chap, xix.] THE BUTTOCK. 383 



The subcutaneous fascia is lax, arid contains a large 

 quantity of fat. It is to this fat rather than to mus- 

 cular development that the buttock owes its roundness 

 and prominence. The enormous buttocks of the so- 

 called " Hottentot Venus," whose model is in many 

 museums, depend for their unusual dimensions upon 

 the greatly increased subcutaneous fat. The amount 

 of adipose tissue normally in the part renders the 

 buttock a favourite place for lipomata. The laxity of 

 the superficial fascia permits large effusions both of 

 blood and pus to take place in the gluteal region, and 

 ecchymoses of the buttock can probably reach a greater 

 magnitude than is possible elsewhere. 



The deep fascia of the buttock, a part of the 

 fascia lata of the thigh, is a structure of much 

 importance. This dense membrane is attached above 

 to the iliac crest, and to the sacrum and coccyx. 

 Descending in front over the gluteus medius, it splits 

 on reaching the anterior edge of the gluteus maximus 

 into two layers, one of which passes in front of the 

 muscle and the other behind. The gluteus maximus 

 is thus enclosed, like the meat in a sandwich, between 

 two layers of fascia, and the two lesser gluteal muscles 

 are bound down within an osseo-aponeurotic space, 

 which is firmly closed above, and only open below 

 towards the thigh, and internally at the sciatic 

 foramina. Extravasations of blood may take place 

 beneath this fascia without any discoloration of the 

 skin to indicate the fact, the blood being unable to 

 reach the surface through the dense membrane. Such 

 extravasations may be long pent up, and, as they 

 would fluctuate, may be mistaken for abscess. 



Deep inflammations beneath this fascia, and 

 especially when beneath the gluteus medius, may be 

 associated with much pain, owing to the circumstance 

 that the inflammatory effusions will be pent up between 

 a wall of bone on one side and a wall of dense fascia 



