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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
than in dislocation inward； both because the head of the femur and the
neck of its articular extremity； being naturally oblique； have
formed a bed under a considerable portion of the hip； and because
the extremity of the foot is not forcibly turned outward； but is
nearly in a line with the body； and is even inclined more inwardly。
When； then； the articular extremity of the femur has worn out a socket
for itself in the flesh where it was lodged； and the flesh is
lubricated； it ceases to be painful in the course of time； and when it
becomes free from pain； they can walk without a staff； if so inclined；
and they can support the body on the injured limb。 From usage then； in
such cases； the fleshy parts are less enervated than in those which
have been mentioned a little before； still； however； they lose their
strength more or less； but in general there is more enervation when
the dislocation is inward than when it is outward。 Some of them； then；
cannot wear their shoes； owing to the unbending state of their leg；
and some of them can。 But when this dislocation takes place in
utero； and when the dislocation having occurred at any time before
manhood； from violence； has not been replaced； or when from disease
the articular extremity has started from its socket； and is
displaced （for many such cases occur； and from some of them； if the
femur become necrosed； obstinate suppurations requiring the use of
tents are formed； and in certain of them the bone is laid bare）；
whether the bone become necrosed or not； the bone of the thigh is much
shortened； and does not usually grow like the sound one； the bones；
too； of the leg； become shorter than those of the other； but in a
small degree； for the same reasons that were formerly stated； such
persons can walk； some of them in the same fashion as adults having an
unreduced dislocation； and some of them walk with the whole foot on
the ground； but limp in walking； being obliged to do so by the
shortness of the limb。 Such is the result； even though they be
carefully and properly trained in the attitudes before they have
strength for walking； and in like manner also； after they have
acquired the necessary strength； but those persons require the most
care who were very young when they met with the accident； for； if
neglected while children； the limb becomes entirely useless and
atrophied。 The fleshy parts of the entire limb are more wasted than
those of the sound limb； but this is much less apt to happen in
their case than in dislocation inward； owing to usage and exercise； as
they are speedily able to make use of the limb； as was stated a little
before with regard to the weasel…armed （galiancones）。
56。 There are persons who； from birth or from disease； have
dislocations outward of both the thighs； in them； then； the bones
are affected in like manner； but the fleshy parts in their case lose
their strength less； the legs； too； are plump and fleshy； except
that there is some little deficiency at the inside； and they are plump
because they have the equal use of both their legs； for in walking
they totter equally to this side that。 Their nates appear very
prominent； from the displacement of the bones of the joint。 But if
in their case the bones do not sphacelate （become carious？） and if
they do not become bent above the hip…joint； if nothing of this kind
happen to them； they become otherwise sufficiently healthy； but the
growth of all the rest of the body； with the