I just replaced my mixing elbow and manifold this spring, yes there is a gasket at the block.
I noticed it ran much cooler after it was changed. So one indication would be temperature. After mine was changed I could hold my hand on it after 10 minutes of running in the slip, running much cooler than the old one.
Mine seemed to have a heavy mineral buildup rather than carbon, so probably had less cooling going on.
I thought the elbow looked quite sturdy, tried to punch a hole in it with a sharp cold chisel and came to the conclusion it was probably structurally sound. I turned it upside down and filled it with 20% muriatic acid I had left over from a concrete job. I plugged the water inlet with a plastic plug to protect the treads and keep the acid inside. It sat for about 4 days and most of the junk washed out. The inside still had some rusty flakes attached to the walls that I want to clean out. I have been playing with electroplating the rust away using an old battery charger and in a washing soda solution. I made an electrode with a 3/4" steel rod that goes right down into the mixing elbow chamber. I don't like to run it while I am not in the shop so it has only been on about 4 hrs now. It appears to be doing a good job but probably needs about 24 hrs to clean it right up. A bigger power source would shorten the time. From my past experience the electroplating process will only remove the rust and leave the good metal alone. When it is done I'll post some pictures.
I intend to keep this in my spare parts inventory on the boat, it may never be used but I am having fun playing with it and trying to learn something.
good luck, Bob