7. The commonly associated defects are: More or less completely septate

bladder, atresia ani, or more rarely double anus, double urethra, increased breadth of the bony pelvis with defect of the symphysis pubis, and possibly duplication of the lower end of the spine, and hernia of some of the abdominal contents into a perineal pouch. Much more rarely, duplication of the heart, lungs, stomach, and kidneys has been noted, and the lower limbs may be shorter than normal. CLASS XI.--Cases of fetus in fetu, those strange instances in which one might almost say that a man may be pregnant with his brother or sister, or in which an infant may carry its twin without the fact being apparent, will next be discussed. The older cases were cited as being only a repetition of the process by which Eve was born of Adam. Figure 63 represents an old engraving showing the birth of Eve. Bartholinus, the Ephemerides, Otto, Paullini, Schurig, and Plot speak of instances of fetus in fetu. Ruysch describes a tumor contained in the abdomen of a man which was composed of hair, molar teeth, and other evidences of a fetus. Huxham reported to the Royal Society in 1748 the history of a child which was born with a tumor near the anus larger than the whole body of the child; this tumor contained rudiments of an embryo. Young speaks of a fetus which lay encysted between the laminae of the transverse mesocolon, and Highmore published a report of a fetus in a cyst communicating with the duodenum. Dupuytren gives an example in a boy of thirteen, in whom was found a fetus. Gaetano-Nocito, cited by Philipeaux, has the history of a taken with a great pain in the right hypochondrium, and from which issued subsequently fetal bones and a mass of macerated embryo. His mother had had several double pregnancies, and from the length of the respective tibiae one of the fetuses seemed to be of two months' and the other of three months' intrauterine life. The man died five years after the abscess had burst spontaneously. Brodie speaks of a case in which fetal remains were taken from the abdomen of a girl of two and one-half years. Gaither describes a child of two years and nine months, supposed to be affected with ascites, who died three hours after the physician's arrival. In its abdomen was found a fetus weighing almost two pounds and connected to the child by a cord resembling an umbilical cord. This child was healthy for about nine months, and had a precocious longing for ardent spirits, and drank freely an hour before its death. Blundell says that he knew "a boy who was literally and without evasion with child, for the fetus was contained in a sac communicating with the abdomen and was connected to the side of the cyst by a short umbilical cord; nor did the fetus make its appearance until the boy was eight or ten years old, when after much enlargement of pregnancy and subsequent flooding the boy died." The fetus, removed after death, on the whole not very imperfectly formed, was of the size of about six or seven months' gestation. Bury cites an account of a child that had a second imperfectly developed fetus in its face and scalp. There was a boy by the name of Bissieu who from the earliest age had a pain in one of his left ribs; this rib was larger than the rest and seemed to have a tumor under it. He died of phthisis at fourteen, and after death there was found in a pocket lying against the transverse colon and communicating with it all the evidences of a fetus. At the Hopital de la Charite in Paris, Velpeau startled an audience of 500 students and many physicians by saying that he expected to find a rudimentary fetus in a scrotal tumor placed in his hands for operation. His diagnosis proved correct, and brought him resounding praise, and all wondered as to his reasons for expecting a fetal tumor. It appears that he had read with care a report by Fatti of an operation on the scrotum of a child which had increased in size as the child grew, and was found to contain the ribs, the vertebral column, the lower extremities as far as the knees, and the two orbits of a fetus; and also an account of a similar operation performed by Wendt of Breslau on a Silesian boy of seven. The left testicle in this case was so swollen that it hung almost to the knee, and the fetal remains removed weighed seven ounces. Sulikowski relates an instance of congenital fetation in the umbilicus of a girl of fourteen, who recovered after the removal of the anomaly. Aretaeos described to the members of the medical fraternity in Athens the case of a woman of twenty-two, who bore two children after a seven months' pregnancy. One was very rudimentary and only 21 inches long, and the other had an enormous head resembling a case of hydrocephalus. On opening the head of the second fetus, another, three inches long, was found in the medulla oblongata, and in the cranial cavity with it were two additional fetuses, neither of which was perfectly formed. Broca speaks of a fetal cyst being passed in the urine of a man of sixty-one; the cyst contained remnants of hair, bone, and cartilage. Atlee submits quite a remarkable case of congenital ventral gestation, the subject being a girl of six, who recovered after the discharge of the fetal mass from the abdomen. McIntyre speaks of a child of