1000000031

'Iharp: 1his is urcd only in thc future of the tendoo, and is

made Ihin, thalO:'H

f( w

of lhe fibres of

Ot ndcr

uociy

as a

t~ndon

m.ty

injured

in lhe pal1ing of

it.

Thls

aeedle

laice

cnou~h

for

rt.tching

the

I t llJo

A chi/liJ.

D .

The lar&"1 erooke.d oeedle oeedrary fo r ,he tying of

oloy Vt:ffds,

and fhuuld

be:

ufed

with a ligature o( the Gze

is thre ..dt.'d

\Vidl

t ..

king up [he

rpermatick

vdrels

iD ca·

IIr:ttton, or ihe

f~r:loral

ar.d'humcral

3ncrles

amputuion.

Th i, n« dle m.y allo be u[<d il\ fe wing up deep wounds.

A erooked needle .nd ligature o( ,he mon ufeCu l fize,

bciog

nOI

much too

liule

for lhe 1000gcll

veffels,

nor a great

deal too big ror ,be

fllla lld };

and

lherefore

lhe

taking np

of lhe cre.a en oumber of

vdrels in ao amputation,

is lhe

p' opcr needle ' o be cmployed . This oced le . Ifu is of . eon –

vc:ni~nt

(ize

fo~

fewi o:;; up

moll

wounds.

A fm.1I erookcd ncedle and ligature (or taking up ,he

~e(fl!r

tlrteries, fuch as

thor~

of the

[calpo

and

,heCt:'

of the

íkif\ that are waunded in opcning

abfceOes.

G re:tt

CHe

lhou ld be taken

lhe

makers of theCe needles.

to l!ive lhem a dlle lemper: for

they are [00 foft. (he

force fome limes exened to carry lhem lhrouch die

fldh,

wd l bend

lhelll;

they are

toO

briulc

they (nap;

bOlh

which

~ccidelús

:nay happen to be terrib!!! inconvcoiencies,

lhe furgeon

nal

provided with

fuRicient

numbcr

'them.

is of great importance alfo to give them lhe form

_of part of a cirele, which makes them

rafs

much more

Tea–

c1ily round any vefrd. ,han i( ,hey wer. made panly of •

cirele, and partly of a

nraight

linc, and in lilking up veffc!s

Olt

Ihe bOHom of a decp wound is abfolulcly

nccc{fuy,

being impraéticable to

lu ro

lhe needIe with a fhaight haodle,

and bring

rour.d [he veliel when iD lh;u fiW2tion. The

congeX furf2cc of the needle is lhr, and its two edges ue

{harp. l ts concave fide is compofed of [\Vo furf"ces,

ri~ng

from ,he edges of lhe oeedle , and meeting in a ridge or emi·

nence. fo lhat the needle has three fides. The beO m¡HC–

ri.lls for IDaking

I¡g~tures ,

are the flaxen thread that Ol oc·

ITIclkers ufe

which is fufficiently (lrong when fou r, fjx , or

eighl oC' che threads are twitled together :lInd waxed; and

is nol fo ap'

cut the velTels, as threads that are more

finely fpu n.

Clraight rieedle;

f~ch

:liS

glovers ufc . with a threc–

t dged poi nr. ufcful in the uni nterrupted fUlure, in the fu–

t ure of tondons, where the crooked one

is nOI prefc:rred,

and in fewing up dead bodies , and is rathcr more handy for

taking up the vell\:l, o( ,he fcalp.

S U1·URES .

' VHEN a \Vound. is receot, and the parts of

are "divi–

ded by a rharp inHrument, wirhout any fanhc:r violence, and

in Cuch a manner that lhey may be made tO approach each

olher, by bClng relurned with the hands, they will, ifheld

in clore cont!lél for fome time. re·unite by inofculation,

:md ccmt nt hke one b.,tOch of a tree ingrafted on 3nolhcr.

