chap, xix.] THE BUTTOCK. 429 



At least three fonrsae exist over the great 

 trochanter, separating that process from the three 

 gluteal muscles respectively. The most important of 

 these is the bursa between the gluteus maximus and 

 the bone. When this sac is inflamed much difficulty 

 is experienced in moving the limb, and the thigh is 

 generally kept flexed and adducted. This position 

 means absolute rest from movement on the part of the 

 gluteal muscles, which, when acting, would extend 

 and abduct the limb, and bring pressure to bear upon 

 the tender bursa. 



The bursa is quite close to the bone, so close that 

 it is said that caries of the trochanter has followed 

 upon suppuration of the little sac (T. P. Teale). 

 There is a bursa over the ischial tuberosity that is 

 often inflamed in those whose employments involve 

 much sitting, the bursa being directly pressed upon in 

 that position. This sac is the anatomical basis of 

 the disease known in older text-books as " weaver's 

 bottom," or " lighterman's bottom." When enlarged 

 this bursa may press upon the inferior pudendal nerve 

 (page 384). 



The arteries and nerves of the buttock. 

 The gluteal artery is about the same size as the ulnar, 

 and the sciatic as the lingual. The former vessel 

 may sometimes be of much greater magnitude, and 

 has led, when wounded, to rapid death from haemorr- 

 hage. Wounds of the gluteal vessel will probably 

 involve only the branches of the artery, since the 

 greater part of the main trunk is situate within the 

 pelvis. Gluteal aneurisms are not very uncommon, 

 and with regard to the treatment of these tumours it 

 may be noted that the gluteal artery, or, better, the 

 internal iliac trunk, can be compressed through the 

 rectum. Compression so applied has been adopted 

 for the treatment of gluteal aneurism by Dr. Sands 

 of New York (Amer. Journ. Med. Sc., 1881), but 



