214 
DEPARTMENT OF SURGERY. 
gut sutures, which often soften and give way to slight tension, 
and for this reason are considered too treacherous for this series 
of stitches, which should be carefully and substantially applied 
in order to relieve the stitches that bind the serous coats together, 
of part of their tension. As this series of stitches are more liable 
to become infected from the contents of the alimentary canal 
than those of the periphery, and, as the silk may infect other 
parts of the wound with which it may come in contact during 
ligation, it is therefore very essential that the silk b z perfectly 
aseptic, or, in other words, well sterilized. 
Classification of Intestinal Sutures :—The sutures employed 
in these operations are usually named in honor of the originator, 
and the ones that we will consider in this article are, viz.: 
1. Jobert’s suture. 
2. Eembert’s suture. 
3. Czerny’s suture. 
4. Chaput’s suture. 
5. Czerny-Lembert suture. 
Each of these has been tried by many surgeons and their 
respective merits noted. In some cases the more simple ones 
prove very satisfactory, while in other cases, and apparently un¬ 
der the same circumstances, have been found very unsatisfactory ; 
however, the most efficient suture known thus far is a compound, 
or rather a combination of two simple ones (Czerny-Eembert 
suture, Figs. 4 and 5), which we shall describe later in this 
article; but at present it suffices to note that each method of 
suturing has its indications and contra-indications ; its advan¬ 
tages and disadvantages ; and that each operator should choose 
the method which in his judgment will give him the best re¬ 
sult ; and in selecting his method of suturing, he should con¬ 
sider the health and general condition of the patient upon which 
the operation is to be performed. Susceptibility to infection, 
and the power of endurance of the patient, are also important 
factors to be considered, before the method of procedure is 
adopted and the operation is undertaken. 
In considering the merits of the different sutures, it should 
be remembered that some of the simple methods will answer 
the purpose under some circumstances, while other methods 
which are more complicated, requiring more time, care and 
efficiency to apply them properly, are not necessary to accom¬ 
plish the required result, if the patient is in good condition ; and 
in such cases, a plain and simple method will shorten the pro¬ 
cedure and simplify the technique, which adds to the brilliancy 
