37。Inthosecasesinwhichthefracturedportionsaredepressedandflattened，ifitisdepressedinfrontatthecartilage，somethingmaybeintroducedintothenostrilstorectifytheparts。Ifnot，allsuchdeformitiesmayberestoredbyintroducingthefingersintothenostrils，ifthiscanbemanaged，butifnot，athickspatulaistobeintroducedwiththefingers，nottotheforepartofthenose，buttothedepressedportion，andthephysicianistotakeholdofthenoseexternallyonbothsides，andatthesametimeraiseitup。Andifthefracturebemuchintheforepartonemayintroduceintothenostrilsasalreadystated，eithercaddisscrapedfromalinentowel，orsomethingsuchwrappedupinapieceofcloth，orratherstitchedinCarthaginianleather，andmouldedintoashapesuitabletotheplaceintowhichitistobeintroduced。Butifthefracturebeatagreaterdistance，itisnotpossibletointroduceanythingwithin，forifitwasirksometobearanythingofthekindintheforepart，howisitnottobesowhenintroducedfartherin？Atfirst，then，byrectifyingthepartsfromwithin，andsparingnopainsuponthemfromwithout，theyaretobebroughttotheirnaturalposition，andset。Afracturednosemaybereadilyrestoredtoshape，especiallyonthedayoftheaccident，orevenalittlelater，butthephysiciansactirresolutely，andtouchitmoredelicatelyatfirstthantheyshould；forthefingersshouldbeappliedonbothsidesalongthenaturallineofthenose，anditistobepusheddownward，andthus，withpressurefromwithin，thedisplacementistoberectified。Butforthesepurposesnophysicianisequaltotheindex—fingersofthepatienthimself，ifhewillpayattentionandhasresolution，fortheyarethemostnaturalmeans。Eitherofthefingersistobeplacedfirmlyalongthewholenose，andthusitistobegentlyheld，andsteadily，ifpossibleuntilitbecomefirm，butifnot，hehimselfistoholditforaslongatimeaspossible，orifhecannot，achildorwomanshoulddoit，forthehandsoughttobesoft。Thusmayafractureofthenose，attendedwithdepression，andnotwithdisplacementtotheside，butinastraightline，bemostproperlytreated。Ihaveneverseenacaseoffracturednosewhichcouldnotberectifiedwhenattempted，beforecallusisformed，providedthetreatmentbeproperlyapplied。Butalthoughmenwouldgiveagreatpricetoescapebeingdeformed，yetatthesametimetheydonotknowhowtotakecare，norhaveresolution，iftheydonotexperiencepain，norfeardeath，althoughtheformationofcallusinthenosespeedilyplace，forthemostpartisconsolidatedintendays，providedsphacelusdonottakeplace。
　　38。Whenthefracturedboneisdisplacedlaterally，thetreatmentisthesame，butitisobviousthatthereductionistobemade，notbyapplyingequalforceonbothsides，butbypushingthedisplacedportionintoitsnaturalposition，andpressingonitfromwithout，andintroducingsomethingintothenostrils，andboldlyrectifyingthefragmentswhichinclineinward，untilthewholebeproperlyadjusted，wellknowingthatifyoudonotrestorethepartsatonce，itisimpossiblebutthatthenosemustbedistorted。Butwhenyourestorethepartstotheirnaturalposition，eitherthepatienthimself，orsomeotherperson，istoapplyonefingerormoretothepartwhichprotrudes，andkeepitinpositionuntilthefracturebeconsolidated；butthelittlefingeris，fromtimetotime，tobepushedintothenostril，torectifythepartswhichinclineinward。
　　Whenanyinflammationsupervenes，doughmustbeused，butattentionmuststillbeequallypaidtotheapplicationofthefingers，althoughthedoughbeonthepart。Butifthefracturebeinthecartilage，withlateraldisplacement，theendofthenosemustnecessarilybedistorted。Insuchcasessomeoftheaforementionedmeansofreduction，orwhateversuits，istobeintroducedintothenostril；
　　buttherearemanyconvenientthingstobefoundwhichhavenosmell，andareappropriateinotherrespects；thus，ononeoccasion，I
　　introducedasliceofsheep’slung，asithappenedtobeathand；
　　forsponges，ifintroduced，imbibehumidities。ThentheouterskinofCarthaginianleatherittobetaken，andapieceofthesizeofthethumb，orwhatwillanswer，istobecutoffandgluedtotheoutsideofthenostrilwhichisturnedaside，andthenthispieceofthongistobestretchedtotheproperdegree，orratheralittlemorethanwhatwillbesufficienttomakethenosestraightandregular。
　　Then（forthethongmustbelong）itistobebroughtbelowtheearandroundthehead，andtheendofthethongmayeitherbegluedtotheforehead，orastilllongeronemaybecarriedallroundthehead，andsecured。Thisisanaturalmodeofsettingthenose，isofeasyapplication，andiscalculatedtoenablethecounter—extensiononthenosetobemadegreaterorless，asyoumayincline。Inacasewherethefracturednoseisturnedtotheside，thetreatmentistobeconductedotherwise，asalreadydescribed；andinmostofthemthethongoughttobegluedtotheendofthenose，inordertomakeextensionintheoppositedirection。
　　39。Whenthefractureiscomplicatedwithawound，oneneednotbetroubledonthataccount，butpitch—cerateoranyoftheapplicationsforfreshwoundsistobeappliedtothesores；for，ingeneral，theyadmitofeasycure，evenwhenthereisreasontoapprehendthatpiecesofbonewillcomeout。Theparts，atfirst，aretobeadjustedfearlessly，takingcarethatnothingisomitted，and，subsequently，theyarealsotobeadjustedwiththefingers；moresoftly，indeed，butstillitmustbedone；andofallpartsofthebodythenoseismodeledwiththegreatestease。Andthereisnothingtopreventusfromhavingrecoursetothepracticeofgluingonthethongs，anddrawingthenosetotheoppositeside，eveniftherebeawoundorthepartsbeinflamed，forthesethongsgivenopain。
