AZOTURIA. 
159 
degree the posterior muscles of the thigh (semi-membranosis and 
5emi-tendonosis), rendering the patient quite stiff in her move¬ 
ments and causing her temperature to rise to a maximum of 
103.4° F. 
,On the 23d there was little change in condition except some 
oedematons swelling about the sternum and in the limbs, the 
oedematous condition involving the operative wounds, causing 
the bandage to be saturated with serosity, but not' otherwise 
affecting them unfavorably. 
Up to this date in conformity with my usual practice, no 
medication had been applied ; but to relieve the complications 
present, diuretics were ordered internally and an anodyne lini¬ 
ment to the affected muscles. 
On the 24th there was a general improvement, the muscles 
were less hard, the swelling decreasing and all seemed so favor¬ 
able that the medication was relaxed, and on the following day, 
the improvement continuing, it was discontinued and out-door 
exercise permitted for a short time. 
On the 26th, while the general condition of the patient was 
quite satisfactory, it was seen that the great dorsal muscles were 
commencing to waste rapidly, and having seen two previous 
cases of severe strain of these, due to casting with side¬ 
lines, both of which, without the coincidence of azoturia, 
resulted in extreme atrophy, it was at once concluded that 
in this patient, too, the atrophy would prove rapid and complete. 
On the 27th the atrophy continued with great rapidity and 
on the following day it was seen that the left gluteals were in¬ 
volved also to a moderate degree. 
On March ist, the atrophy of the great dorsals was complete, 
giving the appearance of the subcutaneous excision of the entire 
muscles from withers to loins, leaving a deep, wide furrow on 
either side of the spinal column, the dorsal spines of which 
stood up sharply. 
The general improvement was rapid, so that on March 3d, 
she was discharged convalescent, the operative wounds entirely 
healed without scar, the appetite and general health good and 
