundes of the bellye, or stitchinge of them this vvhich vve have taken out of Celsus is the least daungerous and the best alsoe, & easyest to be done. That vve must have tvvo threded needles,* 1.4 vvith one threde, the one needle at the one end, and the other needle at the other end of the threde, vvher of vve must take the one needle in the right, & the other in the left hande, vve must beginne in the end, of the su∣perior parte of the vvounde one the left sy∣de, first of all pearcinge throughe the Peritone∣um, then the musculouse fleshe, and the skin∣ne, dravvinge the needle vvith the threde out, vnto the one halfe, from invvardes, outvvar∣des, then vve must vvith the other needle of the left hande, make the seconde stitch, right opposite agaynst the first, in the right syde of the vvounde, beginninge vvith Peritoneo, as vve have sayed of the first stitch, on this sorte the acuitye or poyncte of the needle is farre e∣noughe frō the entralles or guttes, & yet not∣vvithstandinge the heade close vnto the fora∣sayed guttes: VVhen as therfore the needles have pearced & passed throughe from the one syde to the other, vve must as thē chāge hāds, in receavinge agayne of the needles aforesay∣ed, & take the needle, of the right hand, in the left hand, & the needle of the left hand in the right this permutatione or changinge beinge in this sorte effected, vve must then agayne thruste throughe the lippes of the vvoūde, as al readye hath binne done, to vvitt, from the internall parte, tovvardes the externall, & soe proceedinge forevvardes, as much as is suffici∣ent, and allvvayes consideringe that the one stiche be allvvayes layed right opposyte a∣gaynst the other, in this sort proceedinge, vn∣till the vvoūd be vvholye sevved vp, allvvayes remembringe to leave a little apertione, in the bottome of the vvoūde, throughe the vvhich the congealed bloode, and the threde may be avoyded, vvhich apertione, vve must alvvayes keepe aperte or open vvith a little leaden hol∣lovve pipe, vvhich in the end must be tyede & bovvnde vvith a threde, because that by chaū∣ce it doe not come to slippe into the bellye of the patient. And vve must vvel and dilligent∣lye note, that this suture or sovving allvvayes bedone vvith a goode strōge threde,* 1.5 & vvith a needle, somevvhat crooked at the poynct, lay∣inge the stitches, somvvhat closer the one by other, then in other vvoundes of the bodye, because the stirrīge of the bellye, farre sooner causeth the stitches to burst and breake a sun∣der, then in anye other partes of the bodye, & because alsoe the vvoundes of the bellye, are not so subiecte vnto inflammation or incen∣sions, as other althoughe that often times the bellye is thrust throughe.

Notes

• * 1.1

  The sovv¦inge of the bellye must not be done as the o∣ther sutu∣res.
• * 1.2

  An other fashon of sovvinge of the bel¦lye, accor∣dinge to some mēs sayinges.
• * 1.3

  The man¦ner of sovvinge of the bel¦lye out of Celsus-
• * 1.4

  By the left lippe vve must not onder¦stāde the left syde of the pa∣tient for it is the right syde of the vvounde, but rather the left syde of the Chy∣rurgiane.
• * 1.5

  What mā¦ner of threde & needle vve must haue.