The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. VI. Of Sutures.

WHen Wounds are made alongst the Thighs, Legs, and Arms, they may easily want Su∣tures, because the Solution of continuity is easily restored by Ligatures,* 1.1 but when they are made overthwart, they require a Suture, because the flesh and all such like parts, being cut are drawn towards the sound parts; whereby it comes to pass that they part the fur∣ther each from other; wherefore that they may be joyned and so kept, they must be sewed, and if the Wound be deep, you must take up much flesh with your Needle; for if you only take hold of the upper part, the wound is only superficially healed: but the matter shut up, and ga∣thered together in bottom of the wound, will cause abscesses and hollow Ulcers: Wherefore now we must treat of making of Sutures.

The first, called Interpunctus, leaves the distance of a fingers breadth,* 1.2 and therefore is fit for the green wounds of the fleshy parts, which cannot be cured with a Ligature, and in which no

heterogeneous or strange body remains.* 1.3 It is performed after this manner. You must have a smooth Needle with a thred in it, having a three-square point, that so it may the better enter the skin, with the head of it somewhat hollowed, that the thred amy lie therein; for so the Needle will the better go through.* 1.4 You must also have a little Pipe with a hole or window in the end, which you must hold and thrust against the lip of the wound, that it be not moved to the one side or other, whilst you thrust through the Needle: And that we may see through that window when the Needle is thrust through, and also draw it together with the thread, and withal hold the lip of the Wound in more firmly, that it follow not at the drawing forth of the Needle and thred. Having thus pierced the lips of the Wound, tie a knot, near to which cut off the thread; lest that if any of it be left below the knot, it may so stick to the Emplasters that it cannot be plucked and separated from them without pain, when they are taken off. But you must note the first stitch must be thrust through the midst of the Wound, and then the second must be in that space which is be∣tween the midst and one of the ends; but when you have made your stitches, the lips of the Wound must not be too closely joyned, but a little space must be left open between them, that the matter may have free passage forth, and inflammation and pain may be avoided: otherwise, if they shall be closely joyned together without any distance between, a tumor after arising when the matter shall come to suppuration, the lips will be so much distended that they may easily be broken by the stifness of the thred. But you must neither take hold of too much nor too little flesh with your Needle; for too little will not hold, and too much causeth pain and inflammation. And besides, leaves an ill favoured scar. Yet in deep wounds, such as are those which are made in the thick∣er Muscles, the Needle must be thrust home, that so it may comprehend more of the fleshy sub∣stance; lest the thred drawn away by the weight of the flesh not taken hold of, may be broken. But oft-times wounds are seen made in such places as it would be needful, the Chirurgeon should have a crooked Needle and Pipe, otherwise the Suture will not succeed according to his desire. Wherefore I have thought good to set forth both their figures, that you may use either as occa∣sion shall serve.

[illustration]

The Figures of Pipes with Fenestels in them, and Needles fit for Sutures.

* 1.5The second Suture is made just after the same manner as the Skinner sows their fels or furs. And the guts must be sowed with this kind of Suture, (if they shall be at any time wounded) that the excrements come not forth by the wound.

* 1.6The third Suture is made by one or more Needles having thred in them, thrust through the wound, the thred being wrapped to and again at the head and the point of the Needle, as Boys use to fasten their Needle, for fear of losing it, in their caps or clothes. This kind of Suture is fit in the curing and healing of Hare-lips, as we shall shew you hereafter expressed by a Figure.

* 1.7The fourth kind of Suture is termed Gastroraphia, invented for the restoring and uniting the great Muscles of the Epigastrium, or lower Belly, cut with a great wound together with the Peri∣tonaeum lying under them. The manner whereof we shall shew in due place.

* 1.8The fifth kind is called the dry Suture, which we use only in the wounds of the face, which al∣so we will describe in its proper place.

Notes

• * 1.1

  What wounds stand in no need of a Su∣ture.
• * 1.2

  The first man∣ner of Suture.
• * 1.3

  The form of your Needle.
• * 1.4

  The form of the pipe with a window in it.
• * 1.5

  The second means of Su∣ture.
• * 1.6

  The third manner of Suture.
• * 1.7

  The fourth kind of Suture termed Gastro∣raphia.
• * 1.8

  The fift kind called the Dry Suture.