CHAP. XXXI. Of the dislocation of the Elbow.
* 1.1 THe Elbow may also be four manner of wayes dislocated; to wit, inwardly, outwardly, up∣wards, and downwards. By the part which is inwards, I mean that which looks towards the center of the body, when as the arm is placed in a natural site, to wit, in a middle figure between prone and supine; I make the outward part, that which is contrary thereto. By the upper part I mean 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 cavities than that of the shoulder, by so much when it is luxated it is the more difficultly 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 arm do receive and enter each other by that manner of articulation which is termed Ginglymus, as we 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 there∣of of are not turned about the shoulder-bone in a full orb, and by an absolute turning. Wherefore if at any time the cubit be bended more straitly and closely than that the inner process can retain its place and station in the bottom of its sinus, the hind-process falleth out and is dislocated back∣wards: But when as the fore-process is extended more violently, and forced against the bottom of its cavity, it slyes and departs out of its place as beaten or forced thence, and this kind of luxa∣tion is far more difficultly restored than the former: adde hereunto, that the utter extremity of the cubit, which is called Ol••cranum, is the higher, but the other inner is the lower; whence it is that every one can better and more easily bend than extend their cubits: Therefore such a dislo∣cation is caused by a more violent force, than that which is made to the inner side.* 1.2 The sign of this luxation is, the arm remains extended, neither can it be bended, for the inner process stayes in the external cavity which is hollowed in the bottom of the shoulder-bone, which formerly was possessed by the inner part of the Olecranum; which thing makes the restitution difficult, for that this process is kept, as it were, imprisoned there: But when it falleth out dislocated to the fore∣part, the arm is crooked, neither is it extended, and it is also shorter than the other. But if the elbow be fallen out of its place according to the other manner of dislocations, to wit, upwards or downwards, the natural figure thereof is perverted, for the arm is stretched forth, but little not∣withstanding bended towards that part from whence the bone went, that is, figured after a middle manner between bending and extending thereof. What kind soever of dislocation shall befall it, the action of the elbow will either not be at all, or certainly not well, untill that it be restored to its former place; there is a swelling in the part whereinto it is flown, and a cavity there from whence it is fled,* 1.3 which also happens in the dislocations of all other parts. Furthermore, one dis∣location of the elbow is compleat 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 happens, and not unless with great violence, so it is not so easily restored again, especially if that you do not prevent inflammation, for being inflamed it makes the restitution either difficult, or wholly impossible, principally that which falleth outwards.