158 
W. L. WILLIAMS. 
Low neflrotomy was performed on both fore feet by a student 
who had not previously attempted the operation, the work being 
as promptly and skillfully performed as could be expected. 
The patient struggled violently and persistently throughout 
and upon her release got up without assistance or unusual effort 
and walked to her stall, apparently weak and stiff from her con¬ 
finement, but without suggestion of grave injury. At lo p. m. 
she was down but apparently comfortable and was left for the 
night without suspicion of anything unusual. 
On the morning of the i8th, it required the aid of two men 
to assist her to her feet. She was then with difficulty walked 
to an adjacent stall and placed in slings. Examination showed 
the two ileo-spinali muscles, as well as the gluteals, much 
swollen, hard and tense, the left side being most severely affected. 
The urine was abundant and of a dark chocolate color charac¬ 
teristic of azoturia. 
As is usual in severe or moderate cases of azoturia, the slings 
could not be borne, and the patient was lowered to the floor and 
well bedded. Becoming uneasy again after some three hours, 
she was once more lifted to her feet and placed in slings, and 
was then found able to remain in them, bearing her chief weight 
on the feet. She was accordingly left in the slings until the 
morning of the 19th, when she had so far recovered from the 
attack that the slings were discontinued and the patient got up 
and down at will. She ate fairly well and drank a moderate 
quantity of water. The tumefaction of the muscles appeared to 
decrease for a time without medication, but soon began to 
increase. 
On Feb. 2 2d the great dorsal muscles were enormously 
swollen, hard, tender, hot, standing up above the spinal column, 
the course of which was marked by a furrow, the affected muscles 
standing out clearly from neighboring structures, thus marking 
as clearly and with as great detail the exact area of the dorsalis 
muscles on each side from withers to the loins as could be done 
by a dissection, the tumefaction extending backward and in¬ 
cluding to some extent the gluteal muscles also, and to a lesser 