"fo m.lincain Ihem in lhis fituatioo, fcveral fOrls of futures

Irave becn inventcd, tlnd formerly praétifed ; bUl the num·

ber of ,hem has o( late becn very mueh reduced. Thofe

now chiefly dercribed, are the interru pted, tb: gl0\'er'5, Ihe

quillect, lhe twifled, and lhe Jry furures

but tht! inter·

rupted and

t\vi~ed,

are almon the onl)' ure.ful ones

for lhe

quilled future

15,

ncver . preferable tO

tI~e ~nlerrUptc~

the

dry fumre is ridlculous

~erms,

fince: It

ooly. a

plcce.of

plainer ap"lieJ

many ddTerent ways to rC_Ullll e

rh t:

111'$

,cf a

wou~d;

ami ,he glover's, or uninterrupted llilCh,

which i, ad.ifed in fup"ficial wounds, to Frevent the de–

formity of arcar, dot's ratber.

the frequency of the

llit ches,

occ~fion

it,

and is theldore tO be rejeélc!cl in fa·

you r of

comprefs and Hick.ing plainer ; the only ¡oflaDce

where it (hould be ufed, is

wound of the imeflioe.

\Vounds are not fit fubj céls for ruture, when there

ti.

ther a contufion, laceralíon, lofs of fubClance, great

inflam..

malioD, difflculty of bringing the lips ioto appofitlon, or

fome cxtraneous body Inhnu.ned ioto tbem ; though fome·

times

laccralcd wound may be affiUed Wilh one or tWo

Hi tches.

has formerly betn forbidden to

Cew

up woullds

of the head

bUI tbis precaution is

ve.ry

tiule: regarded by

tbe

moneros.

l ( we nitch up a wound that has none of thefe o.nade••

we :.Iways employ the inte.rrupted future:, paffing the needle

two, three, or four times, in proportion

lhe length of

il,

though lhere caDreldom be more than three llitches re·

quired.

T he method of doing it is thi.: the wound being emp–

tie:d of the grumous blood, and your affiflant hilviTlg brought

the lips of

togecher, that th<y may lie quite even; you

carefully carry your needle from without, ¡n\\ :uds

Ihe

bOlt OO1. and

on [rom withio. outwards; ufing the c.u–

tion

oí

maki ng the punéture far eoough from lhe edge of

the wound, which will DOt only facilit..ate lhe pafling the

Jigaturc, but will 21fo preTem it from eati ng through the

fldo and fldh; this dirtance may be Ihree or four ten,hs of

an ¡oeh : as many more flit ches as you fhall make, wlll be

only repetilions o( the fame procefs. . The threads beinc

.11 p.lfed, you begin tying ,hem in ,he middle of ,he wound,

tbough,

,he lip' are held c.refull y ,ogether all ,he while.

as (hey OlOuld be. it wi)} be of no great confequenee w)1ich

i, done firfl . T he m'on uf, f.1kind ofknot iD large wounds,

is a fingle one (¡ra

over this,

liule: lineo corppre:fs, on

whieh is tO be rnade ar.other !ingle knot ; aod lhe; a n,p4'

knor, which may be loofened upon any inflammatioo : but

in fmal! wounds, there: is no danger f,om the double knot

alon~.

withouI any comprefs tOtie il upon ; and Ihis

¡,

mon

geoerally praéhfed. If a . ¡olent inBamm2tioo Olould fuc·

eeed. loofening the ligature ooly will not fuf11ec:

it muíl

be eut through and drawn away, and lhe wouod be. treattd

afterwlirds without any fUlure . When lhe wound is fmall ,

the lefs it i$ diHnrbed by dreffing, the beBer; but in large

ones, thc:re will fomelimcs be a confiderable difcha rge, ami

if Ihe thrt'<lds be not c:lIl\tiouOy carried through the bon om

of jt, abfc('{fes \ViiI frcquently enfue from lhe maller being

pent. up

undernealh~

aod not ft ndiDg i{fue.

no acciJt:nt

h:lppeo, you mufl:, afler the lirs are firmly a(!glutin4led .

uke away the ligi\lures, :lod drefs the orifices which they

Jeave.

mufl be remcmbered, thu durine the cure, the Cuture

mufl be always

.ffin~d

by ,he application ofb.ndage, ii pof–

fi blc, which is frequently of tht! grca(t:{t importance; :lInd

that fon of bandage Wllh IWO heads, ..tnd a

fli,

in the mido

die, which is by Oluch ,he ben, will in mol! cafes be (ound

praébeablc.

The , wifl,d fu, ure being princip.1I y employed in ,he hare –

lip. wc Ih ..1I rerel

,fe

its J d CriplioA fo r lhe

f~(t ion

0 0

thlt

hCJd.

1/ ,

Suture if T er.dons.

' VOtlNDS of lhe tendons

:1Te

not only

kno.wn

hc.tl

salO,

bu, er<D to admit of k w,ne up

11!"

thof, of ,he

~ ,Ih y

¡~,