378 INTERNAL SECRETIONS 



Some of the cases described above could be explained as 

 adrenal cases; one might suppose that an intensified mas- 

 culinizing action by the adrenals had temporarily interfered 

 with and changed the female sex glands, which primarily 

 were present, and had already begun their feminizing hormonic 

 activity, into male ones. These cases recall in many details 

 what Minoura observed in his experiments with testicular 

 and ovarian transplantation in hens' eggs (see pp. 310, 311). 



In view of these considerations I come to the conclusion 

 that there are many indications of an hormonic basis for 

 intersexuality in man, though the cases of the so-called glandular 

 hermaphroditism, i.e., cases where ovary and testicle have 

 been simultaneously present, are extremely rare. The hormonic 

 basis may be an adrenal or a gonadal one. In the first instance 

 there will be more chance that the sex glands will be mono- 

 sexual, an almost complete transformation of the gonad into 

 the opposite sex having taken place. In the second instance 

 the chance of observing glandular intersexuality will be 

 greater. If the hormonic basis is an adrenal one, this does not 

 mean that the adrenals have a direct masculinizing influence 

 on the sex characters ; the primary effect seems to he masculiniza- 

 tion of the sex gland, by the intermediation of which the mascu- 

 linization of the sex characters takes place. I also hold the opinion 

 that many cases adduced by various authors as evidence against 

 the theory of a gonadal hormonic intersexuality in man, can 

 be explained as having been formerly true hermaphrodites, 

 who became afterwards false hermaphrodites owing to the 

 degeneration and disappearance of one or both sex glands. 

 With Sauerbeck and Steinach I believe that there is no sharp 

 limit between true and false hermaphroditism. 



When claiming that intersexuality in man may be caused 

 by an intersexual hormonic activity of the gonad or by 

 some other hormonic disturbance, I do not wish to deny 

 that intersexuality in some cases may be caused by an 

 abnormality relating to the somatic basis only, as supposed by 

 many authors. 



(c) Is hypospadia a symptom of intersexuality ? 



As mentioned above, the clitoris of the masculinized guinea 

 pig becomes transformed into a penis-like organ, that is, 

 into a kind of hypospadic penis. Now the question arises 



