44. If to these signs be added the circumstances which accompany the accident, the severe pain that is always felt, the crack which is sometimes heard by the patient, and the possibility of producing a perceptible crepitation, by rubbing the fragments in contrary directions, after having first brought them together, it will be difficult to be mistaken respecting the existence of the fracture, which indeed the swelling of the part alone can conceal from the practitioner, if, as sometimes happens, it be considerable. But then, being soon dispersed, either spontaneously, or by the action of discutients, it leaves the accident unmasked, accompanied by the signs just enumerated. 45. To the swelling is oftentimes added, an echymosis more or less considerable, when the accident has been produced by a fall on the elbow. But by this, no change is effected in the essential characters, which are always sufficient to distinguish a fracture from a luxation backwards, with which it has been sometimes confounded, as appears from many examples recorded in different works. § XV. OF THE PROGNOSIS. 46. I will not dwell on the question, so much agitated of late, namely, whether or not the olecranon be susceptible of consolidation or reunion. Already has it been hundreds of times answered by experience. What could theory add to the conviction already impressed on us from that quarter? It was by exhibiting to the crowd of pupils who attended his clinical lectures, fractures of this kind perfectly reunited, that Desault refuted the weak arguments, of the periosteum not being able, in consequence of not covering the anterior surface of the olecranon, to produce a union between its fragments, of the synovia mixing with the matter of callus, diluting it, weakening it, preventing it from becoming sufficiently hard for the purpose of reunion, &c. We will only observe, that these ideas are borrowed from a theory which modern experiments have proven to be unfounded, and which, were it true, would be applied in the present case quite unphilosophically, since it would deny to certain parts of man the power or property of restoration or being healed, a property common to all the component parts of beings endowed with life, and which even constitutes one of their essential and discriminative characters. 47. Is the consolidation of the olecranon effected in the same mode as in other bones? The observations of many practitioners, Camper in particular, seem to prove that a ligamento-cartilaginous substance is always the medium of the union of fragments. Desault once found this substance in a corpse, but it was in a case where the fracture had been improperly treated, and where, of course, no inference could be drawn with regard to ordinary cases.