Ernest Rumley Dawson.

The causation of sex in man; a new theory of sex based on clinical materials together with chapters on forecasting or predicting the sex of the unborn child and on the determination or production of either sex at will online

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resulting child was a boy.

On the other hand, I find that the female sex is due to
ova which arise from the left ovary only: to prove it it is
necessary to give cases of female pregnancy with the corpus
luteum in the left ovary, thus:

Dr. Amand Routh, 1 in a case of " Uterine appendages
showing Haematosalpinx," says:

" These bilateral appendages were removed. The uterus was
enlarged, and this condition, with the dilated tube and the corpus
luteum, was taken to mean that an early tubal gestation was present,
especially as the corpus luteum was on the same side as the tubal

Subsequently the patient was found to be pregnant five

" So that at the date of the removal of the appendages she must
have been two and a half months pregnant. Her labour was un-
eventful. Her child was small."

Dr. Routh now informs me that the corpus luteum was
in the left ovary; the child when subsequently born was
a girl.

Dr. Herman's * case. Disease of right ovary. Child
female. No corpus luteum mentioned.

" On the right side a cheesy-matter-containing body was attached
to the right broad ligament : examined microscopically it was
thought to be the ovary. The foetus was a female."

The right ovary being disintegrated and diseased, the
left ovary must have supplied the ovum, and the child was
consequently a female.

1 Amand Routh, " Trans. Obstet. Soc.," 1898, p. 307.

2 Herman, " Trans. Obstet. Soc.," 1897, pp. 135-7.


Dr. H. R. Spencer's 1 three cases of Porro's operation.
Dr. H. R. Spencer removed the pregnant uterus owing to
fibroids in the first case. The child was a female, and
though the corpus luteum is not mentioned, it is distinctly
stated that the left ovary was larger than the right.

The presence of a true corpus luteum invariably tempo-
rarily increases the size of the ovary in which it is contained,
until it shrinks and disappears; so that in this case it is
reasonable to conclude that the larger size of the left, or
normally smaller ovary, was due to the presence therein of
the corpus luteum of the pregnancy.

Gerrish 2 says :

" During pregnancy the gland (ovary) which contains the corpus
luteum is much larger than its fellow."

And the difference in the size of the two ovaries caused
by the presence or absence of the corpus luteum was strongly
insisted on by Montgomery in 1837, in his book " Signs and
Symptoms of Pregnancy," in which, besides giving a special
plate, No. X., of such ovaries, he gives on p. 221 measure-
ments to prove it.

1 H. R. Spencer, " Trans. Obstet. Soc.," 1896, pp. 397 and 399.

2 Gerrish, op. cit., p. 849.



EXTRA-UTERINE pregnancy is the technical term for cases
where a child develops in the wrong place -i.e. outside the
uterus or womb.

The commonest position for the child to grow in, outside
of the womb, is in one or other Fallopian tube, hence these
cases are called tubal pregnancies. In a few instances it
actually grows in the ovarian sac or Graafian follicle which
contained the ovum, hence this is called ovarian pregnancy.

In the very great majority of cases of tubal pregnancy,
the tube which becomes pregnant is the one on the same
side of the uterus as the ovary which supplies the ovum which
becomes fertilised i.e. in the tube nearest the ovary.

The following cases will prove that the pregnancy and the
corpus-luteum-bearing ovary are usually on the same side.

Dr. Pocock's case. 1 Pregnancy in right tube; corpus in
right ovary. Case of extra-uterine gestation.

" The foetus had escaped from the ruptured sac formed at or near
the fimbriated extremity of the right Fallopian tube, where the
placenta was placed. There was a well-marked corpus luteum
in the right ovary. The foetus was about three months."

No sex is given, and though I wrote privately for it I
could not discover it.

E. Rumley Dawson's case. 2 Pregnancy in right tube;
corpus in right ovary. The right Fallopian tube had con-
tained the fertilised ovum.

