Part 52
When, then, a dislocation has not been reduced, but has been misunderstood
or neglected, the leg, in walking, is rolled about as is the case
with oxen, and the weight of the body is mostly supported on the sound
leg, and the limb at the flank, and the joint where the dislocation
has occurred is necessarily hollow and bent, while on the sound side
the buttock is necessarily rounded. For if one should walk with the
foot of the sound leg turned outward, the weight of the body would
be thrown upon the injured limb, but the injured limb could not carry
it, for how could it? One, then, is forced in walking to turn the
leg inward, and not outward, for thus the sound leg best supports
its own half of the body, and also that of the injured side. But being
hollow at the flank and the hip-joint, they appear small in stature,
and are forced to rest on a staff at the side of the sound leg. For
they require the support of a staff there, since the nates inclines
to this side, and the weight of the body is carried to it. They are
forced also to stoop, for they are obliged to rest the hand on the
side of the thigh against the affected limb; for the limb which is
injured cannot support the body in changing the legs, unless it be
held when it is applied to the ground. They who have got an unreduced
dislocation inward are forced to put themselves into these attitudes,
and this from no premeditation on their part how they should assume
the easiest position, but the impediment itself teaches them to choose
that which is most conformable to their present circumstances. For
persons who have a sore on the foot, or leg, and cannot rest upon
the limb, all, even children, walk in this way; for they turn the
injured limb outward in walking, and they derive two advantages therefrom,
to supply two wants; the weight of the body is not equally thrown
upon the limb turned outward, as upon the one turned inward, for neither
is the weight in a line with it, but is much more thrown upon the
one under the body; for the weight is in a straight line with it,
both in walking and in the shifting of the legs. In this
[p. 251]position
one can most quickly turn the sound limb under the body, by walking
with the unsound limb outward, and the sound inward. In the case we
are now treating of, it is well that the body finds out the attitudes
which are the easiest for itself. Those persons, then, who have not
attained their growth at the time when they met with a dislocation
which is not reduced, become maimed in the thigh, the leg, and the
foot, for neither do the bones grow properly, but become shortened,
and especially the bone of the thigh; and the whole limb is emaciated,
loses its muscularity, and becomes enervated and thinner, both from
the impediment at the joint, and because the patient cannot use the
limb, as it does not lie in its natural position, for a certain amount
of exercise will relieve excessive enervation, and it will remedy
in so far the deficiency of growth in length. Those persons, then,
are most maimed who have experienced the dislocation
in utero, next
those who have met with it in infancy, and least of all, those who
are full grown. The mode of walking adopted by adults has been already
described; but those who are children when this accident befalls them,
generally lose the erect position of the body, and crawl about miserably
on the sound leg, supporting themselves with the hand of the sound
side resting on the ground. Some, also, who had attained manhood before
they met with this accident, have also lost the faculty of walking
erect. Those who were children when they met with the accident, and
have been properly instructed, stand erect upon the sound leg, but
carry about a staff, which they apply under the armpit of the sound
side, and some use a staff in both arms; the unsound limb they bear
up, and the smaller the unsound limb, the greater facility have they
in walking, and their sound leg is no less strong than when both are
sound. The fleshy parts of the limb are enervated in all such cases,
but those who have dislocation inward are more subject to this loss
of strength than, for the most part, those who have it outward.