GENERAL SUMMARY WITH REGARD TO THE NATURE OF IIERMAFRRODITIC MALFORMA TIONS.
1. Of the varieties of spurious hermaphro ditism.—On some of these varieties it is un necessary for us to dwell here. The first species of spurious male hermaphroditism, or that arising from extroversion of the urinary bladder, is elaborately discussed elsewhere (see BLADDER); and two others, namely, the second female species consisting of prolapsus of the uterus, and the second male consisting of an adhesion of the penis to the scrotum, seem both referable to the head rather of disease than of original malformation. This latter indeed ap pears in all probability only an effect or result of adhesive inflammatory action in the affected parts during embryonic or fittal life. Both of the two remaining forms of spurious hermaphroditism,— viz. those consisting of hypospadic fissure of the urethra, scrotum, and perineum in the male, and of abnormal magnitude of the clitoris in the female,—seem readily explicable upon the doc trine of arrestment and anormality in the deve lopment of the malformed parts.
We have already described at sufficient length the process of development of the dif ferent copulative organs, and have shewn that those various degrees of hypospadic malforma tion which constitute the common form of spurious hermaphroditism in the male, may be traced to arrestment of this process at various periods or stages of its progress. And we may here remark that the earlier this arrestment occurs, the distinction of the true sexual type of the malformed organs will always be the less marked, because the younger the embryo, and, on a similar principle, the lower we descend in the scale of animal existence, we find the dif ferences between the organs of the two sexes proportionally the less pronounced, until at last we arrive at that primitive type in which these organs present altogether a common, neu tral, or indeterminate character.
We have also already shewn that at a certain early stage of the development of the female organs, the female clitoris holds the same, or nearly the same relatively larger size to the whole embryo as the penis of the male, and that so far we may consider the occasional occurrence of spurious hermaphroditism from magnitude of the clitoris, and its resemblance in this respect to the male organ, as a perma nent condition of a type of embryonic structure that is normally of a temporary or transitory existence only. But besides this permanence of the embryonic type of the clitoris, we must farther, in all the more complete instances of spurious female hermaphroditism, admit an excess of development in the malformed external sexual parts, and more particularly in the line of the median reunion of the two primitive lateral halves or divisions of these parts. In this way the vagina (a remnant in the
female of the primitive perinwal cleft or fissure) is often in such cases more or less con tracted and closed, so much so indeed in some instances as to leave only, as in the male, a small canal common to the genital and urinary passages. If the median junction is extended still farther, this canal comes also to imitate the male urethra in this respect, that it is united or shut up below in such a way as to be carried onward to a greater or less length, and in a more or less perfect condition along the under surface of the enlarged clitoris ; and occasion ally the male type of structure is still more completely repeated in the female organization by the median reunion of the two labia, giving the appearance of theunited scrotum and closed perin2eum of the opposite sex.
If we divide the whole sexual apparatus of the male and female into three corresponding transverse spheres or segments,—the first or deep parts including the testicles and ovaries, the second or median comprehending the male seminal canals and prostate gland, and the female oviducts and uterus, and the third or external embracing the copulating organs of the two sexes,—we shall find that, relatively speaking, the deep and the external spheres are naturally most developed in the male economy, while the median, comprising the uterus, (the principal and most active organ in the female reproductive system,) is developed in the greatest degree in that sex. In malformed females presenting a spurious hermaphroditic character, this important portion of the female sexual organization is, in general, either itself in some respects malformed, or, from the structure of the other parts of the sexual appa ratus being imperfect, its specific importance in the economy is cancelled, and therefore the energy of development takes the same direction as in the male, being expended upon the more complete evolution of the organs of the external and deep spheres. Hence the greater size of the clitoris, and the greater development which we have just now pointed out, in the median line of reunion of the external sexual parts ; and hence also the occasional though rare occurrence, in the same cases, of the descent of the ovaries through the inguinal rings into the labia,—an anomaly that certainly consists in a true excess of development, and which we cannot but regard as interesting, both in this respect, and as affording a new point of analogy between these organs themselves and the male testicles.