A treatise on orthopedic surgery . abscesses, may appear as atumor over the outer extremity of Pouparts ligament at thejunction of the transversalis and iliac fascise, or the fluid mayfollow the course of the iliac artery to the thigh, or, escapingfrom the greater sacrosciatic foramen, form a gluteal iliac or psoas abscess is most often confined to one side, butit may be bilateral, the two sacs communicating with oneanother by a larger or smaller channel. 112 OFTHOPEDIC SUEGEEY. In the thoracic region the abscess may remain indefinitely inthe posterior mediastinum, where, if large,
A treatise on orthopedic surgery . abscesses, may appear as atumor over the outer extremity of Pouparts ligament at thejunction of the transversalis and iliac fascise, or the fluid mayfollow the course of the iliac artery to the thigh, or, escapingfrom the greater sacrosciatic foramen, form a gluteal iliac or psoas abscess is most often confined to one side, butit may be bilateral, the two sacs communicating with oneanother by a larger or smaller channel. 112 OFTHOPEDIC SUEGEEY. In the thoracic region the abscess may remain indefinitely inthe posterior mediastinum, where, if large, its presence may bedemonstrated by an area of dnlness extending toward the lateralregion of the thorax, or it may perforate the intercostal musclesand appear on the posterior or lateral aspect of the chest, or itmay pass downward through the aortic opening in the dia-phragm and become an iliac abscess. Abscess caused by disease of the occipitoaxoid region mayforce its way forward between the recti muscles and appear be- FiG. Bilateral lumbar abscess. hind the pharynx as the retropharyngeal abscess, or the fluidmay take the opposite direction and distend the suboccipitaltriangle and then pass forward to the region of the mastoidprocess. In other instances the abscess may dissect its wayabout the base of the skull or pass upward through the foramenmagnum or downward into the spinal canal. Abscesses from the middle cervical region usually pass out-ward between the scaleni and loneus colli muscles to the interval TUBEBCULOUS DISEASE OF THE SPINE. 113 between the trapezius and sternomastoid, perforating the skinabout the middle of the lateral aspect of the neck near theanterior border of the latter muscle. These are the paths usually followed bj the tuberculous fluid,but occasionally it may enter the spinal canal or break into thepleural cavity or lung or intestine or by the side of the rectumor elsewhere. Treatment of Abscess.—Abscess is by far the most serious com-plicatio
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