" The right Fallopian tube had ruptured. The right ovary con-
tained a corpus luteum."

The embryo was too young to distinguish its sex.

1 " Lancet," March 3, 1888, p. 416.

2 " Trans. Obstet. Soc.," 1898, p. 156.



Dr. W. Duncan*- describes and has a drawing of a case
of tubal gestation.

" The right tube had ruptured. The right ovary contained a large
corpus luteum."

Dr. Lewers 2 describes a case of right tubal pregnancy:

" There was a large corpus luteum in the right ovary; no corpus
uteum in the left ovary " ;

and again, p. 364:

"Left tubal (interstitial) pregnancy; corpus luteum in the left

Dr. Cullingworth 3 : also a right tubal pregnancy.

" The right ovary contained a corpus luteum | in. in diameter.
Left tube and ovary were normal."

Dr. Amand-Routh 4 :

" Pregnancy in left tube; corpus luteum in left ovary. The right
tube was normal; a nodule could be felt on the left tube."

The report on the specimen by Mr. J. H. Targett says:

" The specimen consists of the (left) Fallopian tube, ovary, and
adjacent portion of the broad ligament. The ovary contains a
recent corpus luteum. The Fallopian tube is dilated with an oval
cyst. The histological evidence of gestation is thus assured."

B. Dyball 5 reports:

" Left tubal pregnancy, and the left ovary contained a corpus
luteum of pregnancy \ in. in diameter."

Sir J. Bland-Sutton has diagrams illustrating the corpus
luteum on the same side as the tubal pregnancy in his
"Diseases of Ovaries," 1896, Figs. 105, 108, 115; and
Fig. 95 in " Diseases of Women," 1904.

This is still further proved by cases of repeated tubal
pregnancy; thus:

1 " Trans. Obstet. Soc.," 1894, p. 68; cj. also 1896, p. 36 a similar case.

2 " Diseases of Women," 1897, p. 375.

3 " Trans. Obstet. Soc.," 1895, p. 143.

4 Ibid., 1898, p. 222.

5 B. Dyball, " Case of Tubal Gestation," " Brit. Med. Journ.," March 26,
1904, p. 718.


Dr. Lewers 1 describes a case where he removed the left
pregnant tube and the left ovary, which contained the corpus
luteum, in 1894; becoming pregnant again in the remaining,
or right tube, that too was removed in May 1900, the
accompanying right ovary necessarily containing the corpus
luteum. |

In the " Journal of Obstetrics and Gynaecology of the
British Empire," vol. iv. p. 301, I have reported a very
similar case, the left ovary containing the corpus luteum
when the left tube was pregnant, and the right ovary neces-
sarily doing so when the right tube became pregnant two
years later, for the appendages of the opposite side had been

And similarly Lieut. -Col. A. J. Sturmer, in the same
volume (p. 139), has reported two such cases, the corpus
luteum being on the same side as the pregnant tube in each case.

Opitz, 2 quoted by Dr. Russell Andrews, " found the
corpus luteum on the same side as the pregnant tube in
fifteen out of eighteen cases."

The above cases, then, should suffice to prove that the
pregnant tube and the corpus luteum-bearing ovary are
usually on the same side; but cases might be indefinitely

From this fact it follows that if we find a pregnancy in
the right Fallopian tube, and that foetus is a male, even
though the presence of a corpus luteum be not mentioned,
we are quite justified in declaring the ovum came from
the right ovary, or ovary of the corresponding side to the

The following cases of this therefore support my theory
that ova from the right ovary produce male children.

Taylor's case. 3 Abdominal pregnancy. Right tube, male

" The pregnancy may be regarded as originally one of the right
Fallopian tube. The child weighs 7 lb., and is a male foetus."

"It was impossible to say whether the right ovary had been
removed with the placenta, or whether it had been left in the pelvis
below the reflections of the sac."

1 " Trans. Obstet. Soc.," 1900, p. 325.

