These researches, which are marked by the stamp of trustworthiness, and are markedly exact, are recorded in the Bulletin de la Societe Zoolo gique de France, 1883. They consist of the account of the travels of Peron and Lesueur in 1805, and a critical and exhaustive study by Dr. Raphael Blanchard. It results from these papers that the reason why certain travelers have stated that they saw this hypertrophy, and others have de nied its existence, is that women of different races were examined. It is not the Hottentot women, but the females of the Bushmen, who as a rule possess this apron, while the great majority of the former do not. The Bushmen are a race very different from the Hottentots and the Kaffirs. Very small and very wild, they are gradually being driven further and further away by the colonists, as also by the Hottentots and the Kaffirs. It would appear as though the IIottentot women had acquired the so-called apron through admixture with the Bushmen. From admixture with other races who possess a normal development of the genitalia, the Hot tentot apron does not appear in the children. Contrary to the opinion of Otto and others, all authorities are now agreed, as the result of autopsies, and as certified by these French travelers, that the Hottentot apron is due to great hypertrophy of the nymphs. A further peculiarity of these women is an immense deposit of fat in the nates (Fig. 39), as is repre sented in the well-known Hottentot Venus, and they show further pecu liarities in the breasts. The labia majora are as a rule very small.
These anomalies appear early, so that even children possess the apron and the fat nates. In the male the deposit of fat does not occur. Since now the brain of the Bushmen is very small, the nasal bones very fiat, the tibim flattened out (plactycnemic, that is to say, like the blade of a sword), these are all not only signs of a race of low development, but place them very near the apes, and therefore Blanchard draws the con elusion that the so-called Hottentot apron, the slight development of the labia majors, the deposit of fat on the nates, etc., must be ranked as atavism. To compare this race with the anthropoidal apes, in the female ourang-outang the labia majors are scarcely developed as also the mons veneris, while the clitoris is always large and its glands markedly project ing. The citoris is always split inferiorly. The labia minora in the chimpanzee are greatly developed, although less so in the other three kinds.
The majority of the above characters are alike in the females of the Buschmen and of the anthropomorphous apes, and hence Blanchard's con elusion seems allowable. We must also, however, lay stress on atavism, seeing that the Hottentot apron is seen in Europeans. In the year 1885, at the Erlangen clinic, we saw an individual with a so-called apron nearly as large as the one shown in Blanchard's drawing, although she presented no trace of atavism and was of German extraction Hyrtl records the fact that in certain barbaric African races, the en larged clitoris—possibly this is simply Otto's third form—hangs like a sail over the external genitals; and as a guarantee of the virginity of the female, it is fastened by a ring to the perineum. We would be inclined
to consider such barbarism as impossible, were it not for the fact that different travelers testify that on the upper Nile, and in the centre of Africa, it is the custom to freshen and to sew together the labia of young girls, in order to insure their virginity.
Hypertrophy of the nympha is met with among us as the result of disease. Meissner records six cases where the labia minora were very large and had become inflamed and tender, as the result of irritation in walking, riding, etc. Such patients were driven to seek surgical relief from their sufferings. Since in other works syphilis is referred to as a frequent cause of hypertrophy, it is allowable to suppose that condylomata have often been mistaken for simple hypertrophy. The history and careful examina tion ought always to make the differential diagnosis.
Hypertrophy of the Clitoris.—In little girls the clitoris is, as a rule, relatively large, and the older the child grows, the more it diminishes in size. In this respect there is a vast difference from the behavior of the corresponding organ in the male. The reason has already been given by Lisfranc. The corpora cavernosa clitoridis, which are inserted at the pubic angle, lie close together near the descending rami. When, at puberty, these spread further apart, the corpora cavernosa are drawn away from one another, and so the glans of the clitoris projects but slightly. We question if such a simple mechanical explanation will answer.
Hypertrophy of the clitoris even as of the nymplue is met with more frequently in tropical countries. It has frequently been claimed that masturbation will cause the hypertrophy, but this is only exceptionally the case. In those countries where hypertrophy is frequent, it is often congenital, and circumcision is resorted to. Certainly we should rather look for the results of onanism in highly civilized people than in the children of nature, and since marked hypertrophy of the clitoris is rare in Europe, the opinion is general that it is the result of natural or onan istic sexual irritation.
In many of the recorded cases it is doubtful if there was hypertrophy, and not really a new growth of the organ. Meissner mentions cases of unquestionable hypertrophy recorded by Tulpius, de Graaf, P. Zachias, Avicenna, Plater, Rhodius, Panaroli, A. Severinus. At the Hamburg hospital Fricke extirpated a clitoris which was nearly as large as an erect penis; Armand found in a three year old child, in addition to great devel opment of the mons veneris and the labia majora, a clitoris one inch long, and half an inch thick. Similarly a case has been recorded by Coste, where a woman of twenty-one had a clitoris the size Of the penis of a four teen year old boy. AliHeld records a number of cases of hypertrophy. The remaining cases of Meissner, on the other hand, do not concern hy pertrophy, but new growths springing in part from the organ itself, and in part from the prepuce. Tumors fourteen inches long, or the size of a child's head, are not to be ranked among the hypertrophies.