　　40。Infracturesoftheearallsortsofbandagesdoharm。Foronewouldnotthinkofapplyingitquiteloose，andifappliedmoretightly，itonlydoesthemoreharm，foreventhesoundear，whenconfinedwithabandage，becomespainful，throbs，andgetsintoafebrilestate。Withregardtocataplasms，theheaviest，onthewhole，aretheworst；butalmostallkindsarebad，formabscesses，occasionanincreaseofhumors，andafterwardtroublesomesuppurations；andafracturedearstandsinlessneedofsuchapplicationsthananyotherpart；themostready，ifrequired，isthepasteofmeal，butneithershouldithaveweight。Itshouldtouchaslittleaspossible；foritisagoodsometimestoapplynothingatall，bothtotheearandtomanyothercases。Attentionmustbepaidtothepatient’spositionduringsleep。Andthebodymustbereduced，moreespeciallyiftherebedangerlesttheearsuppurate；
　　itwillalsobebettertoopenthebowels，andifthepatientcanbereadilymadetovomit，thismaybeaccomplishedbymeansofthesyrmaism。Ifthepartcometosuppuration，itshouldnotbehastilyopened；foroftenwhenmatterappearstobeformeditisabsorbedagain，evenwhennocataplasmisapplied。Butifforcedtoopenit，thepartwillgetsoonestwelliftransfixedwithacautery，andyetitshouldbewellunderstoodthattheeargetsmaimed，andislessthantheotherifburnedthrough。Ifnotburnedthrough，anincision，andnotaverysmallone，shouldbemadeontheupperside；forthepusisfoundtobesurroundedwithathickercoveringthanonewouldhavesupposed；anditmaybesaid，ingeneral，thatallpartsofamucousnatureandwhichformmucus，asbeingallviscid，whentouched，slipfrombelowthefingerstoeitherside；andonthataccountthephysician，insuchcases，findsthathehastopasshisinstrumentthroughathickersubstancethanhesupposed；andincertainganglioniccases，whentheskinisflabbyandmucous，manyphysiciansopenthem，expectingtofindacollectioninthem；herethephysicianformsawrongjudgment，butbysuchaprocedurenogreatharmresultstothepatientfromhavinghadthepartopened。Butwithregardtowateryparts，andsuchasarefilledwithmucus，andwhicharesituatedinregionswhereeveryoneoftheparts，ifopened，willoccasiondeathorsomeotherinjury，thesewillbetreatedofinanotherwork。When，therefore，incisionismadeintheear，allsortsofcataplasmsandpledgesshouldbeavoided，anditistobetreatedeitherwithapplicationsforrecentwounds，oranythingelsewhichisneitherheavynorwilloccasionpain，forifthecartilagebelaidbareandabscessesform，thecasewillbetroublesome；thishappensfromsuchmodesoftreatment。Inallaggravatedcases，themosteffectualremedyisthetransfixingofthepartwithahotiron。
　　41。Thevertebraeofthespinewhencontractedintoahumpbehindfromdisease，forthemostpartcannotberemedied，moreespeciallywhenthegibbosityisabovetheattachmentofthediaphragmtothespine。Certainofthosebelowthediaphragmarecarriedoffbyvaricesinthelegs，moreespeciallybysuchasoccurintheveinattheham；andinthosecaseswherethegibbositiesareremoved，thevaricestakeplacealsointhegroin；andsomehavebeencarriedoffbyadysenterywhenitbecomeschronic。Andwhenthegibbosityoccursinyouthbeforethebodyhasattaineditsfullgrowth，inthesecasesthebodydoesnotusuallygrowalongthespine，butthelegsandthearmsarefullydeveloped，whilsttheparts（abouttheback）arearrestedintheirdevelopment。Andinthosecaseswherethegibbosityisabovethediaphragm，theribsdonotusuallyexpandproperlyinwidth，butforward，andthechestbecomessharp—pointedandnotbroad，andtheybecomeaffectedwithdifficultyofbreathingandhoarseness；forthecavitieswhichinspireandexpirethebreathdonotattaintheirpropercapacity。Andtheyareunderthenecessityofkeepingtheneckbentforwardatthegreatvertebra，inorderthattheirheadmaynothangdownward；this，therefore，occasionsgreatcontractionofthepharynxbyitsinclinationinward；for，eveninthosewhoareerectinstature，dyspnoeaisinducedbythisboneinclininginward，untilitberestoredtoitsplace。Fromthisframeofbody，suchpersonsappeartohaveappeartohavemoreprominentnecksthanpersonsingoodhealth，andtheygenerallyhavehardandunconcoctedtuberclesinthelungs，forthegibbosityandthedistensionareproducedmostlybysuchtubercles，withwhichtheneighboringnervescommunicate。Whenthegibbosityisbelowthediaphragm，insomeofthesecasesnephriticdiseasesandaffectionsofthebladdersupervene，butabscessesofachronicnature，anddifficulttocure，occurintheloinsandgroins，andneitherofthesecarriesoffthegibbosity；andinthesecasesthehipsaremoreemaciatedthanwhenthegibbosityisseatedhigherup；
　　butthewholespineismoreelongatedinthemthaninthosewhohavethegibbosityseatedhigherup，thehairofthepubesandchinisofslowergrowthandlessdeveloped，andtheyarelesscapableofgenerationthanthosewhohavethegibbosityhigherup。Whenthegibbosityseizespersonswhohavealreadyattainedtheirfullgrowth，itusuallyoccasionsacrisisofthethenexistingdisease，butinthecourseoftimesomeofthemattack，asinthecaseofyoungerpersons，toagreaterorlessdegree；but，notwithstanding，forthemostpart，allthesediseasesarelessmalignant。Andyetmanyhavebornetheaffectionwell，andhaveenjoyedgoodhealthuntiloldage，moreespeciallythosepersonswhosebodyisinclinedtobeplumpandfat；andafewofthemhavelivedtobeyondsixtyyearsofage，butthemostofthemaremoreshort—lived。Insomecasesthecurvatureofthespineislateral，thatistosay，eithertotheonesideortheother；themostofsuchcasesareconnectedwithtubercles（abscesses？）withinthespine；andinsome，thepositionsinwhichtheyhavebeenaccustomedtoliecooperatewiththedisease。Butthesewillbetreatedofamongthechronicaffectionsofthelungs；forthesethemostsuitableprognosticsofwhatwillhappeninthesecasesaregiven。
　　42。Whenthespineprotrudesbackward，inconsequenceofafall，itseldomhappensthatonesucceedsinstraighteningit。Whereforesuccussiononaladderhasneverstraightenedanybody，asfarasI