eleven, playing about and feeling well, but whose abdomen progressively increased in size 1 1/2 inches each day. After ten days there was a large fluctuating mass on the right side; the abdomen was opened and the mass enucleated; it was found to contain a fetal mass weighing nearly five pounds, and in addition ten pounds of fluid were removed. The child made an early recovery. Rogers mentions a fetus that was found in a man's bladder. Bouchacourt reports the successful extirpation of the remains of a fetus from the rectum of a child of six. Miner describes a successful excision of a congenital gestation. Modern literature is full of examples, and nearly every one of the foregoing instances could be paralleled from other sources. Rodriguez is quoted as reporting that in July, 1891, several newspapers in the city of Mexico published, under the head of "A Man-mother," a wonderful story, accompanied by wood-cuts, of a young man from whose body a great surgeon had extracted a "perfectly developed fetus." One of these wood-cuts represented a tumor at the back of a man opened and containing a crying baby. In commenting upon this, after reviewing several similar cases of endocymian monsters that came under his observation in Mexico, Rodriguez tells what the case which had been so grossly exaggerated by the lay journals really was: An Indian boy, aged twenty-two, presented a tumor in the sacrococcygeal region measuring 53 cm. in circumference at the base, having a vertical diameter of 17 cm. and a transverse diameter of 13 cm. It had no pedicle and was fixed, showing unequal consistency. At birth this tumor was about the size of a pigeon's egg. A diagnosis of dermoid cyst was made and two operations were performed on the boy, death following the second. The skeleton showed interesting conditions; the rectum and pelvic organs were natural, and the contents of the cyst verified the diagnosis. Quite similar to the cases of fetus in fetu are the instances of dermoid cysts. For many years they have been a mystery to physiologists, and their origin now is little more than hypothetic. At one time the fact of finding such a formation in the ovary of an unmarried woman was presumptive evidence that she was unchaste; but this idea was dissipated as soon as examples were reported in children, and to-day we have a well-defined difference between congenital and extrauterine pregnancy. Dermoid cysts of the ovary may consist only of a wall of connective tissue lined with epidermis and containing distinctly epidermic scales which, however, may be rolled up in firm masses of a more or less soapy consistency; this variety is called by Orth epidermoid cyst; or, according to Warren, a form of cyst made up of skin containing small and ill-defined papillae, but rich in hair follicles and sebaceous glands. Even the erector pili muscle and the sudoriparous gland are often found. The hair is partly free and rolled up into thick balls or is still attached to the walls. A large mass of sebaceous material is also found in these cysts. Thomson reports a case of dermoid cyst of the bladder containing hair, which cyst he removed. It was a pedunculated growth, and it was undoubtedly vesical and not expelled from some ovarian source through the urinary passage, as sometimes occurs. The simpler forms of the ordinary dermoid cysts contain bone and teeth. The complicated teratoma of this class may contain, in addition to the previously mentioned structures, cartilage and glands, mucous and serous membrane, muscle, nerves, and cerebral substance, portions of eyes, fingers with nails, mammae, etc. Figure 64 represents a cyst containing long red hair that was removed from a blonde woman aged forty-four years who had given birth to six children. Cullingworth reports the history of a woman in whom both ovaries were apparently involved by dermoids, who had given birth to 12 children and had three miscarriages--the last, three months before the removal of the growths. The accompanying illustration, taken from Baldy, pictures a dermoid cyst of the complicated variety laid open and exposing the contents in situ. Mears of Philadelphia reports a case of ovarian cyst removed from a girl of six and a half by Bradford of Kentucky in 1875. From this age on to adult life many similar cases are recorded. Nearly every medical museum has preserved specimens of dermoid cysts, and almost all physicians are well acquainted with their occurrence. The curious formations and contents and the bizarre shapes are of great variety. Graves mentions a dermoid cyst containing the left side of a human face, an eye, a molar tooth, and various bones. Dermoid cysts are found also in regions of the body quite remote from the ovary. The so-called "orbital wens" are true inclusion of the skin of a congenital origin, as are the nasal dermoids and some of the cysts of the neck. Weil reported the case of a man of twenty-two years who was born with what was supposed to be a spina bifida in the lower sacral region. According to Senn, the swelling never caused any pain or inconvenience until it inflamed, when it opened spontaneously and suppurated, discharging a large quantity of offensive pus, hair, and sebaceous material, thus proving it to have been a dermoid. The cyst was freely incised, and