Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. V. Of the putting together of the soft and fleshy parts.

THe fleshy and soft parts, disjoyned, * 1.1 preternaturally are joyned together, either without any division of them, or by solution of their continuity, that putting together, which is performed without any division of parts is various, and of different parts, and first of all sometimes certaine parts being slid out of their places, come to be put into their naturall place againe, such are the guts, and paunch, which sometimes by the wounds of the paunch come out, sometimes the Rim of the belly being loosned, or broken, falls into the groine, and cods, or breake out at the navell, hitherto belongs the wombe, and gut Rectum, which sometimes also fall out of their places, and therefore all these are to be put into their places againe, but how the restoring of each singular part ought to be performed, is spoken in our Institutions, and 3 d. Book of praxis.

Moreover, * 1.2 for what belongs to the manner of joyning together, wounded parts, without division, the lips of the wounds, since they are disjoyned, are to be brought and joyned together, and when they are brought, being joyned are to be kept together, which may be done too wayes without solution of continuity, either

by swathing, or gluing, or a suture with the Glue, and in∣deed as for swathing that is convenient being made for Wounds according to the length of the member, * 1.3 and not very deep, and when we hope by fasciation only, the lips may be joyned. A future is not rashly to be appointed, and indeed if the wound be long, narrow, and straight, swathing is better, that is, deligation of three fingers breadth is enough. The manner of fasciation may be seen in the Institutions.

But when in transverse and long wounds, * 1.4 sasciation a∣lone is not sufficient to draw and continue the lips of the wound together, there is need of a suture; but when in wounds of the face prickings cause deformities, and in o∣ther long and great wounds before the glutination of the wound the sutures are broke; render bodies also cannot in∣dure a seam which is made with a needle, a certain lutina∣tion or suture is invented by glue, by which without any division of the wounded part, or stitching with a needle, the lips of the wound are drawn together. Provision to perform this may be seen in the Institutions.

But that conjunction of wounded parts which is made by solution of continuity is performed with a suture and pipes to the suture, * 1.5 three Instruments are to be used, the Nee∣dle must be triangular and thred strong, least it should be broken, not too hard, but softned with Wax, equall, or e∣ven, the Pipe ought to be Gold mixt with Copper, or Sil∣ver, with a hole in the end that the Needle may passe through the hole, and the Pipe holding it, and being put to i••, it may stay the lips of the wound, least whilst the needle is put to it it should be stirred, neither should it be lengthned to the protraction of the thred and needle: the manner of the suture is two-fold, the one is that which is performed in the same manner as Skinners or Furriers use to sow their skins, being fitted for wounded guts; the other is thus, in the middle of the wound, with a Needle drawing a double thred, the lips of the wound are tied, and a knot being made, the thred a little above the knot, is to be cut off: Moreover in the middle space on both sides another hole is to be pricked with a double thred, and a knot being made in the like manner, tis to be cut off, and that is to be con∣tinued till the lips of the wound be rightly sowne together, and brought to mutuall contract. * 1.6

There is mention also amongst the ancients of a Pipe,

but what it was for the most part is unknown at this day, since it is incredible that those iron hooks should be fixed to the skin, since that would have caused intollerable pain, the opinion of Gabriel Fallopius is more probable, who teach∣eth that pipe to be that suture newly described, which is cal∣led Intercisa, and at this day is most frequent, which is drawn with a needle drawing a double thred through both the lips of the wound, and above the wound, with three involutions, both the ends of the thred are tied together and knit into a knot. But the word Fibula signifies every Instrument that joyneth things together. And thus much of the Chyrurgicall operation which is of putting or joyn∣ing together.

Notes

• * 1.1

  Setting of soft parts.
• * 1.2

  Wounds, how set.
• * 1.3

  Swathing.
• * 1.4

  A suture by glue.
• * 1.5

  A suture by a needle.
• * 1.6

  Fibulae.