　　know，butitisprincipallypracticedbythosephysicianswhoseektoastonishthemob—fortosuchpersonsthesethingsappearwonderful，forexample，iftheyseeamansuspendedorthrowndown，orthelike；andtheyalwaysextolsuchpractices，andnevergivethemselvesanyconcernwhatevermayresultfromtheexperiment，whetherbadorgood。Butthephysicianswhofollowsuchpractices，asfarasIhaveknownthem，areallstupid。Thedevice，however，isanoldone，andIgivegreatpraisetohimwhofirstinventedthis，andanyothermechanicalcontrivancewhichisaccordingtonature。ForneitherwouldIdespair，butthatifsuccussionwereproperlygoneabout，thespine，incertaincases，mightbetherebyrectified。But，indeed，formyownpart，Ihavebeenashamedtotreatallsuchcasesinthisway，becausesuchmodesofprocedurearegenerallypracticedbycharlatans。
　　43Thosecasesinwhichthegibbosityisneartheneck，arelesslikelytobebenefitedbythesesuccussionswiththeheaddownward，fortheweightofthehead，andtopsoftheshoulders，whenallowedtohangdown，isbutsmall；andsuchcasesaremorelikelytobemadestraightbysuccussionappliedwiththefeethangingdown，sincetheinclinationdownwardisgreaterinthisway。Whenthehumpislowerdown，itismorelikelyinthiscasethatsuccussionwiththeheaddownwardshoulddogood。Ifone，then，shouldthinkoftryingsuccussion，itmaybeappliedinthefollowingmanner：—Theladderistobepaddedwithleatherlinedcushions，laidacross，andwellsecuredtooneanother，toasomewhatgreaterextent，bothinlengthandbreadth，thanthespacewhichtheman’sbodywilloccupy；heisthentobelaidontheladderuponhisback，andthefeet，attheankles，aretobefastened，atnogreatdistancefromoneanother，totheladder，withsomefirmbutsoftband；andheisfurthertobesecured，inlikemanner，bothaboveandbelowtheknee，andalsoatthenates；andatthegroinsandchestlooseshawlsaretobeputroundinsuchafashionasnottointerferewiththeeffectofthesuccussion；andhisarmsaretobefastenedalonghissidestohisownbody，andnottotheladder。Whenyouhavearrangedthesemattersthus，youmusthoistuptheladder，eithertoahightowerortothegable—endofahouse；buttheplacewhereyoumakethesuccussionshouldbefirm，andthosewhoperformtheextensionshouldbewellinstructed，sothattheymayletgotheirholdequallytothesameextent，andsuddenly，andthattheladdermayneithertumbletothegroundoneitherside，northeythemselvesfallforward。But，iftheladderbeletgofromatower，orthemastofaship，fastenedintothegroundwithitscordage，itwillbebetter，sothattheropesrunuponapulleyoraxle—tree。Butitisdisagreeableeventoenlargeuponthesematters；andyet，bythecontrivancesnowdescribed，thepropersuccussionmaybemade。
　　44。Butifthehumpbesituatedveryhighup，andifsuccussionbebyallmeanstobeused，itwillbebettertodoitwiththefeetdownward，ashasbeensaid，fortheforcedownwardwillbethegreaterinthiscase。Thepatientistobewellfastenedtotheladderbycordsatthebreast，attheneckbymeansofaverylooseshawlsoasmerelytokeepthepartproperlyontheladder，andtheheadistobefastenedtotheladderattheforehead，thearmsaretobestretchedalongandattachedtothepatient’sbody，andnottotheladder，andtherestofthebodyisnottobebound，exceptsoastokeepitinplacebymeansofalooseshawlwrappedrounditandtheladder；attention，moreover，shouldbepaidthattheseligaturesdonotinterferewiththeforceofthesuccussion，andthelegsarenottobefastenedtotheladder，butshouldbeplacednearoneanother，soastobeinlinewiththespine。Thesemattersshouldbethusarranged，ifrecourseistobehadatalltosuccussiononaladder；
　　foritisdisgracefulineveryart，andmoreespeciallyinmedicine，aftermuchtrouble，muchdisplay，andmuchtalk，todonogoodafterall。
　　45。Inthefirstplace，thestructureofthespineknown，forthisknowledgeisrequisiteinmanydiseases。Wherefore，onthesideturnedtothebelly（theanterior？）thevertebraeareinaregularline，andareunitedtogetherbyapulpyandnervousbandofconnection，originatingfromthecartilages，andextendingtothespinalmarrow。
　　Therearecertainothernervouscordswhichdecussate，areattached（tothevertebrae？），andareextendedfrombothsidesofthem。Butwewilldescribeinanotherworktheconnectionsoftheveinsandarteries，theirnumbers，theirqualities，theirorigin，theirfunctionalofficesinparticularparts，inwhatsortofsheathsthespinalmarrowisinclosed，wheretheyarise，wheretheyterminate，howtheycommunicate，andwhattheiruses。Ontheoppositeside（behind？）thevertebraeareconnectedtogetherbyaginglymoidarticulation。Commoncords（nerves？）areextendedtoallparts，boththosewithinandwithout。Thereisanosseousprocessfromtheposteriorpartofallandeachofthevertebra，whethergreaterorsmaller；andupontheseprocessestherearecartilaginousepiphyses，andfromthemarisenervousproductions（ligaments？），akintotheexternalnerves（tonoi）。Theribsareunitedtothem，havingtheirheadsinclinedrathertotheinsidethantheout，andeveryoneofthemisarticulatedwiththevertebrae；andtheribsinmanareverycurved，and，asitwere，arched。Thespacebetweentheribsandtheprocessesofthevertebraeisfilledonbothsidesbymuscles，whicharisefromtheneckandextendtotheloins（？）。Thespine，longitudinally，isastraightlineslightlycurved；fromtheossacrumtothegreatvertebrawhichisconnectedwiththearticulationofthefemur，thespineinclinesbackward，forthebladder，theorgansofgeneration，andthelooseportionoftherectum，aresituatedthere。
　　Fromthis，totheattachmentofthediaphragm，thespineinclinesinward，andthisportionalone，fromtheinternalparts，givesorigintomuscles，whicharecalledpsoae。Fromthistothegreatvertebra（seventhcervical？）whichisabovethetopsoftheshoulders，itisconvexbehindlengthways；butitismoreinappearancethanitreallyis，forthespinousprocessesarehighestinthemiddle，andlesssoaboveandbelow。Theregionoftheneckisconvexbefore。
