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On The Articulations   


through until you come in contact with the spatula. The following
directions enable you to determine how much of the skin of the
armpit should be grasped; all men have glands in the armpit greater or
smaller, and also in many other parts of the body. But I will treat in
another work of the whole constitution of the glands, and explain what
they are, what they signify, and what are their offices. The glands,
then, are not to be taken hold of, nor the parts internal to the
glands; for this would be attended with great danger, as they are
adjacent to the most important nerves. But the greater part of the
substances external to the glands are to be grasped, for there is no
danger from them. And this, also, it is proper to know, that if you
raise the arm much, you will not be able to grasp any quantity of skin
worth mentioning, for it is all taken up with the stretching; and also
the nerves. which by all means you must avoid wounding, become exposed
and stretched in this position; but if you only raise the arm a
little, you can grasp a large quantity of skin, and the nerves which
you ought to guard against are left within, and at a distance from the
operation. Should not, then, the utmost pains be taken in the whole
practice of the art to find out the proper attitude in every case?
So much regarding the armpit, and these contractions will be
sufficient, provided the eschars be properly placed. Without the
armpit there are only two places where one might place the eschars
to obviate this affection; the one before and between the head of
the humerus and the tendon at the armpit; and then the skin may be
fairly burned through, but not to any great depth, for there is a
large vein adjacent, and also nerves, neither of which must be touched
with the heat. But externally, one may form another eschar
considerably above the tendon at the armpit, but a little below the
head of the humerus; and the skin must be burned fairly through, but
it must not be made very deep, for fire is inimical to the nerves.
Through the whole treatment the sores are to be so treated, as to
avoid all strong extension of the arm, and this is to be done
moderately, and only as far as the dressing requires; for thus they
will be less cooled (for it is of importance to cover up all sorts
of burns if one would treat them mildly), and then the lips of them
will be less turned aside; there will be less hemorrhage and fear of
convulsions. But when the sores have become clean, and are going on to
cicatrization, then by all means the arm is to be bound to the side
night and day; and even when the ulcers are completely healed, the arm
must still be bound to the side for a long time; for thus more
especially will cicatrization take place, and the wide space into
which the humerus used to escape will become contracted.

12. When attempts to reduce a dislocated shoulder have failed, if
the patient be still growing, the bone of the affected arm will not
increase like the sound one, for although it does increase in so far
it becomes shorter than the other; and those persons called
weasel-armed, become so from two accidents, either from having met
with this dislocation in utero, or from another accident, which will
be described afterward. But those who while they were children have
had deep-seated suppurations about the head of the bone, all become
weasel-armed; and this, it should be well known, will be the issue,
whether the abscess be opened by an incision or cautery, or whether it
break spontaneously. Those who are thus affected from birth are
quite able to use the arm yet neither can they raise the arm to the
ear, by extending the elbow, but they do this much less efficiently
than with the sound arm. But in those who have had the shoulder
dislocated after they were grown up, and when it has not been reduced,
the top of the shoulder becomes much less fleshy, and the habit of
body at that part is attenuated; but when they cease to have pain,
whatever they attempt to perform by raising the elbow from the sides
obliquely, they can no longer accomplish as formerly; but whatever
acts are performed by carrying the arm around by the sides, either
backward or forward, all those they can perform; for they can work

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