there were found numerous openings of sweat glands, from which drops of perspiration escaped when the patient was sweating. Dermoid cysts of the thorax are rare. Bramann reported a case in which a dermoid cyst of small size was situated over the sternum at the junction of the manubrium with the gladiolus, and a similar cyst in the neck near the left cornu of the hyoid bone. Chitten removed a dermoid from the sternum of a female of thirty-nine, the cyst containing 11 ounces of atheromatous material. In the Museum of St. Bartholomew's Hospital in London there is a congenital tumor which was removed from the anterior mediastinum of a woman of twenty one, and contained portions of skin, fat, sebaceous material, and two pieces of bone similar to the superior maxilla, and in which several teeth were found. Dermoids are found in the palate and pharynx, and open dermoids of the conjunctiva are classified by Sutton with the moles. According to Senn, Barker collected sixteen dermoid tumors of the tongue. Bryk successfully removed a tumor of this nature the size of a fist. Wellington Gray removed an enormous lingual dermoid from the mouth of a negro. It contained 40 ounces of atheromatous material. Dermoids of the rectum are reported. Duyse reports the history of a case of labor during which a rectal dermoid was expelled. The dermoid contained a cerebral vesicle, a rudimentary eye, a canine and a molar tooth, and a piece of bone. There is little doubt that many cases of fetus in fetu reported were really dermoids of the scrotum. Ward reports the successful removal of a dermoid cyst weighing 30 pounds from a woman of thirty-two, the mother of two children aged ten and twelve, respectively. The report is briefly as follows: "The patient has always been in good health until within the last year, during which time she has lost flesh and strength quite rapidly, and when brought to my hospital by her physician, Dr. James of Williamsburg, Kansas, was quite weak, although able to walk about the house. A tumor had been growing for a number of years, but its growth was so gradual that the patient had not considered her condition critical until quite recently. The tumor was diagnosed to be cystoma of the left ovary. Upon opening the sac with the trocar we were confronted by complications entirely unlooked for, and its use had to be abandoned entirely because the thick contents of the cyst would not flow freely, and the presence of sebaceous matter blocked the instrument. As much of the fluid as possible was removed, and the abdominal incision was enlarged to allow of the removal of the large tumor. An ovarian hematoma the size of a large orange was removed from the right side. We washed the intestines quite as one would wash linen, since some of the contents of the cyst had escaped into the abdominal cavity. The abdomen was closed without drainage, and the patient placed in bed without experiencing the least shock. Her recovery was rapid and uneventful. She returned to her home in four weeks after the operation. "The unusual feature in this case was the nature of the contents of the sac. There was a large quantity of long straight hair growing from the cyst wall and an equal amount of loose hair in short pieces floating through the tumor-contents, a portion of which formed nuclei for what were called 'moth-balls,' of which there were about 1 1/2 gallons. These balls, or marbles, varied from the size of moth-balls, as manufactured and sold by druggists, to that of small walnuts. They seemed to be composed of sebaceous matter, and were evidently formed around the short hairs by the motion of the fluid produced by walking or riding. There was some tissue resembling true skin attached to the inner wall of the sac." There are several cases of multiple dermoid cysts on record, and they may occur all over the body. Jamieson reports a case in which there were 250, and in Maclaren's case there were 132. According to Crocker, Hebra and Rayer also each had a case. In a case of Sangster, reported by Politzer, although most of the dermoids, as usual, were like fibroma-nodules and therefore the color of normal skin, those over the mastoid processes and clavicle were lemon-yellow, and were generally thought to be xanthoma until they were excised, and Politzer found they were typical dermoid cysts with the usual contents of degenerated epithelium and hair. Hermaphroditism.--Some writers claim that Adam was the first hermaphrodite and support this by Scriptural evidence. We find in some of the ancient poets traces of an Egyptian legend in which the goddess of the moon was considered to be both male and female. From mythology we learn that Hermaphroditus was the son of Hermes, or Mercury, and Venus Aphrodite, and had the powers both of a father and mother. In speaking of the foregoing Ausonius writes, "Cujus erat facies in qua paterque materque cognosci possint, nomen traxit ab illis." Ovid and Virgil both refer to legendary hermaphrodites, and the knowledge of their existence was prevalent in the olden times. The ancients considered the birth of hermaphrodites bad omens, and the Athenians threw them into the sea, the Romans, into the Tiber. Livy speaks of an hermaphrodite being put to death in Umbria, and another in Etruria. Cicero, Aristotle, Strabonius, and