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On The Articulations   


are already past remedy? This is far from being the case, for it
belongs to the knowledge of medicine to be acquainted also with these,
and they cannot possibly be separated from one another; for to such as
are curable, means are to be used to prevent them from becoming
incurable, studying how they may best be prevented from getting into
an incurable state. And incurable cases should be known, that they may
not be aggravated by useless applications, and splendid and creditable
prognostics are made by knowing where, how, and when every case will
terminate, and whether it will be converted into a curable or an
incurable disease. When then, from birth, or during one's youth,
this dislocation backward occurs, and is not reduced, whether it be
connected with violence or disease (for many such dislocations occur
in diseases, but the nature of the diseases in which dislocations take
place, will be described afterward); if, then, the dislocated limb
be not reduced, the bone of the thigh becomes shortened, the whole
limb is impaired, is arrested in its growth, and loses its flesh
from want of use; the articulation at the ham is also impaired, for
the nerves (ligaments?) become stretched, from cases formerly
stated, wherefore those who have this dislocation, cannot make
extension at the knee-joint. In a word, all parts of the body which
were made for active use, if moderately used and exercised at the
labor to which they are habituated, become healthy, increase in
bulk, and bear their age well, but when not used, and when left
without exercise, they become diseased, their growth is arrested,
and they soon become old. Among these parts the joints and nerves
(ligaments?), if not used, are not the least liable to be so affected;
they are impaired, then, for the reasons we have stated, more in
this variety of dislocation than in the others, for the whole limb
is wasted, both in its bones and in its fleshy parts. Such persons,
then, when they attain their full growth, keep the limb raised and
flexed, rest the weight of the body on the other leg, and support
themselves with a staff, some with one, and others with two.

59. In dislocations of the head of the thigh-bone forward (they
are of rare occurrence), the patients cannot extend the leg
completely, but least of all can they bend it at the groin; they are
pained, also, if forced to bend the limb at the ham. The length of the
leg, if compared at the heel, is the same as that of the other; but
the extremity of the foot inclines less to project forward. But the
whole limb has its natural direction, and inclines neither to this
side nor to that. These cases are particularly attended with severe
pain, and they are more apt to be accompanied with retention of
urine at first than any of the other dislocations; for the head of the
thigh-bone is lodged very near to important nerves. And the region
of the groin appears swelled out and stretched, while that of the
nates is more wrinkled and flabby. The symptoms now stated are those
which attend this dislocation of the thigh-bone.

60. When persons have attained their full growth before meeting with
this dislocation, and when it has not been reduced, upon the
subsidence of the pain, and when the bone of the joint has been
accustomed to be rotated in the place where it is lodged, these
persons can walk almost erect without a staff, and with the injured
leg almost quite straight, as it does not admit of easy flexion at the
groin and the ham; owing, then, to this want of flexion at the
groin, they keep the limb more straight in walking than they do the
sound one. And sometimes they drag the foot along the ground, as not
being able to bend the upper part of the limb, and they walk with
the whole foot on the ground; for in walking they rest no less on
the heel than on the fore part of the foot; and if they could take
great steps, they would rest entirely on the heel in walking; for
persons whose limbs are sound, the greater the steps they take in
walking, rest so much the more on the heel, while they are putting
down the one foot and raising the opposite. In this form of

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