No detailed account of other pathological manifestations of the sexual life will now be attempted, since this work professes to deal only with subjects of a wide and general significance. We cannot consider those cases, for instance, in which there is developmental defect of the reproductive organs; those, for example, in which there is no discoverable development of the reproductive glands. But some reference may be made to hermaphroditism. In the human species true hermaphroditism is a very rare occurrence, whereas apparent hermaphroditism, the so-called pseudo-hermaphroditism, is comparatively frequent. The sexual life of pseudo-hermaphrodites has in some instances been very carefully studied, more especially with reference to the relationship of pseudo-hermaphroditism to the direction of the sexual impulse. It appears that in a number of cases of pseudo-hermaphroditism, not only did the secondary sexual characters exhibit an inverted or contrary sexual development, but the sexual impulse was also inverted--was directed, that is to say, towards individuals of the same sex as that to which the pseudo-hermaphrodite really belonged. Beyond question, cases have been observed in which pseudo-hermaphrodites with testicles have had sexual inclination towards males; and pseudo-hermaphrodites with ovaries, sexual inclination towards females. In many of these cases, such contrary sexual tendencies could be traced back into childhood. We have, of course, to reckon with the fact that in the case of pseudo-hermaphrodites the diagnosis of the sex is usually based upon the formation of the external genital organs, and without any expert examination of the reproductive glands; thus they are often brought up as members of a sex to which they do not really belong, and in consequence of this their education is sexually inverted. In such cases it may reasonably be suggested that the homosexuality is the result, not so much of a congenital inversion of the sexual impulse, as of the contrary sexual education. For a detailed treatment of the subject of hermaphroditism, reference should be made to the special literature of the subject, and above all to the exhaustive and laborious work of Neugebauer.[66] Chapter VI ETIOLOGY AND DIAGNOSIS