b. If possible a still more perfect example of the present variety of transverse hermaphro ditism in the human subject has lately been observed at Naples. The malformation occurred in the person of an individual Maria E. Arsano, who died at the age of eighty in one of the pauper charities at Naples, and who had passed through life as a female and been married as such. No suspicion of the malformation existed during life, and it was only at first accidentally discovered in preparing the dead body for demonstration in the anatomical theatre of Professor Ricco, who afterwards carefully dissected the malformed parts in com pany with Professors Sorrentino and Grosetti. We have taken the following account and sketches from Ricco's published description of the case.* The external organs of generation were those of the female in their natural or normal state, consisting of the mons veneris with a scanty quantity of hair (fig. 295, a); of the labia ex terra (fig. 295 & 296, b b) naturally formed, and the nymphs (fig. 295 & 296, d d) ; of the clitoris (fig.295 & 296, c), which was perfectly imperforate, and of the ordinary size of the same organ in the adult female ; of the orifice of the urethra (fig. 295 & 296, c) situated be low the clitoris; and of the os vagina (fig. 295 & 296,f), which was of the usual size and diameter. Altogether the aperture of the vulva was natural. The canal of the urethra was of the usual length, as seen at u in the section of the pelvis represented in fig. 296, in which s marks the divided symphysis pubis, and p the peritonum. The os vaginae shewed no vestiges of the membrane of the hymen, or, in other words, was without carunculm myrtiformes. The canal of the vagina (fig. 296, v) was about two inches long, but without rugw, and it ter minated internally in a completely blind extre mity or cul-de-sac. The uterus was entirely wanting, as were also the Fallopian tubes and uterine ligaments.
The internal organs of reproduction were, on the other hand, completely male. The two testicles (fig. 295, g g) were situated in the region of the pubis, and were scarcely clear of the inguinal rings. They were of the usual ovoid figure, and natural in size. They had internally the structure of the tubuli seminiferi, but it was not well developed. The spermatic cords were quite normal both in regard to their composition and the origin and course of their bloodvessels. The right spermatic artery (fig. 295, /) arose, as usual, from the renal, and the corresponding vein (m), after forming the pampiniform plexus (k), opened into the vena cava inferior; while on the left side the artery (/) arose from the aorta, and the vein (m) ter minated in the left emulgent. The epididymes of the testes were also of the usual vermiform figure, and the corresponding vasa deferentia (fig. 295 & 296 h h) coursed towards their vesi culw seminales (fig. 296, j), and terminated in an attenuated membranous expansion without any external aperture or ducti ejaculatorii. The vesiculre seminales (see the left one j in fig. 296) were placed between the urinary blad der (o) and rectum (r); they were smaller and more shrunk than those of the adult male, though certainly they preserved their naturally oblong form. Their internal hollow or tubular structure was indistinct. The prostate gland was not present. The urinary bladder (o) and
ureters (a n), the rectum (r), and the other intestinal viscera, with the abdominal blood vessels (s, the aorta, t, the vena cava, fig. 295) seem to have been all quite natural.
The head of the above individual was of the usual size, the neck long, and the stature ordinary. The periphery of the thorax was so expanded as almost to equal that of the male, notwithstanding the presence of well pro nounced mammy. The face, although entirely free from hair, had yet neither the expression of that of a female nor of a male, but shewed more of that mixed character which is seen in the eunuch. The pelvis was altogether that of a male in its form and dimensions, and the limbs were perfectly masculine. According to information collected after death, the voice was deep, and the temperament strong and firm. Though there was never any menstruation, yet, from being constantly employed in domestic occupation, the mental character was feminine, and the married state had been willingly entered into.
2. Transverse hermaphroditism with the ex ternal sexual organs of the male type.—The male organs that are present consist of the penis, which is provided with a regular formed prepuce, glans, corpora cavernosa, and corpus spongiosum, with the urethra perforating it, and of the prostate gland, verumontanum, &c. The co-existing female organs are the ovaries, the Fallopian tubes with their infundibula, and the uterus.
We are not aware of any recorded instances of this variety of hermaphroditic malformation among the lower animals. We have already, under the head of spurious hermaphroditism in the female from enlargement of the clitoris, &c., mentioned several cases, in which, from excessive developement, the external organs in women had assumed some of the characters of the corresponding parts in man ; but the two following cases described by Professors Esch richt of Copenhagen, and Bouillaud of Paris, present instances of malformation in which the more exterior sexual organs were all formed upon the male, and the internal upon the female type.
a. The subject of the case described by Eschricht • was a twin child that died very shortly after birth, and in whom the external sexual organs were of the male type, and the internal female. The penis (fig. 297, a) and scrotum (b) were well developed, but the usual raphe seen upon the latter was absent. The urethral canal of the glans and body of the penis was pervious throughout, and admitted of a sound being easily passed into the bladder. The glans was remarkably thin and slender. The prepuce could be easily pushed back. No testicles could be felt in the scrotum, and in ternally there was an uterus with Fallopian tubes and ovaries. The uterus (c) was about an inch in length, and had the general form presented by this organ in female infants. It contained a cavity marked with rugm, but had no orifice inferiorly, nor any vagina attached to it. Its blind or imperforate neck was firmly attached to the posterior walls of the urinary bladder (g), while its fundus was directed very obliquely downwards and over to the left side. From the left side of the fundus of the uterus a twisted Fallopian tube (d) proceeded, having large vessels was abnormal. The other twin child was well formed and lived.