Part 23
The symptoms of dislocation backward are:-The parts before more empty,
behind they protrude, the foot straight, flexion impossible, except
with pain, extension least of all: in these the limb is shortened.
They can neither extend the limb at the ham, nor at the groin, unless
it be much raised, nor can they bend it. The uppermost joint, in most
cases, takes the lead: this is common in joints, nerves, muscles,
intestines, uteri, and other parts. There the bone of the hip-joint
is carried backward to the nates, and on that account it is shortened,
and because the patient cannot extend it. The flesh of the whole leg
is wasted in all cases, in which most, and to what extent, has been
already stated. Every part of the body which performs its functional
work is strong, but, not withstanding, if inactive, it gets into a
bad
[p. 288]condition, unless its inactivity arise from fatigue, fever, or
inflammation. And in dislocations outward, the limb is shortened,
because the bone is lodged in flesh which yields; but, not withstanding,
in dislocations inward, it is longer, because the bone is lodged on
a projecting bone. Adults, then, who have this dislocation unreduced,
are bent at the groins in walking, and the other ham is flexed; they
scarcely reach the ground with the ball of the foot; they grasp the
limb with the hand, and walk without a staff if they choose; if the
staff be too long, their foot cannot reach the grounds-if they wish
to reach the ground, they must use a short staff. There is wasting
of the flesh in cases attended with pain; and the inclination of the
leg is forward, and the sound leg in proportion. In congenital cases,
or when in adolescence, or from disease, the bone is dislocated (under
what circumstances will be explained afterward), the limb is particularly
impaired, owing to the nerves and joints not being exercised, and
the knee is impaired for the reasons stated. These persons, keeping
the limb bent, walk with one staff or two. But the sound limb is in
good flesh from usage.