Pliny all speak concerning this subject. Martial and Tertullian noticed this anomaly among the Romans. Aetius and Paulus Aegineta speak of females in Egypt with prolonged clitorides which made them appear like hermaphrodites. Throughout the Middle Ages we frequently find accounts, naturally exaggerated, of double-sexed creatures. Harvey, Bartholinus, Paullini, Schenck, Wolff, Wrisberg, Zacchias, Marcellus Donatus, Haller, Hufeland, de Graff, and many others discuss hermaphroditism. Many classifications have been given, as, e.g., real and apparent; masculine, feminine, or neuter; horizontal and vertical; unilateral and bilateral, etc. The anomaly in most cases consists of a malformation of the external genitalia. A prolonged clitoris, prolapsed ovaries, grossness of figure, and hirsute appearance have been accountable for many supposed instances of hermaphrodites. On the other hand, a cleft scrotum, an ill-developed penis, perhaps hypospadias or epispadias, rotundity of the mammae, and feminine contour have also provoked accounts of similar instances. Some cases have been proved by dissection to have been true hermaphrodites, portions or even entire genitalia of both sexes having been found. Numerous accounts, many mythical, but always interesting, are given of these curious persons. They have been accredited with having performed the functions of both father and mother, notwithstanding the statements of some of the best authorities that they are always sterile. Observation has shown that the sexual appetite diminishes in proportion to the imperfections in the genitalia, and certainly many of these persons are sexually indifferent. We give descriptions of a few of the most famous or interesting instances of hermaphroditism. Pare speaks of a woman who, besides a vulva, from which she menstruated, had a penis, but without prepuce or signs of erectility. Haller alludes to several cases in which prolonged clitorides have been the cause of the anomaly. In commenting on this form of hermaphroditism Albucasiusus describes a necessary operation for the removal of the clitoris. Columbus relates the history of an Ethiopian woman who was evidently a spurious female hermaphrodite. The poor wretch entreated him to cut off her penis, an enlarged clitoris, which she said was an intolerable hindrance to her in coitus. De Graff and Riolan describe similar cases. There is an old record of a similar creature, supposing herself to be a male, who took a wife, but previously having had connection with a man, the outcome of which was pregnancy, was shortly after marriage delivered of a daughter. There is an account of a person in Germany who, for the first thirty years of life, was regarded as feminine, and being of loose morals became a mother. At a certain period she began to feel a change in her sexual inclinations; she married and became the father of a family. This is doubtless a distortion of the facts of the case of Catherine or Charles Hoffman, born in 1824, and who was considered a female until the age of forty. At puberty she had the instincts of a woman, and cohabitated with a male lover for twenty years. Her breasts were well formed and she menstruated at nineteen. At the age of forty-six her sexual desires changed, and she attempted coitus as a man, with such evident satisfaction that she married a woman soon afterward. Fitch speaks of a house-servant with masculine features and movements, aged twenty-eight, and 5 feet and 9 inches tall, who was arrested by the police for violating the laws governing prostitution. On examination, well-developed male and female organs of generation were found. The labia majora were normal and flattened on the anterior surface. The labia minora and hymen were absent. The vagina was spacious and the woman had a profuse leukorrhea. She stated that several years previously she gave birth to a normal child. In place of a clitoris she had a penis which, in erection, measured 5 1/4 inches long and 3 5/8 inches in circumference. The glans penis and the urethra were perfectly formed. The scrotum contained two testicles, each about an inch long; the mons veneris was sparsely covered with straight, black hair. She claimed functional ability with both sets of genitalia, and said she experienced equal sexual gratification with either. Semen issued from the penis, and every three weeks she had scanty menstruation, which lasted but two days. Beclard showed Marie-Madeline Lefort, nineteen years of age, 1 1/2 meters in height. Her mammae were well developed, her nipples erectile and surrounded by a brown areola, from which issued several hairs. Her feet were small, her pelvis large, and her thighs like those of a woman. Projecting from the vulva was a body looking like a penis 7 cm. long and slightly erectile at times; it was imperforate and had a mobile prepuce. She had a vulva with two well-shaped labia as shown by the accompanying illustration. She menstruated slightly and had an opening at the root of the clitoris. The parotid region showed signs of a beard and she had hair on her upper lip. On August 20, 1864, a person came into the Hotel-Dieu, asking treatment for chronic pleurisy. He said his age was sixty-five, and he pursued the calling of a mountebank, but remarked that in early