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CHAP. XXXI. Of the dislocation of the Elbow.
THe Elbow may also be foure manner of wayes dislocated, to wit, inward∣ly, * 1.1 outwardly, upwards and downewards. By the part which is inwards, I meane that which lookes towards the center of the body, when as the arme is placed in a naturall site, to wit, in a middle figure betweene prone and supine; I make the outward part, that which is contrary thereto. By the upper part I meane that which is towards the heaven, and by the lower that which is next to the earth: and by how much the joint of the elbow consists of more heads and ca∣vities, than that of the shoulder, by so much when it is luxated it is the more diffi∣cultly set, and it is also more subject to inflammation, and to grow hard thereupon, as Hippocrates saith. Now the joint of the elbow is more difficultly dislocated than that of the shoulder, and more hardly set, for that the bones of the cubit and arme doe receive and enter each other by that manner of articulation which is termed Ginglymus, as wee have formerly more at large treated in our Anatomy, and a little before in our treatise of fractures. The Elbow is therefore dislocated, for that the processes thereof are not turned about the shoulder-bone in a full orbe, and by an ab∣solute turning. Wherefore if at any time the cubit be bended more straitly and close∣ly than that the inner processe can retaine its place and station in the bottom of its si∣nu••, the hinde processe falleth out and is dislocated backwards. But when as the fore∣processe is extended more violently, and forced against the bottom of its cavity, it flyes and departs out of its place as beaten or forced thence, and this kinde of luxati∣on is farre more difficultly restored than the former: adde hereunto that the utter ex∣tremitie of the cubite, which is called Olecranum, is the higher, but the other inner is * 1.2 the lower; whence it is that every one can better and more easily bend than extend their cubits. Therfore such a dislocation is caused by a more violent force, than that which is made to the inner side. The signe of this luxation is, the arme remaines ex∣tended, neither can it be bended, for the inner processe stayes in the externall cavity, which is hollowed in the bottom of the shoulder-bone, which formerly was posses∣sed by the inner part of the Olecranum; which thing makes the restitution difficult, for that this processe is kept, as it were, imprisoned there. But when it falleth out dislocated to the fore part, the arme is crooked, neither is it extended, and it is also shorter than the other. But if the elbow bee fallen out of its place according to the other manner of dislocations, to wit, upwards or downewards, the naturall figure thereof is perverted, for the arme is stretched forth, but little notwithstanding ben∣ded towards that part from whence the bone went, that is, figured after a middle manner betweene bending and extending thereof. What kinde soever of dislocati∣on shall befall it, the action of the Elbow will either not bee at all, or certainely not well untill that it be restored to its former place; there is a swelling in the part wher∣into it is flowne, and a cavity there from whence it is fled, which also happens in the dislocations of all other parts. Furthermore, one dislocation of the Elbow is com∣pleat and perfect, another imperfect. The latter as it easily happens, and through a small occasion, so it is easily restored; but on the contrary a perfect, as it hardly hap∣pens, and not unlesse with great violence, so it is not so easily restored againe, especi∣ally if that you doe not prevent inflammation, for being inflamed it makes the resti∣tution either difficult, or wholly impossible, principally that which falleth outwards.