Fifth wheels were developed to allow the front axel of a carriage or cart to pivot, effectively turning it in to a dolly that was the hooked to a team.
They were developed directly from the original way of attaching the other four wheels on the carriage just turned sideways. It is pretty much a miniature wheel placed between the axel and suspension.
Always a good quiz to ask someone where the 19th and 20th wheels are on an 18 wheel tractor trailer.
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Shouldn't it be called an 11th wheel?