life he had been taken for a woman. He had menstruated at eight and had been examined by doctors at sixteen. The menstruation continued until 1848, and at its cessation he experienced the feelings of a male. At this time he presented the venerable appearance of a long-bearded old man. At the autopsy, about two months later, all the essentials of a female were delineated. A Fallopian tube, ovaries, uterus, and round ligaments were found, and a drawing in cross-section of the parts was made. There is no doubt but that this individual was Marie-Madeline Lefort in age. Worbe speaks of a person who was supposed to be feminine for twenty-two years. At the age of sixteen she loved a farmer's son, but the union was delayed for some reason, and three years later her grace faded and she became masculine in her looks and tastes. It was only after lengthy discussion, in which the court took part, that it was definitely settled that this person was a male. Adelaide Preville, who was married as a female, and as such lived the last ten years of her life in France, was found on dissection at the Hotel-Dieu to be a man. A man was spoken of in both France and Germany a who passed for many years as a female. He had a cleft scrotum and hypospadias, which caused the deception. Sleeping with another servant for three years, he constantly had sexual congress with her during this period, and finally impregnated her. It was supposed in this case that the posterior wall of the vagina supplied the deficiency of the lower boundary of the urethra, forming a complete channel for the semen to proceed through. Long ago in Scotland a servant was condemned to death by burial alive for impregnating his master's daughter while in the guise and habit of a woman. He had always been considered a woman. We have heard of a recent trustworthy account of a pregnancy and delivery in a girl who had been impregnated by a bed-fellow who on examination proved to be a male pseudohermaphrodite. Fournier speaks of an individual in Lisbon in 1807 who was in the highest degree graceful, the voice feminine, the mammae well developed, The female genitalia were normal except the labia majora, which were rather diminutive. The thighs and the pelvis. were not so wide as those of a woman. There was some beard on the chin, but it was worn close. the male genitalia were of the size and appearance of a male adult and were covered with the usual hair. This person had been twice pregnant and aborted at the third and fifth month. During coitus the penis became erect, etc. Schrell describes a case in which, independent of the true penis and testicles, which were well formed, there existed a small vulva furnished with labia and nymphae, communicating with a rudimentary uterus provided with round ligaments and imperfectly developed ovaries. Schrell remarks that in this case we must notice that the female genitalia were imperfectly developed, and adds that perfect hermaphroditism is a physical impossibility without great alterations of the natural connections of the bones and other parts of the pelvis. Cooper describes a woman with an enormous development of the clitoris, an imperforate uterus, and absence of vagina; at first sight of the parts they appeared to be those of a man. In 1859 Hugier succeeded in restoring a vagina to a young girl of twenty who had an hypertrophied clitoris and no signs of a vagina. The accompanying illustrations show the conformation of the parts before operation with all the appearance of ill-developed male genitalia, and the appearance afterward with restitution of the vaginal opening. Virchow in 1872, Boddaert in 1875, and Marchand in 1883 report cases of duplication of the genitalia, and call their cases true hermaphrodites from an anatomic standpoint. There is a specimen in St. Bartholomew's Hospital in London from a man of forty-four, who died of cerebral hemorrhage. He was well formed and had a beard and a full-sized penis. He was married, and it was stated that his wife had two children. The bladder and the internal organs of generation were those of a man in whom neither testis had descended into the scrotum, and in whom the uterus masculinus and vagina were developed to an unusual degree. The uterus, nearly as large as in the adult female, lay between the bladder and rectum, and was enclosed between two layers of peritoneum, to which, on either side of the uterus, were attached the testes. There was also shown in London the pelvic organs from a case of complex or vertical hermaphroditism occurring in a child of nine months who died from the effects of an operation for the radical cure of a right inguinal hernia. The external organs were those of a male with undescended testes. The bladder was normal and its neck was surrounded by a prostate gland. Projecting backward were a vagina, uterus, and broad ligaments, round ligaments, and Fallopian tubes, with the testes in the position of the ovaries. There were no seminal vesicles. The child died eleven days after the operation. The family history states that the mother had had 14 children and eight miscarriages. Seven of the children were dead and showed no abnormalities. The fifth and sixth children were boys and had the same sexual arrangement. Barnes, Chalmers, Sippel, and Litten describe