376 INTERNAL SECRETIONS 



in the last few years in relation to the problem as to the 

 existence of an endocrine basis for intersexuality. 



Polano (1920) described a case of a "girl*' of twenty-two 

 with an hypertrophied penis-like clitoris. On the left side 

 there were an ovary and a testicle containing rather infantile 

 seminal tubules and interstitial cells. On the right side there 

 was a malignant tumour. An uterus and tubes were present also. 

 This case gives full support to the hormonic theory of herma- 

 phroditism. It is the same with the case described by Sand 

 (1922 b) of a "boy" of ten with a highly hypospadic penis or 

 an hypertrophied chtoris and labia, together with an uterus 

 and tubes, and a testicle on one side and an ovary on the 

 other, as determined by histological examination of pieces 

 excised from the respective glands for this purpose prior to 

 deciding whether to operate. Berblinger (1923) has recently 

 described a case very similar to that of Bell. In a girl at the 

 age of twelve some growth of beard had taken place, but never- 

 theless menstruation set in at the age of sixteen. At the age 

 of twenty-one a tumour of the proportions of a walnut was 

 removed from the right labium. The psychical development, 

 which was till then indifferent, became now typically female. 

 The histological examination revealed that the tumour was 

 an ovario testis containing typical Graafian follicles, corpus 

 luteum and spermatogonia, but no spermatozoa. 



Mittasch's case (1920) was a man of 54; the genitalia were 

 externally male, but the scrotal sac was empty ; an uterus and 

 more or less developed tubes were present. Besides the female 

 internal organs there was a vas deferens, seminal vesicles and 

 a prostate. The gonads were testicles containing seminal 

 tubules with spermatogonia and spermatocytes. There was 

 an hypertrophy of the adrenals. A similar case (a man of yy) 

 was recently described by Priesel (1921) but without any 

 hypertrophy of the adrenals being described. These cases 

 might be classified as those of an hormonic intersexuaUty, 

 if we assume with Sauerbeck (1909, 191 1) that the male or 

 female generative part of an intersexual gonad may disappear 

 during embryonic or postembryonic development, and that 

 such an intersexual gland may become afterwards unisexual. 

 This assumption means, as Sauerbeck pointed out many years 

 ago in view of his own observations and those of others, that 

 it is very difiicult to draw a sharp line between true and false 



