Where pain is not so great that relaxation of parts does not occur, one
can, by gently moving an extremity in various directions--as in flexion,
extension and lateral motion as well as by rotation--cause to be
manifested this peculiar grating,--the friction of newly broken bone.
This is known as _true crepitation_. Where the subject, suffering
phalangeal fracture, manifests evidence of pain due to tensing the
structures about a fractured part, one may anesthetize the parts by
using about two cubic centimeters of a two per cent. solution of cocain
upon the plantar nerves, proximal to the fracture. It is perhaps best to
deposit the cocain solution by means of two hypodermic punctures at
different points along the course of each nerve, though closely situated
to one another, thereby making more sure of the solution actually
contacting the nerve. In some multiple fractures of the first or second
phalanx this is quite necessary; otherwise, pain produced by passive
manipulation causes the subject to keep the tendons so tense that
crepitation may not be detected. The unnecessary infliction of pain is
always to be avoided.

We know as _false crepitation_ a vibrating impulse occasioned by normal
contact of articular portions of bones such as in the metacarpophalangeal
joint when this structure is passively moved, where the subject permits
the parts to remain in a state of complete relaxation.

Attempts to recognize supersensitiveness or inflammation by means of
passive movement of the shoulder or hip, whether gently or forcefully,
is not productive of good, in any case, in large animals. Because of the
bulk and weight of parts so manipulated, as well as the resistance the
subject offers even in normal cases, no accurate conclusion is to be
arrived at in this manner in the average instance. Animals nearly always
resist the placing of members in any position that is so unusual and