　　46。Incasesofdisplacementbackwardalongthevertebrae，itdoesnotoftenhappen，infact，itisveryrare，thatoneormorevertebraearetornfromoneanotheranddisplaced。Forsuchinjuriesdonotreadilyoccur，asthespinecouldnoteasilybedisplacedbackwardbutbyasevereinjuryontheforepartthroughthebelly（whichwouldprovefatal），orifapersonfallingfromaheightshouldpitchonthenates，orshoulders（andeveninthiscasehewoulddie，butnotimmediately）；anditalsowouldnotreadilyhappenthatsuchadisplacementcouldtakeplaceforward，unlesssomeveryheavyweightshouldfalluponitbehind；foreachoftheposteriorspinalprocessesissoconstructed，thatitwouldsoonerbebrokenthanundergoanygreatinclinationforwardfromaforcewhichwouldhavetoovercometheligamentsandthearticulationsmutuallyconnectingthem。Andthespinalmarrowwouldsuffer，iffromthedisplacementofavertebraitweretobebenteventoasmallextent；forthedisplacedvertebrawouldcompressthespinalmarrow，ifitdidnotbreakit；andifcompressedandstrangled，itwouldinduceinsensibilityofmanygreatandimportantparts，sothatthephysicianneednotgivehimselfanyconcernaboutrectifyingthedisplacementofthevertebra，accompanied，asitis，bymanyotherillconsequencesofaseriousnature。Itisevident，then，thatsuchacasecouldnotbereducedeitherbysuccussionorbyanyothermethod，unlessoneweretocutopenthepatient，andthen，havingintroducedthehandintooneofthegreatcavities，weretopushoutwardfromwithin，whichonemightdoonthedeadbody，butnotatallontheliving。Wherefore，then，doIwriteallthis？Becausecertainpersonsfancythattheyhavecuredpatientsinwhomthevertebrahadundergonecompletedislocationforward。Some，indeed，supposethatthisistheeasiestofallthesedislocationstoberecoveredfrom，andthatsuchcasesdonotstandinneedofreduction，butgetwellspontaneously。Manyareignorant，andprofitbytheirignorance，fortheyobtaincreditfromthoseaboutthem。Thesearedeceivedinthisway，fortheysupposethespinousprocessestobethevertebraethemselves，becauseeveryoneofthemappearsroundtothetouch，notknowingthatthesebonesareprocessesfromthevertebrae，asformerlystated；butthevertebraeareataconsiderabledistancebeforethem；forofallanimals，man，inproportiontohisbulk，hasthebelly（internalcavity？）thenarrowestfrombehindtobefore，especiallyatthebreast。When，therefore，anyoftheseprocessesareseverelyfractured，whetheroneormore，thepartthereappearslowerthanoneitherside，andforthatreasontheyaredeceived，supposingthatthevertebraearedisplacedinward。Andthepatientcontributealsotodeceivethem；foriftheyattempttoputthemselvesintoabentposition，theyarepained，fromtheskinbeingstretchedattheseatoftheinjury，andatthesametimethefragmentsoftheboneswoundtheskinstillmore；butiftheybendforward，theyfeeleasier，fortheskinatthewoundisthusrelaxed，andthebonesarelessdisposedtohurtthem；andiftouched，theyshrinkandbendforward，andthepartwhichistouchedappearsemptyandsoft。Allthecircumstancesnowmentionedcontributetodeceivethephysician。Suchpatientsspeedilygetwellwithoutanybadeffects，forcallusreadilyformsinallsuchbonesasareporous。
　　47。Therearemanyvarietiesofcurvatureofthespineeveninpersonswhoareingoodhealth；forittakesplacefromnaturalconformationandfromhabit，andthespineisliabletobebentfromoldage，andfrompains。Gibbosities（orprojectionsbackward）fromfallsgenerallytakeplacewhenonepitchesonthenates，orfallsontheshoulders。Inthiscasesomeoneofthevertebraemustnecessarilyappearhigherthannatural，andthoseoneithersidetoalessdegree；butyetnoonegenerallyhasstartedoutofthelineoftheothers，buteveryonehasyieldedalittle，sothataconsiderableextentofthemiscurved。Onthisaccountthespinalmarroweasilybearssuchdistortions，becausetheyareofacircularshape，andnotangular。Theapparatusforthereductioninthiscasemustbemanagedinthefollowingmanner：astrongandbroadboard，havinganoblongfurrowinit，istobefastenedintheground，or，inplaceoftheboard，wemayscoopoutanoblongfurrowinthewall，aboutacubitabovethefloor，oratanysuitableheight，andthensomethinglikeanoakenbench，ofaquadrangularshape，istobelaidalong（thewall？）atadistancefromthewall，whichwilladmitofpersonstopassroundifnecessary，andthebenchistobecoveredwithrobes，oranythingelsewhichissoft，butdoesnotyieldmuch；andthepatientistobestovedwithvapor，ifnecessary，orbathedwithmuchhotwater，andthenheistobestretchedalongtheboardonhisface，withhisarmslaidalongandboundtohisbody；themiddle，then，ofathongwhichissoft，sufficientlybroadandlong，andcomposedoftwocrossstrapsofleather，istobetwicecarriedalongthemiddleofthepatient’sbreast，asnearthearmpitsaspossible，thenwhatisoverofthethongsatthearmpitsistobecarriedroundtheshoulders，andafterwardtheendsofthethongaretobefastenedtoapieceofwoodresemblingapestle；theyaretobeadaptedtothelengthofthebenchlaidbelowthepatient，andsothatthepestle—likepieceofwoodrestingagainstthisbenchmaymakeextension。Anothersuchbandistobeappliedabovethekneesandtheankles，andtheendsofthethongsfastenedtoasimilarpieceofwood；andanotherthong，broad，soft，andstrong，intheformofaswathe，havingbreadthandlengthsufficient，istobeboundtightlyroundtheloins，asnearthehipsaspossible；andthenwhatremainsofthisswathelikethong，withtheendsofthethongs，mustbefastenedtothepieceofwoodplacedatthepatient’sfeet，andextensioninthisfashionistobemadeupwardanddownward，equallyandatthesametime，inastraightline。Forextensionthusmadecoulddonoharm，ifproperlyperformed，unlessonesoughttodomischiefpurposely。Butthephysicians，orsomepersonwhoisstrong，andnotuninstructed，shouldapplythepalmofonehandtothehump，andthen，havinglaidtheotherhandupontheformer，heshouldmakepressure，attendingwhetherthisforceshouldbeapplieddirectlydownward，ortowardthehead，ortowardthehips。