Part 1
I am acquainted with one form in which the shoulder-joint is dislocated,
namely, that into the armpit; I have never seen it take place upward
nor outward; and yet I do not positively affirm whether it might be
dislocated in these directions or not, although I have something which
I might say on this subject. But neither have I ever seen what I considered
to be a dislocation forward. Physicians, indeed, fancy that dislocation
is very apt to occur forward, and they are more particularly deceived
in those persons who have the fleshy parts about the joint and arm
much emaciated; for, in all such cases, the head of the arm appears
to protrude forward. And I in one case of this kind having said that
there was no dislocation, exposed myself to censure from certain physicians
and common people on that account, for they fancied that I alone was
ignorant of what everybody else was acquainted with, and I could not
convince them but with difficulty, that the matter was so. But if
one will strip the point of the shoulder of the fleshy parts, and
where the muscle (
deltoid?) extends, and also lay bare the tendon
that goes from the armpit and clavicle to the breast (
pectoral muscle?),
the head of the humerus will appear to protrude strongly forward,
although not dislocated, for the head of the humerus naturally inclines
forward, but the rest of the bone is turned outward. The humerus is
connected obliquely with the cavity of the scapula, when the arm is
stretched along the sides; but when the whole arm is stretched forward,
then the head of the humerus is in a line with the cavity of the humerus,
and no longer appears to protrude forward. And with regard to the
variety we are now treating of, I have never seen a case of dislocation
forward;
[p. 211]and yet I do not speak decidedly respecting it, whether such
a dislocation may take place or not. When, then, a dislocation into
the armpit takes place, seeing it is of frequent occurrence, many
persons know how to reduce it, for it is an easy thing to teach all
the methods by which physicians effect the reductions, and the best
manner of applying them. The strongest of those methods should be
used when the difficulty of reduction is particularly great. The strongest
is the method to be last described.