cases of spurious hermaphroditism due to elongation of the clitoris. In Litten's case a the clitoris was 3 1/2 inches long, and there was hydrocele of the processus vaginalis on both sides, making tumors in the labium on one side and the inguinal canal on the other, which had been diagnosed as testicles and again as ovaries. There was associate cystic ovarian disease. Plate 4 is taken from a case of false external bilateral hermaphroditism. Phillips mentions four cases of spurious hermaphroditism in one family, and recently Pozzi tells of a family of nine individuals in whom this anomaly was observed. The first was alive and had four children; the second was christened a female but was probably a male; the third, fourth, and fifth were normal but died young; the sixth daughter was choreic and feeble-minded, aged twenty-nine, and had one illegitimate child; the seventh, a boy, was healthy and married; the eighth was christened a female, but when seventeen was declared by the Faculty to be a male; the ninth was christened a female, but at eighteen the genitals were found to be those of a male, though the mammae were well developed. O'Neill speaks of a case in which the clitoris was five inches long and one inch thick, having a groove in its inferior surface reaching down to an oblique opening in the perineum. The scrotum contained two hard bodies thought to be testicles, and the general appearance was that of hypospadias. Postmortem a complete set of female genitalia was found, although the ovaries were very small. The right round ligament was exceedingly thick and reached down to the bottom of the false scrotum, where it was firmly attached. The hard bodies proved to be on one side an irreducible omental hernia, probably congenital, and on the other a hardened mass having no glandular structure. The patient was an adult. As we have seen, there seems to be a law of evolution in hermaphroditism which prevents perfection. If one set of genitalia are extraordinarily developed, the other set are correspondingly atrophied. In the case of extreme development of the clitoris and approximation to the male type we must expect to find imperfectly developed uterus or ovaries. This would answer for one of the causes of sterility in these cases. There is a type of hermaphroditism in which the sex cannot be definitely declared, and sometimes dissection does not definitely indicate the predominating sex. Such cases are classed under the head of neuter hermaphrodites, possibly an analogy of the "genus epicoenum" of Quintilian. Marie Dorothee, of the age of twenty-three, was examined and declared a girl by Hufeland and Mursina, while Stark, Raschig, and Martens maintained that she was a boy. This formidable array of talent on both sides provoked much discussion in contemporary publications, and the case attracted much notice. Marc saw her in 1803, at which time she carried contradicting certificates as to her sex. He found an imperforate penis, and on the inferior face near the root an opening for the passage of urine. No traces of nymphae, vagina, testicles, nor beard were seen. The stature was small, the form debilitated, and the voice effeminate. Marc came to the conclusion that it was impossible for any man to determine either one sex or the other. Everard Home dissected a dog with apparent external organs of the female, but discovered that neither sex was sufficiently pronounced to admit of classification. Home also saw at the Royal Marine Hospital at Plymouth, in 1779, a marine who some days after admission was reported to be a girl. On examination Home found him to possess a weak voice, soft skin, voluminous breasts, little beard, and the thighs and legs of a woman. There was fat on the pubis, the penis was short and small and incapable of erection, the testicles of fetal size; he had no venereal desires whatever, and as regards sex was virtually neuter. The legal aspect of hermaphroditism has always been much discussed. Many interesting questions arise, and extraordinary complications naturally occur. In Rome a hermaphrodite could be a witness to a testament, the exclusive privilege of a man, and the sex was settled by the predominance. If the male aspect and traits together with the generative organs of man were most pronounced, then the individual could call himself a man. "Hermaphroditus an ad testamentum adhiberi possit qualitas sesus incalescentis ostendit." There is a peculiar case on record in which the question of legal male inheritance was not settled until the individual had lived as a female for fifty-one years. This person was married when twenty-one, but finding coitus impossible, separated after ten years, and though dressing as a female had coitus with other women. She finally lived with her brother, with whom she eventually came to blows. She prosecuted him for assault, and the brother in return charged her with seducing his wife. Examination ensued, and at this ripe age she was declared to be a male. The literature on hermaphroditism is so extensive that it is impossible to select a proper representation of the interesting cases in this limited space, and the reader is referred to the modern French works on this subject, in which the material is exhaustive and the discussion thoroughly scientific.