2 " Journal of Obstetrics and Gynaecology," vol. iv. p. 290.

3 J. W. Taylor, " Trans. Obstet. Soc.," 1897, pp. 183-5.


Dr. Cullingworth's case. 1 Sac on right side; male child.

" The sac containing the foetus consisted of the right broad liga-
ment. The stretched Fallopian tube ran diagonally upwards and
outwards, and then ceased to be traceable as a distinct tube.

" The foetus was one of the male sex."

Sir J. Bland -Sutton's case. 2v < Right tubal pregnancy.
Drawing shows sex male, and (?) corpus luteum in right

" Fluid blood has escaped from a rent in the right broad ligament.
The Fallopian tube on that side was enlarged, and was removed
with the ovary. The embryo appears to have lodged in the right
Fallopian tube."

The drawing which accompanies the case shows the foetus
to be a male, and what is possibly the corpus luteum in the
right ovary, for the left was not removed.

In the following case in the practice of one of my colleagues
the patient was thought to have inflammation of the right
ovary. She died from haemorrhage internally rather
suddenly on March 18, 1899.

At the post mortem which was ordered I found that the left Fallopian
tube and left ovary were normal, and there was no corpus luteum
in it. The gestation sac was formed from the right Fallopian tube,
which had burst between the layers of the right broad ligament.
There the child (a boy) continued to develop for nearly three months
longer, when a second rupture into the peritoneal cavity took place,
killing the patient by the extent of the haemorrhage. The right
ovary and corpus luteum could not be found. The child (a male)
had developed in the right Fallopian tube, and the left ovary did
not contain a corpus luteum ; so we know the right ovary had originally
provided the ovum.

In the following case the child (a boy) had originally
begun to develop in the right Fallopian tube, from which
it passed to finish its development in the abdominal cavity,
forming the so-called tubo-abdominal form of pregnancy.
The afterbirth or placenta continued to chiefly develop in
the right tube. There is no account of the corpus luteum,
as the right ovary would probably be destroyed in the growth
of the child and its placenta.

1 C. J. Cullingworth, " Trans. Obstet. Soc.," 1893, pp. 157, 159.

2 J. Bland-Sutton, Ibid., 1891, pp. 71, 72.


/. B. Hellier 1 says:

" A dead foetus was removed by abdominal section from the
peritoneal cavity, together with a tumour which arose from the
right oviduct, and contained the placenta. It was then found that
the right foot was attached to a pelvic tumour which lay in the utero-
vesical pouch and on the right side. The foetus is a male. The
placenta is contained within a sac . . . made up partly of the
ampullar end of the tube."

Dr. M. Abdul-Hamid, medical officer to Kalioub Hospital,
Egypt, has reported a similar case. The pregnancy was
in the right tube, which ruptured into the abdominal
cavity, whence Dr. Hamid removed the male foetus two
months after full term by abdominal section.

Slamjer 2 in 1901 reported a case where the foetus was a
male, and had developed in the right broad ligament a right
mesometric gestation.

In the " Medico-Chirurgical Review and Journal," vol. x.,
1828, p. 223, is the case of Mrs. E. Bryan, who died as the
result of an extra-uterine gestation. The child was " a
full-grown male infant." It had developed in the right
Fallopian tube originally, and had then, after rupture,
continued to grow between the layers of the right broad
ligament a right mesometric gestation.

" The left ovarium and corresponding' Fallopian tube are sound."

In the same journal (vol. v., 1826, pp. 618, 619) is another
case. Post morten a male foetus was found to have escaped
by rupture from a cyst on the right-hand side of the uterus,
which had arisen from the right ovary.

