A hematocolpos is produced when the vagina becomes distended with menstrual blood above such an obstruction.
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.