urrent acute infectious disease, may delay the reparative
process. The influence of syphilis, except in its gummatous form, in
interfering with union is doubtful. The influence of old age as a
factor in delaying union has been overestimated; in the great majority
of cases, fractures in old people unite as rapidly and as firmly as
those occurring at other periods of life.

_Treatment._--The general condition of the patient should be improved,
by dieting and tonics. One of the most reliable methods of hastening
union in these cases is by inducing passive hyperaemia of the limb
after the method advocated by Bier, and this plan should always be
tried in the first instance. An elastic bandage is applied above the
seat of fracture, sufficiently tightly to congest the limb beyond,
and, to concentrate the congestion in the vicinity of the fracture, an
ordinary bandage should be applied from the distal extremity to within
a few inches of the break. The hyperaemia should be maintained for
several hours (six to twelve) daily. An apparatus should be adjusted
to enable the patient to get into the open air, and in fractures of
the lower extremity the patient should move about with crutches in the
intervals, putting weight on the fractured bone. This method of
treatment should be persevered with for three or four weeks, and the
limb should be massaged daily while the constricting bandage is off.

Among the other methods which have been recommended are the injection
between the fragments of oil of turpentine (Mikulicz), a quantity of
the patient's own blood (Schmieden), or alcohol and iodine; the
forcible rubbing of the ends together, under an anaesthetic if
necessary; and the administration of thyreoid extract. If these
methods fail, the case should be treated as one of un-united fracture.
As a rule, satisfactory union is ultimately obtained, although much
patience is required.

#Non-Union.#--Sometimes the fragments become united by a dense band of
fibrous tissue, and the reparative process goes no further--_fibrous
union_. This is frequently the case in fractures of the patella, the
olecranon, and the narrow part of the neck of the femur.

_False Joint--Pseudarthrosis._--In rare cases the ends of the
fragments become rounded and are covered with a layer of cartilage.
Around their ends a capsule of fibrous tissues forms, on the inner
aspect of which a layer of endothelium develops and secretes a
synovia-like fluid. This is met wit