"Some two months ago, I was called to a hotel of this city to treat (for peritonitis) a guest registered in the house, and known as Mr. L. Z—, of Boston. I found the patient in bed. The patient was of rather undersize, somewhat more delicate of extremities and generally frailer in osseous structure (as far a passing glance would indicate this) than is the average man, but not really markedly so; a smooth face, plain features not distinctively feminine; short greyish hair abundant. Various articles of exclusively masculine clothing were lying about the room. There were cigarettes and liqueurs on a table. The patient was seriously ill, and spoke asthmatically in a low, masculine voice. As I began to make some examinations, I was requested, perfectly calmly, "Not to be surprised at anything". I was however a good deal disconcerted to become convinced in a few minutes that my patient was not a man, but a woman. This concealment of sex the supposed "Mr. Z—" promptly admitted, at the same time requesting me to observe the closest secrecy as to the matter. The patient's attack of peritonitis was warded off, so that "Mr. Z—" soon was able to proceed on her journey to New Orleans; but not till she had reposed enough confidence in me to gratify my curiosity as to such a masquerade and to allow me some professional examination of as singular a type, which advanced far toward full masculinity".
"The facts in the case are as follows. "Mr. Z—" who is really Mrs. X—, a widow (after a married life of only five months) is of American-Scandinavian birth. The family has several times included members of weak, or worse, nervous constitution. One grandfather died insane, and an aunt was of such masculine traits, and so eccentric that she was "the talk" of the community. Afterwards this aunt died in an asylum. The parents died in the patient's infancy, and "Mr. Z—" was brought up by other relatives and educated in a convent in a Southern city. She
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