464 woriTDS and iitjueies — xkeatmeitx. 



away by the force of the current. The practioner should next 

 chp away all fragments of loose tissue, whether it be skin, 

 muscle, or tendon. These fragments cannot unite again; 

 therefore remove them, and save nature the trouble by a pro- 

 cess far more tedious and uncertain. 



We have now arrived at that stage of the business where 

 almost every one who professes to understand the matter would 

 exclaim, " Now stitch up the wound." "Whether this should 

 be done, however, will depend upon circumstances. Sutures 

 are advantageous in some cases, and not in others. The general 

 error with regard to sutures is in supposing their application 

 necessary to every wound of the incised, torn, or lacerated 

 varieties. We propose, therefore, to discuss the matter, and 

 determine, so far as experience will permit, not only the proper 

 cases in which to use them, but also the proper kind of suture 

 best adapted for flesh-wounds. 



The cleaner a wound is cut, the more perfect the cure; pro- 

 viding the wound be rationally treated. Sutures to sucli 

 wounds are proper ; but where wounds are much jagged and 

 torn, the skin torn, or the muscular substance broken up or 

 ploughed deeply into — or where foreign substances are lodged 

 within the part injured, and cannot be entirely removed, it is 

 better not to insert sutures, but to cut away the loose bits of 

 skin and flesh, to remove all the dirt which it is possible to 

 remove, and give the wound the most finished appearance pos- 

 sible under the circumstances. On the other hand, in wounds 

 which are large and deep, and where pieces of skin and flesh 

 hang loose, and away from the surface-line of the injured parts 

 sutures will be found of good service : they will efiectually fix 

 the loose parts, and give a ■prober direction to the action of the 

 healing powers. 



