DEPARTMENT OF SURGERY. 
217 
V. S., for his experience and observations in performing lapa¬ 
rotomy upon small domestic animals, and for the valuable in¬ 
formation received from him in this direction. 
i. Jobert's Suture .—The stitch known as Jobert’s suture is 
the most simple suture used in intestinal operations, and is an 
interrupted stitch which is passed through all the coats of the 
intestine and applied as follows : fold the edges of the surgical 
wound inward into the lumen of the intestine and approximate 
them ; then pass the needle through the three coats of the in¬ 
testine into the lumen (Fig. i) ; then through the three coats 
of each of the edges of the surgical wound which have been 
folded in and approximated, and then through the opposite 
side, making the point of exit the same distance from the edge 
of the wound as the point of entrance. 
The distance between the stitches should not exceed five or 
six millimeters, and, in some cases, should be even less. It is 
necessary, however, for the operator to use his own judgment 
as to the proximity and tension of the stitches, and especially 
as to tension, for it is absolutely necessary to have uniform ten¬ 
sion of stitches in all intestinal operations, no matter what 
method of suturing is adopted. 
This method has its advantages and disadvantages. The 
fact that each stitch comes in contact with the contents of the 
alimentary canal is the greatest objection to the method, and 
the rapidity with which an operation can be performed by this 
method of suturing is one of its advantages. In approximations 
or end-to-end anastomoses, these stitches are easily applied, and 
if the intestine is not involved in any serious pathological con¬ 
dition, and it is desirable and advisable to shorten the opera¬ 
tion, this method can be used to a fair advantage; however, the 
result is not certain and should not be used when it is conven¬ 
ient to apply a more reliable suture. 
Jobert describes a method of making intestinal approxima¬ 
tions (Fig. 3) which consists of stitches made in the same man¬ 
ner as those just described; but in this case only one end of the 
intestine is folded inward and the other is inserted into it, which 
brings the two serous coats together ; the stitches are then passed 
through all the coats of both ends into the lumen and out again. 
This method is not advisable, as it is difficult to encourage syn- 
ulosis sufficiently to make good, reliable unions, for there are 
two in this procedure (Fig. 3-a): one between the two mucous 
surfaces of the end that is folded inward, and the other between 
the serous coats of the two ends. The mucous coats do not 