Thismethodofapplyingforceisparticularlysafe；anditisalsosafeforapersontosituponthehumpwhileextensionismade，andraisinghimselfup，tolethimselffallagainuponthepatient。Andthereisnothingtopreventapersonfromplacingafootonthehump，andsupportinghisweightonit，andmakinggentlepressure；oneofthemenwhoispracticedinthepalestrawouldbeaproperpersonfordoingthisinasuitablemanner。Butthemostpowerfulofthemechanicalmeansisthis：iftheholeinthewall，orinthepieceofwoodfastenedintotheground，bemadeasmuchbelowtheman’sbackasmaybejudgedproper，andifaboard，madeoflimetree，oranyotherwood，andnottoonarrow，beputintothehole，thenarag，foldedseveraltimesorasmallleathercushion，shouldbelaidonthehump；nothinglarge，however，shouldbelaidontheback，butjustasmuchasmaypreventtheboardfromgivingunnecessarypainbyitshardness；butthehumpshouldbeasmuchaspossibleonalinewiththeholemadeinthewall，sothattheboardintroducedintoitmaymakepressuremoreespeciallyatthatespeciallyatthatspot。Whenmattersarethusadjusted，oneperson，ortwoifnecessary，mustpressdowntheendoftheboard，whilstothersatthesametimemakeextensionandcounter—extensionasalongthebody，asformerlydescribed。Extensionmayalsobemadewithaxles，whichmayeitherbefastenedinthegroundbesidethebench，orthepostoftheaxlesmaybeattachedtothebenchitself，ifyouwillmakethemperpendicularandovertopping（thebench？）alittleatbothends，orateitherendofthebench。Thesepowersareeasilyregulated，soastobemadestrongerorweaker，andtheyareofsuchforce，thatifoneweretohaverecoursetothemforamischievouspurpose，andnotasaremedy，theywouldoperatestronglyinthiswayalso；forbymakingmerelyextensionandcounter—extensionlongitudinally，withoutanyadditionalforce，onemightmakesufficientextension；andif，withoutmakingextensionatall，onewereonlytopressdownproperlywiththeboard，sufficientforcemightbeappliedinthisway。Suchpowers，then，areexcellentwhichadmitofbeingsoregulated，thattheycanbemadeweakerandstrongerasrequired。
　　Andtheforcesareappliedinthenaturalway；forthepressureaboveforcesthedisplacedpartsintotheirplace。Naturalextensionrestorespartswhichhavecometoonearoneanothertotheirnaturalposition。I，then，amacquaintedwithnopowerswhicharebetterormoreappropriatethanthese；forextensionalongthespinedownwardhasnoproperholdatthebonecalledtheossacrum；andextensionupward，alongtheneckandhead，hasindeedahold；butextensionthusmadeisunseemlytobehold，and，besides，ifincreased，mayoccasionmuchmischiefotherwise。Ioncemadetrialofthefollowingplan。
　　Havingplacedthepatientonhisback，Iputbelowthehumpabladder，notinflated，andafterwardintroducedairintothebladderbymeansofabrasspipeconnectedwithit。Buttheexperimentdidnotsucceed；
　　for，whenthemanwasfairlyextended，thebladderyielded，andtheaircouldnotbeforcedintoit；and，besides，thehumpofthepatientwasapttoslipoffthedistendedbladderwhentheywerepressedtogether。ButwhenIdidnotextendthemanstrongly，thebladderwasswelledupbytheair，andthemanbecamemorebentforwardthanproper。Ihavewrittenthisexpressly；foritisavaluablepieceofknowledgetolearnwhatthingshavebeentriedandhaveprovedineffectual，andwhereforetheydidnotsucceed。
　　48。Incurvaturesforwardofthevertebraefromafall，orfromsomeheavybodyfallinguponthem，ingeneralnooneofthemisdisplacedfarbeyondtheothers，butifoneormorebesodisplaced，thecaseprovesfatal；but，notwithstanding，asformerlystated，thedisplacementiscircular，andnotangular。Insuchcases，then，theurineandfaecesaremoreapttoberetainedthanindisplacementoutward，thefeetandthewholeinferiorextremitiesarecolder，andthesymptomsaremorefatalthanintheformercase；andiftheydosurvive，theyaremoresubjecttoretentionoftheurine，andtolossofstrength，andtotorporintheirlegs。Butifthedisplacementbeintheupperpart，theyexperiencelossofstrengthandtorporofthewholebody。Iknownomechanicalcontrivancebywhichsuchadisplacementcouldbereduced，unlessthatonemightbebenefitedbysuccussiononabladder，oranyothersimilarplanoftreatment，suchasextension，asformerlydescribed。Iamnotawareofanymodeofpressurewhichmightbeappliedalongwiththeextension，likethatoftheboardindisplacementbackward；forhowcouldoneapplypressurefrombeforethroughthebelly？（internalcavity？）Thethingisimpossible。Butneithercoughingnorsneezinghasanypowersoastocooperatewiththeextension，norwouldtheinjectionofairintothebowelshaveanyeffect。Andtoapplylargecuppinginstrumentswiththeviewofdrawingbackthevertebraewhichhaveprotrudedforward，showsagreaterrorofjudgment；fortheyratherpropelthanattract，andthosewhoapplythemarenotawareevenofthisfact，forthegreaterwillbetheinclinationforwardthegreatertheinstrumentapplied，theskinbeingforciblydrawnintothecupping—instrument。Icouldtellofothermodesofsuccussionthanthoseformerlydescribed，whichonemightfancywouldbemoreapplicableinsuchanaffection；butIhavenogreatconfidenceinthem，andthereforeIdonotdescribethem。Onthemain，itshouldbeknown，respectingtheaccidentswhichIhavebrieflydescribed，thatdisplacementsforwardareofafatalandinjuriousnature；butthatdisplacementsbackward，forthemostpart，donotprovefatal，noroccasionretentionofurinenortorporofthelimbs，fortheydonotstretchtheductsleadingtowardtheintestines，noroccasionobstructionofthesame；butdisplacementsforwardproduceboththesebadeffects，andmanyothersinaddition。Andtrulytheyaremoreapttolosethepoweroftheirlegsandarms，tohavetorporofthebody，andretentionofurine，whoexperiencenodisplacementeitherforwardorbackward，butmerelyaviolentconcussionalongthespine，whilethosewhohavedisplacementbackwardareleastsubjecttothesesymptoms。
