Ward reports the successful removal of a dermoid cyst weighing 30pounds 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.
