In the following brief resume we will make use of Ahlfeld's and Blebs' recapitulation of the cases from the literature of foreign countries.
Of instances of true bilateral hermaphroditism, where, that is to say, on both sides there were present two sexual glands, Ahlfeld has reported two (Heppner's and Schnell's.) The description of the latter's case is too obscure to allow us to rank it with certainty in the category of true bi lateral hermaphroditism. The internal genital organs were developed as in the female, but no microscopical examination of any of the organs was made. The case is very doubtful. True enough the external genitals were characteristic of the male, but it is not directly proved that a nor mal scrotum with testicle was present.
The second case, recorded by Heppner, of St. Petersburg, speaks more convincingly in favor of the presence on both sides of duplex or gans. It was a child, two months old, with external genitals of the male type, but with imperforate penis. Externally it had a scrotum and a by pospadiac penis. Behind, into a long uro-genital sinus, opened a ure thra and vagina; at their junction there was present around them a well developed prostate. The uterus, tubes and ovaries were perfectly nor mal. and on each side an additional body which resembled a sexual gland. The parovarium—that is, the shrivelled Wolffian body—lay between the ovary and the second gland, the testicle, and was united to it. The ap pearance then wa3 similar to that which holds in the normal development of the male sex. Heppner was the more convinced that this supernu merary organ was a testicle, because under the microscope he detected canals extending towards the hilus in increased size. The walls of the canals were lined with a structureless membrane, on which there ap peared on the addition of acetic acid neither strive nor nuclei. Vasa def erentia were not detected. Although Heppner came to the conclusion that the organ was a testicle, Slavjansky could not convince himself that it was not an ovary.
An instance of unilateral hermaphroditism,—that is,where on one side both the glands are present,—Ahlfeld says, does not exist, since Banon's case, described by Blebs, cannot be so considered.
Of lateral hermaphroditism there are a number of recorded instances: Sue, Maret, Varocler, Rudolphi, Stark, Barkow, Berthold, Banon, H.
Meyer, Gruber, Klotz. We borrow Ahlfeld's description of these cases.
Sue's case concerned a fourteen year old child. Externally, a man, with hypospadias: internally, there were present on the right a tube with fimbrite, an ovary, a round ligament; on the left, a testicle with two canals which were taken for rasa deferentia. In Maret's case, the indi vidual was seventeen years of age, and externally a male with hypospa dias. Internally the right tube, infundibulum and ovary were present, and to the left one testicle with vas deferens. The uterus was one and one half inches long. In Varocler's case, there existed hypospadias, and the age was eighteen. Internally, the right testicle with vas deferens opening in a normal receptaculum seminis; on the left, tube, ovary, round and broad ligament. The uterus was small and there was no va gina. Rudo1phi wrote of a two to three months old child with hypospadias. In the right in a scrotum was a testicle with vas deferens opening into the uro-genital sinus. Internally was a uterus, and left tube, ovary, parova rium, broad and round ligaments.
Although in the above-cited cases the male sex was only recognizable by the external genitals, the question arises if such hermaphrodites pos sessed the capability of procreation. When Stark examined his case it was twenty-three years old, had seminal emissions and a decided propen sity towards females. Death occurred in 1853 and Meyer described the post-mortem findings. Externally as regards the =mime, hair and beard, the resemblance was to the male sex. The penis was 2 inches long, when flaccid, and three inches when erect, and was hypospadiac. The perineum measured two inches. The uro-genital canal measured eight lines. There existed a prostate, and thence extended a vagina, three in ches long, and ending in a blind pouch, above which was an equally long but more solid uterus. The tubes were permeable. To the right, at the extremity of the tube, was a testicle containing seminal ducts, and to the left was a body like an ovary but entirely covered by the peritoneum. As to whether this was the ovary or not remains highly in doubt.