　　49。Andonemightobservemanyotherinstancesinmedicine，ofconsiderableinjuriesnotprovingserious，butproducingacrisisinsomeaffection，whilelessconsiderableinjuriesprovemoreserious，giverisetochronicdiseases，andextendtheireffectstothewholesystem。Nowsomethingsimilarmayhappeninfractureoftheribs；
　　forinfractureofoneormoreribs，ingeneral，ifthefracturedbonesarenotdriveninward，norarelaidbare，feverrarelysupervenes，neitherdoesitoftenhappenthatthereishaemoptysis，empyema，andsuppuratingsores，whichrequiretreatmentwithpledgets，nornecrosisofthebones；andinthesecasestheordinaryregimenissufficient。For，unlesstheybeseizedwithcontinualfever，astrictdietdoesmoreharmthangood，byinducinginanition，andincreasingthepain，fever，andcough；formoderatefullnessoftheintestineshasatendencytoreplacetheribs，whileevacuationleadstosuspensionoftheribs，andsuspensioninducespain。Ordinarybandaging，externally，issufficientinsuchcases；thebandagesshouldbeappliedmoderatelytight，alongwithcerateandcompresses，orapadofwoolmaybeapplied。Theribisconsolidatedintwentydays，forcallussoonformsinsuchbones。
　　50。Butwhenthereiscontusionofthefleshabouttheribs，eitherfromablow，orafall，orabruise，oranylikecause，thereisoftencopiousvomitingofblood，fortherearecanalsstretchedalongthevacuityofeachrib（intercostalspace？），andnervesproceedingfromthemostimportantpartsofthebodyhavetheiroriginthere。Manyofthese，therefore，aretroubledwithcoughs，tubercles，empyema，externalsuppurations，andsphacelusoftheribs。Andevenwhennosuchsymptomssupervenefromcontusionoftheskinabouttheribs，stillinsuchcasesthereis，generally，morecombinedpainthaninfracturesoftheribs，andrelapsesofpainintheseatoftheinjuryaremoreapttooccur。Whereforesomephysicianspaymuchlessattentiontosuchinjuries，thanwheretheribisfractured，whereas，iftheywerewise，theywouldtreatsuchcaseswithfargreatercarethantheother；foritisproperthatthedietshouldberestricted，thatthepatientsshouldremainatrestasmuchaspossible，andabstainfromvenery，fromfatarticlesoffood，fromsuchasexcitecough，andfromeverythingstrong；theyshouldbebledinthearm，speakaslittleaspossible，shouldhavethecontusedpartboundroundwithfoldedcompresses，plentyofbandages，broaderthanthecontusion，andwhichshouldbesmearedwithcerate；inapplyingthebandages，broadandsoftshawlsshouldbeused，andtheyshouldbeputonmoderatelyfirm，sothatthepatientwillsaythattheyareneithertootightnorloose，andthebandagingshouldcommenceattheseatoftheinjury，andbemademoreparticularlytightthere，andthebandagingshouldbeconductedasisdonewithadouble—headedroller，sothattheskinabouttheribsmaynotberuffled，butmayliesmooth，andthebandagingshouldberenewedeveryday，oreveryalternateday。Itisbetteralsotoopenthebowelswithsomegentlemedicine，soasjusttoproduceanevacuationofthefood，andthedietistoberestrictedfortendays，andthenthebodyistoberecruitedandfilledup；whileyouareuponthereducingsystem，thebandagingshouldbetighter，butwhenyouaremakinghimupagain，itmustbelooser；and，ifhespitbloodfromthecommencement，thetreatmentandbandagingshouldbecontinuedforfortydays；butiftherebenohaemoptysis，treatmentfortwentydayswillgenerallybesufficient；butthelengthoftimemustberegulatedbythemagnitudeoftheinjury。Whensuchcontusionsareneglected，ifnogreatermischiefresulttherefrom，atalleventsthebruisedparthasitsfleshmorepulpythanithadformerly。When，therefore，anysuchthingisleftbehind，andisnotproperlydissipatedbythetreatment，itwillbeworseifthemucositybelodgednearthebone，forthefleshnolongeradherestotheboneasformerly，thebonebecomesdiseased，andchronicsloughingsoftheboneinmanycasesarisefromsuchcauses。Butifthemischiefbenotuponthebone，butitisthefleshitselfwhichispulpy，relapsesandpainswillreturnfromtimetotime，iftherehappentobeanydisorderinthebody；whereforeproperbandaging，andforaconsiderabletime，mustbehadrecourseto，untiltheextravasatedbloodforminginthebruisebedriedupandabsorbed，andthepartbemadeupwithsoundflesh，andthefleshadheretothebone。Thebestcureisthecauteryinthosecaseswhich，fromneglect，havebecomechronic，andtheplaceturnspainful，andthefleshispulpy。
　　Andwhenthefleshitselfispulpy，theburningshouldbecarriedasfarasthebone，buttheboneitselfshouldnotbeheated；butifitbeintheintercostalspace，youneednotmaketheburningsosuperficial，onlyyoumusttakecarenottoburnquitethrough。Butifthecontusionappeartobeatthebone，ifitbestillrecent，andthebonehasnotyetbecomenecrosed，ifitbeverysmall，itistobeburnedashasbeendescribed；butiftherisingalongthebonebeoblong，severalescharsaretobeburnedoverit。Necrosisoftheribwillbedescribedalongwiththetreatmentofsuppuratingsores。
　　51。Therearefourmodesofdislocationatthehip—joint：ofwhichmodes，dislocationinwardtakesplacemostfrequently，outward，themostfrequentlyofalltheothermodes；anditsometimestakesplacebackwardandforward，butseldom。When，therefore，dislocationtakesplaceinward，thelegappearslongerthannatural，whencomparedwiththeotherleg，fortworeasonstruly；forthebonewhicharticulateswiththehip—jointiscarriedfromabovedowntotheischiumwhereitrisesuptothepubes，uponit，then，theheadofthefemurrests，andtheneckofthefemurislodgedinthecotyloidforamen（foramenthyroideum？）。Thebuttockappearshollowexternally，fromtheheadofthethighbonehavingshiftedinward，andtheextremityofthefemuratthekneeisturnedoutward，andthelegandfootinlikemanner。Thefootthenbeingturnedoutward，physicians，fromignorance，bringthesoundlegtoitandnotittothesoundleg；onthisaccount，theinjuredlimbappearstobemuchlongerthanthesoundone，andinmanyothercasessimilarcircumstancesleadtoerrorinjudgment。Neitherdoesthelimbatthegroinadmitofflexionasinthesoundlimb，andtheheadoftheboneisfeltattheperineumtooprominent。These，then，arethesymptomsattendingdislocationofthethighinward。
