144 THE SEX-COMPLEX 



Histological The masses and columns of cells, which do not form 



author's case tubules, resemble what may be seen in the early stage 



of glandular m the development of the normal testis : they have none 



herm- of the appearances of malignant cells, for their nuclei are 



ap ro i ism. re g U j ar anc j q U i e scent, and the cells themselves are nearly 



all of one size and appear stable in their mode of growth. 



With regard to the interstitial cells it might be 



thought that they were ovarian and not testicular. As 



a rule, however, the interstitial cells of the ovary are 



much smaller, and never have I seen them so well 



marked, either in normal or pathological circumstances, 



as here shown. Further, if these interstitial cells were 



really ovarian one would expect to find them in the 



ovarian portion of the ovitestis — from which they are 



entirely absent — rather than in the testicular portion. 



This is the general picture presented by an ovi- 

 testis ; but in the histological diagnosis of the condition 

 there must always be difficulty. In the first place, there 

 are masses of columnar cells which have no definite 

 tubular arrangement. It was probably this irregularity 

 of distribution which gave rise to the opinion, to which 

 allusion has already been made, that in the case 

 described the growth was malignant. In some parts, of 

 course, there is a definitely tubular arrangement of the 

 darkly staining columnar cells ; and in other places 

 tubules may be found lined with a single layer of 

 epithelium, and containing secretion. There is, however, 

 never any definite spermatogenesis to be seen. 

 Clinial It is particularly interesting to note in regard to the 



history of case recor( jed above, that the patient commenced life 



author s case * 



of glandular and passed puberty as a normal girl, menstruating 

 hern> regularly for eighteen months ; that menstruation had 



aphroditism. i\ ien ceased and masculine characteristics had developed, 

 and that in spite of this she suffered with slight meno- 

 pausal symptoms after operation, and has now reverted 

 entirely to the feminine or to a neutral type. This, 

 surely, is dual sex-characterization,if ever there were such 

 a thing : an interesting question which we shall discuss 

 more fully after considering the other varieties of 



