160 
W. L. WILLIAMS. 
without apparent weakness from the extreme muscular atrophy, 
and travelled home, a distance of fifteen miles, without dif¬ 
ficulty. 
While this case points clearly to the possibility of azoturia 
as a casting accident, it suggests perhaps with equal force the 
possible coincident production of both a strain and azoturia of 
the same muscles, tending to confusion in diagnosis and treat¬ 
ment. We have no differential symptoms of a local character 
between the two, although the one is admittedly a local affection, 
the other a constitutional malady, the exact character of which 
is an unsolved problem. In fact, the only grounds for the 
opinion that the two coexisted in this case are that we had pres¬ 
ent the pathognomonic constitutional symptoms of azoturia, 
with the history of violent struggles of the animal under con¬ 
ditions which had previously in our experience produced severe 
strain of the great dorsal muscles without azoturia, the eventual 
results of which were parallel in a]l cases. 
The tumefaction of the great dorsal muscles and their later 
severe atrophy belong quite as much to the one as to the other 
of the two affections. 
It has been already noted that immediately prior to casting 
the patient for the operation she had been sparingly fed and had 
had very slight exercise, each of which tended to obviate azo¬ 
turia, and would generally have sufficed, and left us in a some¬ 
what difficult position to explain the occurrence of the disease. 
Later we discovered that for a period of 20 hours prior to cast¬ 
ing she had been deprived of water, an element not generally 
reckoned with in the etiology of azoturia, although we have 
ventured to suggest a parallel line of thought in a prior article 
in the Review.* Therein and elsewhere we have held that 
azoturia is due to certain definite conditions having for their 
antecedents well determined historical data following each other 
in an unvarying sequence. 
a A sound animal with exalted nutritive powers not drawn 
upon by disease, pregnancy, rapid growth or senile wasting. 
Pathology of Azoturia,” etc., Am. Vet. Rev., Vol. XIV., p. 172 . 
