142 



THE SEX-COMPLEX 



Author's 

 case of 

 glandular 

 partial 

 herm- 

 aphroditism. 



After-history. — The patient made a good recovery 

 from the operation, but subsequently suffered with 

 slight menopausal symptoms. When she was examined 

 eight months after operation I found that all the hair 

 had disappeared from the legs and the upper lip. The 

 voice was slightly higher in tone, and the figure and skin 

 were greatly altered towards the feminine type. The 

 breasts, however, showed very little development, but 

 this was not to be expected in the absence of ovaries. 



The specimen 1 consists of the fundus uteri, the 

 Falloppian tubes, and the gonads — the genital glands 

 being in the position normal to the female and attached to 

 the uterus by ' ovarian ' ligaments. Scars can be seen 

 running lengthwise along the convexity of each gland, 

 indicating the sites from which the pieces were excised 

 for examination. The fimbriated extremity of the left 

 Falloppian tube has become attached to the scar in the 

 corresponding gonad. There is evidence also of a 

 ' parovarium ' on this side. A portion of the ovarian 

 graft, which on histological examination was found to be 

 necrotic, can be seen in the anterior wall of the fundus 

 uteri. 



An X-ray examination of the patient by Mr. Thurstan 

 Holland showed no ossification in the thyroid cartilage; 

 but this would not be expected even in the male at such 

 an early age. 



A laryngeal examination was made by Mr. Guthrie 

 who reported as follows : — 



" I examined the larynx of your patient S.B. again 

 " to-day. The larynx appears to me to present definitely 

 " male characteristics ; the cavity is very roomy, and 

 " the vocal cords are both broader and larger than those 

 " of the ordinary female larynx. Using a graduated 

 " laryngeal mirror I attempted to measure their length, 



(F. T. Paul, J. M. Beattie, E. E. Glynn, R. J. M. Buchanan, and W. 

 Blair Bell), and by other independent authorities (S. G. Shattock, 

 A. Keith, R. Muir). It may be mentioned that an anonymous 

 reviewer {Edin. Med. Journ. New. Ser., 1916, vol. xvii, p. 56) of the 

 first edition of this work dismissed the case in the following words : 

 " His case is merely this — a female with some slight inversion in hair 

 and larynx and the very rare condition of an inclusion of Miillerian 

 epithelium in one sex gland ". As this critic has not seen sections of 

 the gland in question, we may disregard a statement of this kind 

 made ex cathedra. 



1 Now in the Museum of the Royal College of Surgeons, London. 



