The diseases of women : a handbook for students and practitioners . Fig. 14.—The external genitals of a hypospadiac male or pseudo-hermaphrodite. dant beard and mustache. At puberty the voice changesto that of a man and sexual inclination is manifested forwomen. It is a significant fact that the condition of the externalgenitals in pseudo-hermaphrodites affords no reliable indica- tion of the nature of the internal genital An in- MALFORMATIONS OF REPRODUCTIVE ORGANS. 57 dividual with such imperfections as are presented in Fig. 15may or may not have a uterus and Fallopian tubes. Onthe other han
The diseases of women : a handbook for students and practitioners . Fig. 14.—The external genitals of a hypospadiac male or pseudo-hermaphrodite. dant beard and mustache. At puberty the voice changesto that of a man and sexual inclination is manifested forwomen. It is a significant fact that the condition of the externalgenitals in pseudo-hermaphrodites affords no reliable indica- tion of the nature of the internal genital An in- MALFORMATIONS OF REPRODUCTIVE ORGANS. 57 dividual with such imperfections as are presented in Fig. 15may or may not have a uterus and Fallopian tubes. Onthe other hand a uterus may be associated with a perfectpenis and testes. The presence of a uterus does not enableus to decide the sex in a doubtful case. In questionablecases of sex the only absolute test is the genital presence of ovaries is decisive proof of a female; testesindicate the male; and, as accurate discrimination between Fig. 15.—Sagittal section of the pelvic organs of a boy with a well-developed uterus (Mu-seum of Middlesex Hospital). a testis and an ovary is only possible on microscopic exam-ination, it is only in exceptional circumstances that sucn atest can be applied. It is impossible in an elementary work of this kind todescribe the various defects of the reproductive organs whichoccur in pseudo-hermaphrodites, but in the majority ofthese unfortunate individuals the genital glands are testes,notwithstanding the fact that many of them have a uteruswith Fallopian tubes. 58 DISEASES OF WOMEN. The majority of pseudo-hermaphrodites are brought upas girls- this is a misfortune, because at puberty (whichmay be greatly delayed) the supposed girl suddenly assumesthe voice of a man and begins to grow a beard. When there is doubt as to the sex of a child it should benamed, trained, and educated as a boy. Exstrophy of the bladder has sometimes given rise to dif-ficulty in determining the sex of a child (
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