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On The Articulations   


they raise the foot very high, for in this way they could do it;
neither also could they bend the joint at the ham, but with much
greater difficulty, if they do not bend the joint at the groin at
the same time. There are many other things in the body which have
similar connections, both with regard to the contractions of nerves
(ligaments?), and the positions of muscles, and many of them more
worthy of being known than is generally supposed, and with regard to
the nature of the intestine and that of the whole internal cavity, and
with regard to the displacements and contractions of the uterus; but
all these things will be treated of elsewhere, in a work akin to the
present one. But with regard to the matter on hand, they cannot make
extension, as has been already stated; and the limb appears shortened,
for two reasons-first, because it cannot be extended, and also because
the bone has slipped into the flesh of the nates; for the head and
neck of the femur, in this dislocation, are carried downward from
their natural situation, to the outside of the nates. But yet they can
bend the limb, unless prevented by pain, and the leg and foot appear
pretty straight, and not much inclined toward either side, but at
the groin the flesh, when felt, appears looser, from the bone of the
joint having slipped to the other side, but at the nates the head of
the femur may be felt to be more prominent than natural. Such are
the symptoms accompanying dislocation of the thigh backward.

58. When this dislocation occurs in an adult, and is not reduced, he
can walk, indeed, after a time, and when the pain has abated, and when
he has been accustomed to rotate the articular bone in the flesh; he
finds it necessary, however, to make strong flexion at the groin in
walking, for two reasons, both because the limb, for the causes
already stated, becomes much shorter, and he is far from touching
the ground with his heel, and he can barely reach it with the ball
of his foot, and not even thus, unless he bend himself at the
groins, and also bend with the other leg at the ham. And in this case,
he is under the necessity of supporting the upper part of the thigh
with his hand at each step: this also contributes, in a certain
degree, to make him bend the body at the groins; for, during the
shifting of the feet in walking, the body cannot be supported on the
unsound be supported on the unsound limb, unless it be pressed to
the ground by the hand,-the end of the femur not being placed properly
under the body, but having slipped backward to the nates; and if he
should try to rest the weight of his body for a little, upon the foot,
without any other support, he would fall backward, for there would
be a great inclination in this direction, from the hips having
protruded backward far beyond the line of the foot, and the spine
inclining toward the hips. Such persons can walk, indeed, without a
staff, if so accustomed, for because the sole of the foot is in its
old line, and is not inclined outward, they do not require anything to
balance them. Such, however, as, instead of grasping the thigh, prefer
resting their weight upon a staff introduced into the armpit of the
affected side, these, if they use a longer staff, will walk, indeed,
more erect, but will not be able to reach the ground with the foot, or
if they wish to rest upon the foot, they must take a shorter staff,
and will require to bend the body at the groins. The wasting of the
fleshy parts is analogous to what happens in the cases formerly
described, for the wasting is greatest in those cases in which the
patients keep the limb up, and do not exercise it, whilst those who
practice walking, have the least atrophy. The sound leg, however, is
not benefited, but is rather rendered more deformed, if the injured
limb be applied to the ground, for it is forced to cooperate with
the other, being protruded at the hip, and bent at the ham. But if the
patient does not use the injured limb by applying it to the ground,
but carries it up, and rests upon a staff, the sound leg thereby gains
strength, for it is employed in its natural position, and further, the
exercise gives it strength. But it may be said, these things are
foreign to medicine; for what is the use of enlarging upon cases which

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