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On The Articulations   


in these cases the bones of the leg do not grow in like manner, but
become shortened, as being nearest the seat of the injury, and the
bones of the feet also are atrophied, but not in the same
proportion; because, as was said a little while ago, the ankle-joint
is safe, and if they could use it, as in the case of club-foot, the
bones of the foot would be still less atrophied. When the
dislocation takes place at the hip-joint, the bone of the thigh, in
this case, does not generally grow in like manner, as being the one
nearest the seat of the injury, but becomes shorter than the sound
one; but the growth of the bones of the leg is not arrested in like
manner; nor of those of the feet, for this reason, that there is no
displacement between the bones of the thigh and leg, nor between those
of the leg and foot; in those cases, however, the fleshy parts of
the whole limb are atrophied; but if they could make use of the
limb, the growth of the bones would be still more developed, as
formerly stated, only the thigh, although its flesh would be much less
wasted, would still be by no means so fleshy as the sound limb. The
following observations are a proof of this: those persons who are
weasel-armed (galiancones) from birth, owing to dislocation of the
humerus, or when the accident has happened to them before they have
attained their full growth, such persons have the bone of the arm
shortened, but those of the fore-arm and hand are little inferior in
size to the sound, for the reasons which have been stated, because the
humerus is the bone nearest to the joint affected, and, on that
account, it is shorter than natural; but the fore-arm is not equally
affected by the accident, because the joint at which the bones of
the arm and forearm are articulated remains in its natural
condition, and the hand is still further distant than the fore-arm
from the seat of the injury. Such are the reasons why certain of the
bones in this case increase in growth, and certain do not. The
laborious office of the hand contributes much to the development of
the flesh in the fore-arm and hand, for whatever work is done by the
hand, these weasel-armed persons strive to do no less effectually with
the other hand than with the sound; for the arms do not support the
weight of the body like the legs, and the work performed by them is
light. From exercise, then, the fleshy parts on the hand and
fore-arm are not atrophied in weasel-armed persons, and by these means
the arm, too, gains flesh. But in dislocation inward at the hip-joint,
whether from birth or from childhood, the fleshy parts, on that
account, are much more atrophied than those of the hand, because the
patients cannot exercise the leg. Another proof will be given in the
observations which will be presently stated, that these things are
such as I things are such as I have represented.

54. When the head of the femur is dislocated outward, the limb in
these cases, when compared with the other, appears shortened, and this
is natural, for the head of the femur no longer rests on a bone as
in dislocation inward, but along the side of a bone which naturally
inclines to the side, and it is lodged in flesh of a pulpy and
yielding nature, and on that account it appears more shortened.
Inwardly, the thigh about the perineum appears more hollow and flabby,
but externally the buttock is more rounded, from the head of the thigh
having slipped outward, but the nates appear to be raised up, owing to
the flesh there having yielded to the head of the thigh-bone; but
the extremity of the thigh-bone, at the knee, appears to be turned
inward, and the leg and foot in like manner, neither does it admit
of flexion like the sound limb. These, then, are the symptoms of
dislocation outward.

55. When such a dislocation is not reduced in adults, the whole limb
appears to be shortened, and in walking they cannot reach the ground
with the heel, but they walk with the ball of the foot on the
ground, and the points of their toes incline a little inward. But
the injured limb, in this case, can support the body much better

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