Anomaly of form, or deformity, affects either the entire body or portions of it only, - general or partial deformity. It is either primitive or acquired; simple or complicated, that is, conjoined with anomalies of a different nature.

General deformity is rare, even as relates to very faulty abortions.

To primitive, simple partial deformities belong -

(a.) Those in which any part is preternaturally long, broad, thick, spherical, angular, curved, etc.; for example, oval, vertical pupil, oblique uterus.

(b.) The division of parenchymatous organs into two or more parts, by extraordinary lobulation (the lungs, liver, spleen, kidneys); the section of hollow organs by the inordinately sharp partition of a naturally double cavity, or by septformation in a cavity normally single; for example, double apex of the heart, bilocular uterus.

Many of the former, and still more of the latter kinds bear the impress of arrest of development, and present the images of brutes.

Amongst primitive complicated deformities may be classed most of the instances of disproportion and of absence of symmetry manifested in the preternatural volume of individual organs or sections of organs; secondly, those consisting in abnormal position, abnormal association, coalition or cleftformation; and, lastly, those founded in the superfluity or in the deficiency of parts.

Pre-eminent amongst them are hermaphrodites. The forms of hermaphroditism, strictly considered, range under several of the heads just specified as conditional upon anomalies of shape. It would, however, appear most suitable to discuss them here under a single head, seeing that from one or more fundamental anomalies inductive of hermaphroditism there often results a marked deformity of the generative organs; seeing also that the character of many of them consists essentially in a departure from the normal type. They are, in the great majority of cases, arrests of development.

In strict analogy with the relations of lower orders of animals, those malformations should be designated as hermaphrodites, in which the generative organs of both sexes are found united in a single individual. Such monstrosities have, from time immemorial, been abundantly described. We must, however, unite with Joh. Muller and Th. Bischoff in rejecting the great majority of these examples. Bischoff has pointed out the numerous sources of error by which, in such cases, a judgment may be warped; as, for instance, the great resemblance between the generative organs of the two sexes at an early period, the uniform type in the development of both, the coalition of the corpora Wolffiana, the errors formerly prevalent as to the primitive identity of both sexes. It is, therefore, easily intelligible that a judgment to be relied upon can alone be based upon a familiar knowledge of the progressive development of the genital organs, and of their elementary structure. The coexistence of testicles and of ovaries on the same side has been thrown into entire discredit by the arguments of Joh. Muller, who nevertheless admits the occurrence of ovaries on one side and of testicles on the other. Th. Bischoff, however, impugns the accuracy even of the latter observation. Nor will Bischoff unconditionally admit the numerous cases of other portions of the genital organs alleged to have been found bisexual on the same side, or male on the one side and female on the other. The history of development, he affirms, sufficiently teaches us that this species of simulation may be the result partly of an arrest, partly of a peculiar modification in the type of development. Moreover, the progressive development of the uterus, of the seminal vesicles, of the prostate gland, and of Cowper's glands, in both sexes, still remains, notwithstanding the skilful investigations of J. Muller, Rathke, Valentin, so far matter of uncertainty that we can hardly derive any support from analogy with the normal state.

Strictly speaking, therefore, neither in man nor in the higher animals, can hermaphroditism, that is, the coexistence of testicles with ovaries, occur. So far as relates to these essential organs of generation, there can be but male or but female individuals. On the other hand, the rest of the genital organs, which in their rudimental condition closely resemble each other in the two sexes, may, owing to some anomaly in the mode of their development, assume in a male individual more or less of the feminine, in a female individual more or less of the masculine form - and thus, in either case, the semblance of both combined.

If, with Bischoff, we rightly discard from hermaphroditism, cases of individuals with throughout female organs but masculine habit, and, again, with perfect male organs and feminine habit - irrespectively of a simply undersized penis or a preternaturally developed clitoris - we may, consistently with our usual classification, divide hermaphrodites into -

1. Those Which Being, As To The Essential Organs Of Generation

Those Which Being, As To The Essential Organs Of Generation (testicles and ovaries), distinctly male or female, exhibit nevertheless some anomaly of development [be it arrest, overgrowth (up to the masculine type), or disproportion of some other kind] more or less typical of the opposite sex.

(a.) Hypospadia in its highest grades, namely, on the one side with cleft scrotum and the formation of a vagina-like sinus - on the other side, as its analogue, diminutive vagina, closure thereof into a raphe' or suture, partial or entire absence of this organ, with a clitoris developed into the semblance of a penis hypospadias, or one completely channelled with a urethra.

(b.) Cryptorchism: concealed testicles in the one case; in the other its parallel condition, descent of the ovaries into the greater labia pudendi. Now and then associated with the foregoing form.

High grades of these anomalies constitute the so-called transverse hermaphroditism, implying external organs of the one and internal of the other sex. The case of externally female and internally male organs is by far the more common, because due to an arrest in the development of the male organs, whilst the opposite case depends upon the ulterior development of the female organs into the male type.

(c.) The occurrence in the male sex of a womb-like organ.

These cases collectively constitute what is termed spurious hermaphroditism.

2. Lateral Hermaphroditism

The presence of testicles and vas deferens, with or without seminal vesicles, on one side, and of ovarium and tube on the other. It has been before stated that Bischoff attaches little credit to these alleged cases of the coexistence of testicle with ovary.

3. True Hermaphroditism

True Hermaphroditism (hermaphrodite per excessum, androgynus, coexistence of male and of female organs on the same side). With reference to these cases, recorded by Meckel and by Gurlt, Bischoff remarks that not a single one offers conclusive evidence of the union of the two main organs of generation, the testicle and ovary, and that the seeming dualism of the rest of the organs is explicable according to principles of normal development.

Amongst acquired deviations of form are to be enumerated, first, those conditional upon hypertrophy and atrophy; upon change of locality and of connection - as, for instance, hernia, prolapse, oblique position of the uterus from one-sided traction, luxation; upon mechanical interference - for example, amputation, extirpation; upon cicatrization; and, lastly, those malformations of organs which essentially depend upon alterations of texture - misshappen liver, for instance.

The most frequent and marked kinds of deformity are founded upon anomalies of the osseous system; for instance, curvatures of the spine, of the long cylindrical bones, dislocations, preternatural articulations, etc.