362 INTERNAL SECRETION 



of generation. Not only does the genital apparatus in pseudo- 

 hermaphrodites show abnormal development, though in a vary- 

 ing degree, but these individuals possess secondary somatic and 

 psychic sex characteristics which are not in accordance with the 

 type of their sexual glands. 



There are, further, those numerous and undoubtedly bona 

 fide instances in which individuals, with normal unisexual genital 

 glands and normal internal and external genitals, possess more 

 or less clearly marked heterologous sexual characteristics. Such 

 are the large-boned muscular women with flat chests, narrow hips, 

 deep voices, and more or less beard; and the beardless men with 

 rounded outlines and soft flesh, with well-developed mammary 

 glands and high-pitched feminine voices. Halban suggests the 

 name hermaphroditismus secundarius for this class of abnormality, 

 thus enlarging the definition of hermaphroditism to include the 

 secondary stigmata of sex. Moreover, Halban considers that the 

 psychic properties and peculiarities of character, which are 

 described by the terms "masculinity" and "femininity," are 

 congenital characteristics of sex, and the perversion of these he 

 also includes under the heading of secondary pseudo-hermaphro- 

 ditism. 



To consider the more detailed aspect of hermaphroditism and 

 to describe the abnormal combinations of sexual stigmata which 

 have been observed would take us too far afield. The literature 

 of the subject is considerable. Neugebauer, in his recent report, 

 describes 1,300 cases of pseudo-hermaphroditism ; but these 

 observations do not furnish certain evidence either for or against 

 the dependence of somatic sexual distinctions upon the cells of 

 generation. It is affirmed upon all sides that anomalies of the 

 sexual system are very frequently accompanied by structural de- 

 fects in other parts of the body, and that these defects are of a 

 kind which arise, in part, at a very early stage of development 

 (Hegar). So experienced a scientist as Neugebauer regards 

 pseudo-hermaphroditism as actually one of the symptoms of 

 general malformation. And Pick has recently shown that the 

 genital glands of pseudo-hermaphrodites are primarily malformed 

 from the time of the primitive genital trace; he points to the 

 remarkable preponderance of teratoma and tumours developed 

 from a teratomatoid primordial origin among the new formations 

 of pseudo-hermaphrodites. Pick regards these tumours as tissue 

 proliferations from a previous embryonal malformation, in a 

 malformed embryonal organ. It is interesting in this connection 

 that Bertkau, who has brought together all the known instances 

 of hermaphroditism among arthropoda, arrived at the conclusion 

 that all conditions leading to abnormality of any kind are 

 favourable to the development of hermaphroditism. 



These observations seem very clearly to suggest that the 

 cause of the absence of the somatic stigmata of sex is to be found 

 in the imperfect differentiation of the cells of generation. 



