A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
=Hermaphroditism.=--A true hermaphrodite is an individual who possesses
the organs of both sexes in a condition of perfect function. The
existence of true hermaphroditism is denied by many authorities of
the present day, though the older writers firmly believed in it. The
coexistence of testicles and ovaries has never been proved beyond doubt
in the human subject. It is doubtful if there are any cases, recorded
as true hermaphrodites, in which the demonstration of the condition
is not open to serious criticism; such individuals are in reality
pseudo-hermaphrodites. The term hermaphrodite is still, however, very
commonly applied to any individual of doubtful sex.
A _pseudo-hermaphrodite_ is possessed of a distinct sex, and has either
ovaries or testicles, though the external genitals and other secondary
sexual characteristics may present the appearance of a double sex.
In _male pseudo-hermaphroditism_ the individual has testicles, and the
external genital organs simulate those of the female.
In _female pseudo-hermaphroditism_ the individual has ovaries, and the
external genital organs simulate those of the male.
In male pseudo-hermaphroditism the condition of hypospadias is usually
present, the lower surface of the urethra and the perineum being split.
The penis may be very small and imperforate, the urethra opening at its
base. The fissure of the perineum closely resembles the vagina, and the
split scrotum may be mistaken for the labia. Cases of this kind are on
record in which the individuals, ignorant of their true sex, have for
years indulged in sexual connection with men.
In female pseudo-hermaphroditism there is hypertrophy of the clitoris
and the prepuce, with approximation of the labia majora and contraction
or occlusion of the ostium vaginæ, giving the genitals the appearance
of the masculine type.
The secondary sexual characteristics of both varieties of
pseudo-hermaphrodites--the distribution of hair, mammary development,
shape, voice, etc.--are usually of the feminine type.
It is often exceedingly difficult to determine during life the true sex
of the individual in cases of hermaphroditism. The only absolute test
of the sex is the determination of the genital glands.
The labia should be carefully palpated to determine whether or not
testicles are present. Rectal examination should be made to determine
the existence of uterus or ovaries. The sexual inclinations of the
individual should be observed. The discharge from the genitals during
sexual excitement should be examined for spermatozoa.
The presence of a uterus is not necessarily indicative of a female,
as a uterus may be associated with a perfect penis and testes; and a
periodic discharge of blood from the genitals has been found in men.
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