PARTIAL HERMAPHRODITISM 141 



She was then 19 years of age, and amenorrhcea had Author's 

 persisted for over three years. glandular 



On September 3rd 1914 the abdomen was opened partial 

 in the middle subumbilical line. The left genital gland h P 1 ~ diti 

 was found to be of the same size as that of a plum. ap ^ r 

 It had a very smooth surface, and resembled a testis ; 

 the superficial blood-vessels were injected, especially in 

 the neighbourhood of the hilum. No adhesions were 

 present. A wedge-shaped piece was removed length- 

 wise from the convexity of the organ for histological 

 examination. When cut into for the removal of this 

 piece of tissue, the organ presented a yellow, fatty 

 appearance. The raw surfaces were brought together 

 with a cat-gut suture. The genital gland on the right 

 side appeared to be a normal, but somewhat small, 

 ovary. A piece was removed for section in a manner 

 similar to that adopted in the case of the left genital 

 gland. Finally, a small graft from an ovary removed 

 Irom a patient operated upon a few minutes before was 

 implanted in the uterus. 



The suprarenal regions were palpated with the hand 

 in the peritoneal cavity, but beyond a slight rough 

 feeling in the neighbourhood of the left, which might have 

 been due to the tail of the pancreas, nothing abnormal 

 was discovered. For obvious reasons these and the 

 other organs of internal secretion could not be closely 

 studied. It is possible, however, that changes existed 

 in some, if not in all, of them. 



Report from the Pathological Laboratory (Prof. E. E. 

 Glynn) on the pieces excised. " Right ovary. Section 

 " shows an ovary, the stroma of which consists of very 

 " dense connective tissue, but ovulation has taken place, 

 " there being present a large corpus luteum and the 

 " scars of the corpora lutea, and also an almost mature 

 " Graafian follicle. 



" Left ovary. Section shows what is undoubtedly 

 " a columnar -celled carcinoma with well-marked acini." 



Acting on this report, I re-opened the abdomen on 

 September 22nd 1914 and removed both ovaries, the 

 tubes, and the fundus of the uterus. 



When I came to examine the sections myself I came 

 to the conclusion that the left genital gland was an 

 ovitestis, and not the seat of a malignant growth as 

 reported. 1 



1 This opinion was afterwards confirmed by the report of the 

 Pathological Reference Committee of the Liverpool Medical Institution 