Dr. Russell Andrews 3 has reported a case of twin preg-
nancy in the right Fallopian tube. Both children were

In the same manner, pregnancy in the left tube practically
always means a left ovulation; so that finding a female
foetus in the left Fallopian tube, even in the absence of
mention of a corpus luteum being present in the left ovary,
may be taken as proof that the left ovary provided the ovum

1 Hellier, " Trans. Obstet. Soc.," vol. xlv. 1903, p. 366.

" Brit. Med. Journ.," Epitome.
3 " Trans. Roy. Soc. of Med.," vol. ii. 1909, p. 228,


that was fertilised, and hence gives support to my theory;

Sir Jonathan Hutchinson's case. 1 Left tubal gestation.
Child female. Corpus luteum not mentioned.

" At the post-mortem examination we found the tumour adherent
everywhere to the abdominal wall and omentum. On cutting into
the cyst the body of a macerated foetus was found. It was a female,
and at full term. On further dissection of the parts the case proved
to be one of gestation in the left Fallopian tube. The left Fallopian
tube could be traced for a short distance on the front of the cyst.
The left broad ligament passed downwards from the front of the
cyst, and between its extremity and that of the Fallopian tube was
a thickened mass, which might perhaps be the remains of the ovary,
but it was not practicable accurately to identify it."

Dr. Cullingworth's case. 2 Left tube; child female. No
corpus luteum given.

" On August 1 6, at St. Thomas's Hospital, Dr. Cullingworth
removed a fcetus weighing 2 Ib. 13 oz., and measuring 17 in. in length,
through an incision in the anterior abdominal wall. The sac in
which this was contained was very thin, and formed by the greatly
dilated left Fallopian tube. The duration of the pregnancy was
sixteen months ; the fcetus was well preserved, and had the appear-
ance of fully eight months' development."

On writing to Dr. Cullingworth to ascertain the sex, he
says (September i, 1888): " The child was a female."

Lawson Tail 3 quotes a case by Dr. Wagner. Left tube
and ovary implicated. Child female.

" The patient up to the age of twenty-four had given birth to
five children ; in her thirty-seventh year she again became pregnant,
but was never delivered of the child. Labour pains were not present.
For a long time the abdominal enlargement remained constant in
size, and Caesarean section was advised. Finally the tumour began
to grow smaller. Her menses returned, and fair health was ex-
perienced, the only complaint being a feeling of weight in the abdo-
men. At the autopsy the tumour was found to fill the lower pelvis.
The tumour weighed about f Ib., and was about the size of a man's
head. It was covered by a yellowish membrane. The left tube
and ovary seemed to be growing from the tumour, the uterus being
pushed from the right. The foetus was of female sex."

1 " Case of Extra-uterine Foetation simulating Ovarian Dropsy,"
" Lancet," July 19, 1873, p. 71, by Sir J. Hutchinson, F.R.C S.

2 " Lancet," August 25, 1888, p. 391.

3 "Lectures on Ectopic Pregnancy and Pelvic Haematocele, " p. 102,


Dr. Ruth reports a case in the " Medico-Chirurgical
Review and Journal/' July 1825, P- 285, of the removal
of a dead extra-uterine foetus from the abdominal cavity.
It had evidently been a left tubo-abdominal gestation:

" The umbilical cord was traced over the uterus to the left side,
where it was lost in a softened mass, probably the remains of the
placenta. The child was found to be a female."

Dr. A. Smith 1 describes a somewhat similar case a left
tubo-abdominal pregnancy. " The placenta was attached
to the brim of the pelvis on the left side." The main blood
supply came from the left ovarian artery. The left tube
and ovary were destroyed by the growth of the child,
which was a full-time female.

Dr. Lionel Stretton 2 reported the removal of a dead
female foetus from the left broad ligament. It had been
retained many years.

In the two following cases we have twin pregnancies, one
in the uterine cavity, the other extra-uterine, that is, in
one or other Fallopian tube. As we have already seen,
the pregnant tube almost invariably obtains its oosperm
from the ovary of the same side; and as twins or even
triplets can occur in one tube, it is reasonable to claim
that the uterine child was derived from the ovary of the
opposite side to the pregnant tube thus Warnek 3 found on
operation a pregnant left tube, while the uterus gave birth
to a boy.

