340 



WM. C. QUIKBY 



w - . 



though in the region above this area there is felt a small mass which is 

 about 2 cm. long and 1 cm. broad, not tender, and only slightly movable. 

 Radiographs of the head, chest, abdomen, pelvis and hands are entirely 

 normal. The urine is normal, and the ingestion of 150 grams of dextrose 

 caused no glycosuria. The phenol sulphonephthalein output was 60 per 

 cent during the first hour. The Wassermann test was negative. Blood- 

 pressure: Systolic, 115; diastolic, 90. 

 Blood count: Ked blood cells, 5,128,000; 

 white blood cells, 7,780. 



An operation was performed on June 

 14, 1915, to better the hypospadic con- 

 dition and to search for the supposed 

 testicles and bring them down. No trace 

 of the spermatic cord could be found in 

 the inguinal canal. On entering the abdo- 

 men I discovered an infantile uterus with 

 tubes and ovaries of normal appearance. 

 An ovary, with adjoining portion of its 

 tube, was excised for histological ex- 

 amination. 



The specimen consists of an ovary 

 2. 5x1. 3x1. 7 cm., together with about 5 

 cm. of tube, bearing normal fimbria?. 

 Running from one side of the ovary is a 

 layer of very thin tissue, apparently a bit 

 of the broad ligament, containing on one 

 surface a small, very flabby mass in the 



position of the parovarium. The surface of the ovary is smooth, and one 

 section is seen to contain numerous areas varying in size, presumably 

 follicles. The larger of these contain bloody fluid, the smaller watery fluid. 

 Microscopic Examination : Sections of the ovary show a typically 

 normal structure. Graafian follicles contain ova in various stages of de- 

 velopment. No corpora lutea are seen, although there is in one area a 

 splendidly preserved corpus fibrosum. A careful search failed to show 

 any abnormal elements. 



The Fallopian tube shows the usual papillary-like foldings of mucosa 

 with normal epithelium. 



The parovarium shows numerous tubules, thin-walled, and having a 

 single layer of epithelium. 



It is evident from the foregoing that we are dealing here with a case 

 of atypical sexe-ensemble. The sex of an individual must always be de- 

 termined by the nature of the gonad, regardless of the presence of ab- 

 normalities either of other parts of the genital system or of the secondary 

 sexual manifestations of the body as a whole. Consequently, this pa- 



tion of gonad in Case II showing 

 Graafian follicles containing ova 

 in various stages of development. 

 (From the Johns Hopkins Hos- 

 pital Bulletin, February, 191G.) 



