386 THE DISEASES OF THE SEXUAL GLANDS 



ness of the observations. It is true that this doubt does not extend to the 

 observations on anorchia that were made on boys shortly after birth. In such 

 cases are always found also anomalies of the internal genitalia anomalies 

 such as lack of the epididymis or of the funiculi sperm atici or the vesiculae semi- 

 nales. When, however, we hear in many of the observations in old literature 

 as to aplasia of the sexual glands that the external and internal genitalia were 

 quite well developed, or that in the male individual a beard was present, 

 such a doubt is well justified. It is at all events very striking that no such 

 observations have been made in the last decade, although the number of 

 sections has enormously increased. From the observations on anorchia in 

 new-born children the most that can be mentioned is that also without 

 sexual glands there is possible a development, if only a disturbed develop- 

 ment, of the male or female accessory genital apparatus, and perhaps other 

 characteristics of the male sex. 



Also the observations that Landau and Peck publish concerning the exist- 

 ence of individuals of a neutral sex do not seem to me to be free from objec- 

 tions. I quote the following two cases that Peck regarded as especially 

 important. In the case of v. Swinarski-Pfannenstiel there was a fifty-five- 

 year-old unmarried "woman," who had never menstruated. The general 

 habitus was masculine, the clitoris 3 cm. long, both ovaries were considerably 

 enlarged, the superficies smooth, no corpora lutea were to be seen, and on 

 microscopical examination the ovaries were found to be entirely "parenchy- 

 maless." The internal genitalia were those of the female. The case of 

 Houitz was that of a forty-nine-year-old unmarried "woman." The hairi- 

 ness and form of the pelvis were masculine; the large and small labia were 

 present, the clitoris was 6 cm. long and 2 cm. thick. The urogenital sinus 

 was smooth, and on its floor was found an opening through which one could 

 pass a thin sound into the 7 cm. long vagina. Between the thirtieth and for- 

 tieth years of life blood issued from the vagina at intervals of one to several 

 years. At the site of the ovaries on each side was to be found a body of the 

 shape and size of an almond. There was no follicle formation in the ovaries, 

 and the stroma was strikingly hard. In this case which had come to advanced 

 age one could not say with certainty that the follicular apparatus had always 

 been entirely absent. The absence of menstruation does not allow of the 

 statement that at least for a time there did not exist a tendency [start, 

 Ansatz] for menstruation. Also statements to the proportioning of the body 

 are not given. Finally an examination of the suprarenal cortex in such cases 

 would be very desirable. It seems to me therefore that such cases should not 

 enter into our discussion. 



2. Hermaphroditism 



We distinguish a hermaphroditismus verus and hermaphroditismus spurius 

 or pseudohermaphroditism. Cases of hermaphroditismus verus, in which ova- 