So that this male had been derived from the opposite
ovary to the left, that is the right.

Mrs. Stanley Boyd 4 removed a pregnant right tube (ovum
evidently derived from right or male ovary), and the uterus
contained a female child, which similarly must have been
derived from the left or opposite ovary.

This case is further an example of failure to remove all
ovarian tissue, owing to the " adhesions to the pelvic wall
and the right side of the uterus " evidently preventing the

1 Dr. Alfred Smith, " Brit. Med. Journ.," October 5, 1901, p. 961.
1 " Lancet," March, 1909.

3 Warnek, " Brit. Med. Journ.," Epitome, January 25, 1902.
* " Brit. Med. Journ.," October 5, 1901, p. 962.


entire removal of all ovarian tissue, probably in the ovarian
ligament, though there are other possible sites.

It is of course evident that in very many cases, owing to
the early rupture of the Fallopian tube, the sex of the
contained foetus cannot be ascertained.

Dr. Seligson, of Moscow, has, however, collected fourteen
cases of males developing in the right tube, and females
in the left tube.

The following are cases of pregnancy occurring in the
right ovary (right ovarian pregnancy) ; the sex of the children
was male, thus supporting my theory.

Bernutz and Goupil l :

" A woman, aged 34, had had three children prematurely, and
was pregnant the fourth time, the condition being accompanied
by extreme prostration and a good deal of pain on the right of the
pelvis. At the end of the third month she expelled per vaginam
a mole the size of an egg [the uterine decidua. E. R. D.'J. Six
days after this she experienced most agonising pain in the hypo-
gastric region, accompanied by severe vomiting, and soon after
this she died.

" On examination a male foetus was found in the right iliac fossa,
but still attached to the right ovary by the umbilical cord. The
ovary itself was ruptured on its under side. The organs on the left
side were healthy. The uterus was much thickened, and large
enough to admit a f cetus of three months ; such an one was found in
the abdomen."

Bernutz and Goupil 2 :

" A lady had borne eight children when, after an interval of five
years, she became pregnant for the ninth time.

" At the third month she became very weak, had colicky pains,
with symptoms of approaching labour, and died in nine hours.
On opening the abdomen a large quantity of blood was found
effused, and in removing this a male foetus about an inch long was

" It was found afterwards that the right ovary was ruptured in its
length, and that the foetus had been developed therein."

1 Bernutz and Goupil, " Diseases of Women/' vol. i. p. 249, published by
New Sydenham Society, 1866, quoted from " Bibliotheque medicale,"
vol. xxxviii. p. 265; and Dezeimeris, " Journal des connaissances medico-
chirurgicales," 1837.

2 Vol. i. pp. 249, 250. Quoted by Bernutz and Goupil from " Obser-
vation de M. de Saint Moressy, medecin de Riberac en Saintonge," 1662
(dans Duverney, " CEuvres anatomiques, " Paris, 1761, vol. ii. p. 350).


The following is a case of pregnancy in the left ovary (left
ovarian pregnancy) : the child was a girl, thus proving my
theory that left-sided ova produce female children.

Reeves' case. 1 Left-s^ded pregnancy; child female. Right
ovary cirrhotic.

" On opening the abdomen a large tumour was exposed. The
shoulder and head of a foetus were then felt. The broad ligament
was then tied close to the uterus. The placenta was inside the
foetal membranes, which were enclosed between the layers of the
left broad ligament, and the normal-looking Fallopian tube was
stretched across the upper and anterior aspect of the tumour. No
trace of the left ovary could be seen or felt, and in peeling off the
membranes, which were firmly adherent in places, a portion of the
posterior layer of the broad ligament, corresponding to the usual
position of the ovary, was removed with them.

" The right ovary was cirrhotic, and was not removed. The foetus,
which looked like a full-termed one, was a female."

