In like manner were the conditions in Barkow's case, which lived to the age of fifty-four, and was a married man. The wife of this individual had borne a child in her youth. The post-mortem proved this individual to be incapable of procreation. The external genitals were hypospadiac. The prostate was traversed by a vagina; the uterus was herniated in the right scrotum. Near the uterus lay a testicle, but neither tube nor vas deferens. Below the testicle was an ovary, consisting, however, purely of cellular tissue, fat and blood-vessels. and containing no follicle.
Berthold made a post-mortem on a new-born child with hypospadiac penis. The scrotal halves were greatly wrinkled; the uro-genital cleft lines long . Externally, in the right scrotal half, a testicle with epididy mis. Microscopical examination confirmed this. A vas deferens pursued a normal course to open into the uro-genital sinus. Internally there was a uterus unicornu, and on its right no trace of appendage; on its left, how ever, there existed tube, ovary, round ligament, etc. The ovary was lacking in follicles.
II. Meyer's observation concerned a small child. Externally there was an imperforate penis with hypospadias. In the left scrotum a tes ticle. The case was like Berthold's except that the conditions were re versed.
From careful microscopical research Blebs claims to have found cells, like primordial ova, and cylinders like follicles.
In Gruber's case the ovary was degenerated. Klotz's case is yet alive, so that nothing definite can be said about it. The same remark applies to the well known hermaphrodite Katarina, later Karl Hohmann. This case is in many respects similar to those described above, and has been pronounced a true hermaphrodite by the highest authorities. It has a well-developed hypospadiac penis; a testicle in the right scrotum; to the left many physicians have been able to feel a body which in size and form suggests the ovary, and from which proceeds a band which extends to a small organ behind the bladder, and which is considered the uterus. This organ opens by a small orifice into the bladder. The breasts are well developed; on the chin there is long hair, although no proper beard. The speech is deeper than in woman. There is a history of seminal emissions, and early in life of menstruation, although this is not certain. Ahlfeld considers this individual only hypospadiac, and we believe him to be right.
In considering the reported cases, it is apparent that the tendency in development is towards the male sex. And further, in all these individ uals which attained maturity the sexual longings were directed towards the female sex.
As for the expression pseudo-hermaphrudite, it is not scientific.
Where two sexual glands are not to be found in one individual, the word hermaphrodite is inapplicable. Of. lack of development of the genitals we have already spoken under the head of episrcidias and hypetrpubdists.
We may further mention the fact that Mitller's ducts may so develop in the male as to more and more obscure the sex of the individual, so that such a man may during his whole life be taken for a woman, and be mar ried as such.
Uterus Masculinus.—In the female the vagina, uterus and tubes are formed by Mfiller's ducts. In the male these persist, normally, only as an insignificant remnant. This remnant consists in, above, a pediculated little vesicle, and below, a small cul-de-sac, the sinus prostaticus. This is the lower end of the obliterated Miiller's ducts, extending from the opening of the ejaculatory duct to a greater or less distance into the pros tate. These normally obliterated ducts, however, may persist and grow to a greater or less degree. The prostatic sinus may increase in size. This lower end of MilDer's ducts corresponds to the vagina, and when it persists to a considerable degree in a male it might properly be called a vagina masculina. When the abnormal development is higher up, then we can speak of a uterus masculinus.
We propose to sketch here the reported cases, with particular reference to the appearance of the external genitals.
Dohrn's published case bespeaks, generally, a female. The individual was brought up as, and was considered, a girl. When at the age of twenty, she began to suffer from a sensation of bearing down every four weeks, her mother sought medical aid. The physician told her that there existed no impediment to menstruation, but that if she wished to marry an incision would have to be made. The girl married and her husband shortly sent her to Dohrn for an examination, and he pronounced the in dividual a male. This case is all the more interesting in that the external genitals were of the female sex. There were two marked labia majors, made up of muscular fibres. At the upper end of each labium was a sen sitive, round, soft, body, the size of a large pea, which could be pushed a trifle upward. A clitoris 11 inches long, capable of erection, and like an infant's penis, was present. In the vestibule were two openings, the upper, a urethra, the lower led into a blind cul-de-ear, about of an inch in depth, which was the lower blending of Milller's ducts. By rectum no trace of vagina, uterus, or ovaries could be detected, nor, further, any thing like a prostate. (Fig. 48.) The couple obtained a divorce.