　　52。When，then，adislocationhasnotbeenreduced，buthasbeenmisunderstoodorneglected，theleg，inwalking，isrolledaboutasisthecasewithoxen，andtheweightofthebodyismostlysupportedonthesoundleg，andthelimbattheflank，andthejointwherethedislocationhasoccurredisnecessarilyhollowandbent，whileonthesoundsidethebuttockisnecessarilyrounded。Forifoneshouldwalkwiththefootofthesoundlegturnedoutward，theweightofthebodywouldbethrownupontheinjuredlimb，buttheinjuredlimbcouldnotcarryit，forhowcouldit？One，then，isforcedinwalkingtoturntheleginward，andnotoutward，forthusthesoundlegbestsupportsitsownhalfofthebody，andalsothatoftheinjuredside。Butbeinghollowattheflankandthehip—joint，theyappearsmallinstature，andareforcedtorestonastaffatthesideofthesoundleg。Fortheyrequirethesupportofastaffthere，sincethenatesinclinestothisside，andtheweightofthebodyiscarriedtoit。Theyareforcedalsotostoop，fortheyareobligedtorestthehandonthesideofthethighagainsttheaffectedlimb；forthelimbwhichisinjuredcannotsupportthebodyinchangingthelegs，unlessitbeheldwhenitisappliedtotheground。Theywhohavegotanunreduceddislocationinwardareforcedtoputthemselvesintotheseattitudes，andthisfromnopremeditationontheirparthowtheyshouldassumetheeasiestposition，buttheimpedimentitselfteachesthemtochoosethatwhichismostconformabletotheirpresentcircumstances。Forpersonswhohaveasoreonthefoot，orleg，andcannotrestuponthelimb，all，evenchildren，walkinthisway；fortheyturntheinjuredlimboutwardinwalking，andtheyderivetwoadvantagestherefrom，tosupplytwowants；theweightofthebodyisnotequallythrownuponthelimbturnedoutward，asupontheoneturnedinward，forneitheristheweightinalinewithit，butismuchmorethrownupontheoneunderthebody；fortheweightisinastraightlinewithit，bothinwalkingandintheshiftingofthelegs。Inthispositiononecanmostquicklyturnthesoundlimbunderthebody，bywalkingwiththeunsoundlimboutward，andthesoundinward。Inthecasewearenowtreatingof，itiswellthatthebodyfindsouttheattitudeswhicharetheeasiestforitself。
　　Thosepersons，then，whohavenotattainedtheirgrowthatthetimewhentheymetwithadislocationwhichisnotreduced，becomemaimedinthethigh，theleg，andthefoot，forneitherdothebonesgrowproperly，butbecomeshortened，andespeciallytheboneofthethigh；andthewholelimbisemaciated，losesitsmuscularity，andbecomesenervatedandthinner，bothfromtheimpedimentatthejoint，andbecausethepatientcannotusethelimb，asitdoesnotlieinitsnaturalposition，foracertainamountofexercisewillrelieveexcessiveenervation，anditwillremedyinsofarthedeficiencyofgrowthinlength。Thosepersons，then，aremostmaimedwhohaveexperiencedthedislocationinutero，nextthosewhohavemetwithitininfancy，andleastofall，thosewhoarefullgrown。Themodeofwalkingadoptedbyadultshasbeenalreadydescribed；butthosewhoarechildrenwhenthisaccidentbefallsthem，generallylosetheerectpositionofthebody，andcrawlaboutmiserablyonthesoundleg，supportingthemselveswiththehandofthesoundsiderestingontheground。Some，also，whohadattainedmanhoodbeforetheymetwiththisaccident，havealsolostthefacultyofwalkingerect。Thosewhowerechildrenwhentheymetwiththeaccident，andhavebeenproperlyinstructed，standerectuponthesoundleg，butcarryaboutastaff，whichtheyapplyunderthearmpitofthesoundside，andsomeuseastaffinbotharms；theunsoundlimbtheybearup，andthesmallertheunsoundlimb，thegreaterfacilityhavetheyinwalking，andtheirsoundlegisnolessstrongthanwhenbotharesound。Thefleshypartsofthelimbareenervatedinallsuchcases，butthosewhohavedislocationinwardaremoresubjecttothislossofstrengththan，forthemostpart，thosewhohaveitoutward。
　　53。SometellastoryhowtheAmazonianwomendislocatethejointsoftheirmalechildrenwhilemereinfants，someattheknee，andothersatthehip—joint，thattheymaybemaimed，andthatthemalesexmaynotconspireagainstthefemale，andthattheyusethemasartisanstoperformanysedentarywork，suchasthatofashoemakerorbrazier。WhetherthesethingsbetrueornotIdonotknow，butthisI
　　know，thatmatterswouldbesuchasisrepresented，providedtheirchildren，whileinfants，weretohavetheirjointsdislocated。Theconsequencesofdislocationinwardatthehip—jointaremuchgreaterthanofdislocationoutwardatthehip—joint，butattheknee，althoughtherebesomedifference，itisless；butthemodeofeitherimpedimentispeculiar，theirlegsaremorebandiedwhenthedislocationisoutward，butthosewhohavedislocationinwardstanderectontheirfeetwithlessfreedom。Inlikemanner，whenthedislocationisattheanklejoint，ifoutwardtheybecomevari（theirtoesareturnedinward？），buttheycanstand；butifthedislocationbeinwardtheybecomevalgi（theirtoesareturnedoutward？），buttheyhavelessfreedomofstanding。Theproportionalgrowthoftheirbonesisasfollows：inthosecasesinwhichtheboneofthelegisdislocated，thebonesofthefeetgrowverylittle，asbeingveryneartheinjury，butthebonesofthelegincreaseinsize，andwithverylittledefect，butthefleshyparts（muscles？）arewasted。Butwhentheankle—jointisinitsnaturalstate，butthekneeisdislocated，inthesecasesthebonesofthelegdonotgrowinlikemanner，butbecomeshortened，asbeingnearesttheseatoftheinjury，andthebonesofthefeetalsoareatrophied，butnotinthesameproportion；because，aswassaidalittlewhileago，theankle—jointissafe，andiftheycoulduseit，asinthecaseofclub—foot，thebonesofthefootwouldbestilllessatrophied。