PARTIAL HERMAPHRODITISM 149 



subjects are what are known as male tubular partial 

 hermaphrodites. 



By way of illustrating the statements made concern- Andrews' 

 ing the peculiar conflict of sex-characterization seen in tubular 

 most of these cases, I will first briefly mention a case, P artlal 

 under the care of Dr. Russell Andrews, that I had an aphroditism. 

 opportunity of seeing. I am indebted to this surgeon 

 for permission to make use of the following particulars : — 



The patient (fig. 45), supposed to be a young woman, 

 was twenty-three years of age. ' She ' was very good- 

 looking, and had typically feminine secondary character- 

 istics. The external genitalia were of the normal 

 feminine character, and there was a short vagina 

 (urogenital sinus) ; the urethra opened in the position 

 normal in women. 



Laparotomy was performed, and the internal geni- 

 talia were then found to consist of two testicles attached 

 by the lower poles to thick bands (? gubernacula). 



This patient was a woman in all particulars except 

 in the character of the gonads, according to the nature 

 of which it has been the custom to determine the sex. 

 But in modern terms the individual was a male tubular 

 partial hermaphrodite of the ' external ' variety. 



Many instances, moreover, of female partial tubular Tubular 

 hermaphroditism have been described ; Neugebauer 1 , {^errS 

 indeed, has collected 88 cases, and fresh examples, such aphrodites 



r with ovaries. 



as that described by Quinby 2 , are continually being 

 recorded. 



Less difficult is the diagnosis of those cases in which 

 the external genitalia conform to the sex-type exhibited 

 by the gonad : an ensemble which constitutes the 

 ' internal ' variety of tubular partial hermaphroditism. 

 The ' complete ' variety, in which the gonad differs in 

 type from the rest of the internal and from the external 

 genitalia, is probably the most obscure of all from a 

 diagnostic point of view. In all these varieties the 



1 Neugebauer, F. L. von, Hermaphroditismus, Leipzig, 1918. 



2 Quinby, W. C, Bull. Johns Hopk Hosp., 1916, vol. xxvii, p. 50. 