Mr. Reeves says, " There can be no doubt this was a
genuine case of true ovarian pregnancy/'

Whether this was a true ovarian pregnancy or not is
immaterial; it was an undoubted left-sided pregnancy, with
the resulting foetus a female.

That the ovum came from the left ovary is rendered quite
evident by the fact of the cirrhotic condition of the opposite
or right ovary; it is thus a very convincing case.

1 H. A. Reeves, F.R.C.S.Edin., " Ectopic Ovarian Gestation," " Lancet,"
October 25, 1890, p. 872.



THE removal by a surgical operation of an ovary, usually
on account of a tumour therein, is known as ovariotomy;
if performed on one side only it is known as unilateral
ovariotomy, or more definitely as right or left ovariotomy,
according to which ovary was removed; if performed on
both sides, it is a bilateral or double ovariotomy.

Unilateral ovariotomy does not prevent a woman having
children, but they will, I maintain, be all of the same sex,
provided that all ovarian tissue is removed from the one
side. In this event all the ova must necessarily be derived
from one ovary only, viz. from the ovary on the opposite
side to the one removed.

If therefore the left ovary is completely removed a
woman's subsequent children are all boys. In the following
cases the left ovary was removed, and the subsequent
pregnancies gave rise to boys because the ova necessarily
were derived from the right ovary, hence they prove my

Dr. J. A. Wetherell's case. 1 Left ovary removed, sub-
sequent birth of male child. Conception after ovariotomy.

"The patient, Ann H., unmarried; at the age of twenty-five, in
1882, her menstruation became irregular, and she first noticed a
tumour rising in her abdomen. Her medical attendant diagnosed
the case as one of ovarian tumour. She placed herself under the
care of Dr. Granville Bantock in the Samaritan Free Hospital.
The case was one of fibroid tumour of the uterus in a state of cysti-
form degeneration. I tried to lift out the tumour, but it so invaded

1 " Lancet," April 28, 1888.


the broad ligament on the right side that its removal in the usual
way was impossible. Fancying there was nothing to be done but to
remove the ovaries, with a view of checking the growth of the
tumour, I removed the left ovary, which was easily got at.

" The right ovary was nowhere to be found.

" I now looked again very carefully at the tumour, and as it felt
as if there might be some deep-seated fluid in it, I tapped it, and got
out nearly a pint of dirty-looking fluid. There was no way of re-
moving the tumour. I laid the tumour very freely open. She
left the hospital a mere shadow of herself before her illness.

" For four years she enjoyed fairly good health. She was now
quite stout, and married.

" In July 1887 I delivered her of a fine healthy child. She nurses
her baby boy herself."

Dr. R. H. V.'s case. The patient was married in April

" The first child, a boy, was born on August 25, 1901. In March
1902 her left ovary was removed for cystic degeneration. She has
had four pregnancies since, all of which were boys."

The doctor writes of the case that, " if mental influence
could do anything, she ought to have had girls, as she
most devoutly wished for a girl each time.'*

Her left ovary, however, was diseased, and so removed;
hence the subsequent children were from ova from the right
ovary, and therefore were boys.

Dr. Amand Routh 1 reports a case of tubal pregnancy.

" Pregnancy in left tube; corpus luteum in left ovary. The right
tube was normal; a nodule could be felt on the left tube. The left
ovary and tube were removed."

The report on the specimen by Mr. J. H. Targett says:

" The specimen consists of the (left) Fallopian tube, ovary, and
adjacent portion of the broad ligament. The ovary contains a recent
corpus luteum. The histological evidence of gestation is thus

1 2 3 4 6 8 9 10 11 12 13 14 15 16 17 18

Online LibraryErnest Rumley DawsonThe causation of sex in man; a new theory of sex based on clinical materials together with chapters on forecasting or predicting the sex of the unborn child and on the determination or production of either sex at will → online text (page 6 of 18)