Whenthedislocationtakesplaceatthehip—joint，theboneofthethigh，inthiscase，doesnotgenerallygrowinlikemanner，asbeingtheonenearesttheseatoftheinjury，butbecomesshorterthanthesoundone；butthegrowthofthebonesofthelegisnotarrestedinlikemanner；norofthoseofthefeet，forthisreason，thatthereisnodisplacementbetweenthebonesofthethighandleg，norbetweenthoseofthelegandfoot；inthosecases，however，thefleshypartsofthewholelimbareatrophied；butiftheycouldmakeuseofthelimb，thegrowthoftheboneswouldbestillmoredeveloped，asformerlystated，onlythethigh，althoughitsfleshwouldbemuchlesswasted，wouldstillbebynomeanssofleshyasthesoundlimb。Thefollowingobservationsareaproofofthis：thosepersonswhoareweasel—armed（galiancones）frombirth，owingtodislocationofthehumerus，orwhentheaccidenthashappenedtothembeforetheyhaveattainedtheirfullgrowth，suchpersonshavetheboneofthearmshortened，butthoseofthefore—armandhandarelittleinferiorinsizetothesound，forthereasonswhichhavebeenstated，becausethehumerusisthebonenearesttothejointaffected，and，onthataccount，itisshorterthannatural；butthefore—armisnotequallyaffectedbytheaccident，becausethejointatwhichthebonesofthearmandforearmarearticulatedremainsinitsnaturalcondition，andthehandisstillfurtherdistantthanthefore—armfromtheseatoftheinjury。Sucharethereasonswhycertainofthebonesinthiscaseincreaseingrowth，andcertaindonot。Thelaboriousofficeofthehandcontributesmuchtothedevelopmentofthefleshinthefore—armandhand，forwhateverworkisdonebythehand，theseweasel—armedpersonsstrivetodonolesseffectuallywiththeotherhandthanwiththesound；forthearmsdonotsupporttheweightofthebodylikethelegs，andtheworkperformedbythemislight。Fromexercise，then，thefleshypartsonthehandandfore—armarenotatrophiedinweasel—armedpersons，andbythesemeansthearm，too，gainsflesh。Butindislocationinwardatthehip—joint，whetherfrombirthorfromchildhood，thefleshyparts，onthataccount，aremuchmoreatrophiedthanthoseofthehand，becausethepatientscannotexercisetheleg。Anotherproofwillbegivenintheobservationswhichwillbepresentlystated，thatthesethingsaresuchasIthingsaresuchasIhaverepresented。
　　54。Whentheheadofthefemurisdislocatedoutward，thelimbinthesecases，whencomparedwiththeother，appearsshortened，andthisisnatural，fortheheadofthefemurnolongerrestsonaboneasindislocationinward，butalongthesideofabonewhichnaturallyinclinestotheside，anditislodgedinfleshofapulpyandyieldingnature，andonthataccountitappearsmoreshortened。
　　Inwardly，thethighabouttheperineumappearsmorehollowandflabby，butexternallythebuttockismorerounded，fromtheheadofthethighhavingslippedoutward，butthenatesappeartoberaisedup，owingtothefleshtherehavingyieldedtotheheadofthethigh—bone；buttheextremityofthethigh—bone，attheknee，appearstobeturnedinward，andthelegandfootinlikemanner，neitherdoesitadmitofflexionlikethesoundlimb。These，then，arethesymptomsofdislocationoutward。
　　55。Whensuchadislocationisnotreducedinadults，thewholelimbappearstobeshortened，andinwalkingtheycannotreachthegroundwiththeheel，buttheywalkwiththeballofthefootontheground，andthepointsoftheirtoesinclinealittleinward。Buttheinjuredlimb，inthiscase，cansupportthebodymuchbetterthanindislocationinward，bothbecausetheheadofthefemurandtheneckofitsarticularextremity，beingnaturallyoblique，haveformedabedunderaconsiderableportionofthehip，andbecausetheextremityofthefootisnotforciblyturnedoutward，butisnearlyinalinewiththebody，andiseveninclinedmoreinwardly。
　　When，then，thearticularextremityofthefemurhaswornoutasocketforitselfinthefleshwhereitwaslodged，andthefleshislubricated，itceasestobepainfulinthecourseoftime，andwhenitbecomesfreefrompain，theycanwalkwithoutastaff，ifsoinclined，andtheycansupportthebodyontheinjuredlimb。Fromusagethen，insuchcases，thefleshypartsarelessenervatedthaninthosewhichhavebeenmentionedalittlebefore，still，however，theylosetheirstrengthmoreorless；butingeneralthereismoreenervationwhenthedislocationisinwardthanwhenitisoutward。Someofthem，then，cannotweartheirshoes，owingtotheunbendingstateoftheirleg，andsomeofthemcan。Butwhenthisdislocationtakesplaceinutero，andwhenthedislocationhavingoccurredatanytimebeforemanhood，fromviolence，hasnotbeenreplaced，orwhenfromdiseasethearticularextremityhasstartedfromitssocket，andisdisplaced（formanysuchcasesoccur，andfromsomeofthem，ifthefemurbecomenecrosed，obstinatesuppurationsrequiringtheuseoftentsareformed，andincertainofthemtheboneislaidbare），whetherthebonebecomenecrosedornot，theboneofthethighismuchshortened，anddoesnotusuallygrowlikethesoundone，thebones，too，oftheleg，becomeshorterthanthoseoftheother，butinasmalldegree，forthesamereasonsthatwereformerlystated；suchpersonscanwalk，someoftheminthesamefashionasadultshavinganunreduceddislocation，andsomeofthemwalkwiththewholefootontheground，butlimpinwalking，beingobligedtodosobytheshortnessofthelimb。Suchistheresult，eventhoughtheybecarefullyandproperlytrainedintheattitudesbeforetheyhavestrengthforwalking，andinlikemanneralso，aftertheyhaveacquiredthenecessarystrength；butthosepersonsrequirethemostcarewhowereveryyoungwhentheymetwiththeaccident，for，ifneglectedwhilechildren，thelimbbecomesentirelyuselessandatrophied。Thefleshypartsoftheentirelimbaremorewastedthanthoseofthesoundlimb，butthisismuchlessapttohappenintheircasethanindislocationinward，owingtousageandexercise，astheyarespeedilyabletomakeuseofthelimb，aswasstatedalittlebeforewithregardtotheweasel—armed（galiancones）。