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Aspiration Curettage
Volume S5 :-.lumber 2
CORRERPONDENCE
365
one individually, so I am taking this opportunity to ask you if it would be possible to insert a notice in the AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY to inform these physicianR who assisted us that the campaign was completely successful and to express our appreciation for their efforts. Vve are fully aware that the highly lucrative returns from this type of business will tempt others to embark in this :field. \Vc have estimated that a tube of the preparation selling in the neighborhood of five dollars costs but a few cents to prepare for sale. We are, therefore, very much on the alert for the certain resurgence of this ''racket,'' and you may be assured~ that when it appears the full resources of this Administration will be thro~vn into the battle to stamp it out. G. A. GRANGER, M.D. MEDICAL OFFICER. FOOD AND DRUG ADMINISTRATION \VASHINGTON, D. c. NOVEMBER 20, 1947.
Aspiration Curettage
To the Editor: In the November, 1947, issue of the JOURNAL, Williams and Stewart, writing on aspiration curettage of the endometrium in a cancer clinic, refer to a report on office curettage by the undersigned. Williams and Stewart state: "They (Israel and Mazer) subject their patients to surgical dilatation and curettement without hospitalization .... '' May we take exception to the term, ''surgical dilatation,'' which, to us, suggests a forceful act. The technique of office curettage described in the mentioned article does not include surgical dilatation. We state (AM. J. 0BST. & GYNEC. 36: 445, September, 1938): "In multiparous women, the smallest (No. 1) Sims' sharp curette may then be passed without difficulty. However, in some nulliparous women, the cervical canal is narrow and requires pre·liminary dilatation. In such instances, the smallest metal dilator, moistened by a sterile water-soluble lubricant, is passed beyond the internal os. Following this, the curette readily enters the uterine cavity.... '' Vi/e do not regard surgical dilatation of the cervix as a feasible office procedure. S. LEON ISRAEL, M.D. CHARLES MAZER, M.D. 2116 SPRUCE STREET TWENTY·FIRST AND SPRUCE STREETS PHILADELPHIA, p A. DECEMBER 1, 1947.
Estrogens in Dysmenorrhea To the Editor: In the article of Doctors Torpin, Woodbury, and Child on "The Nature of Dysmenorrhea" (AM. J. 0BST. & GYNEC., November, 1947), the authors erroneously credit Sturgis and Albrightt) with the discovery that ''large doses of estrogens administered early in the cycle abolished ovulation, and that the subsequent period was quite painless.'' The original report of Sturgis and Albright, however, refers to an earlier article by Dr. Raphael Kurzrok and mysel£,2 acknowledges our prior use of estrogens in dysmenorrhea and confirms our. observations regarding ovulation and corpus luteum function. I first began to use ·estrogens in the treatment of dysmenorrhea in 1934. The prevailing theory at the time attributed the condition to excessive estrogen action resulting :from absence or hypofunction of the corpus luteum. -Quite by accident one of my patients was given estradiol benzoate, as a result of which she experienced the first painless period of her life. Further trials convinced me that this type of therapy was not without merit and I began an investigation into its modus operandi.
CORRERPONDENCE
365
one individually, so I am taking this opportunity to ask you if it would be possible to insert a notice in the AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY to inform these physicianR who assisted us that the campaign was completely successful and to express our appreciation for their efforts. Vve are fully aware that the highly lucrative returns from this type of business will tempt others to embark in this :field. \Vc have estimated that a tube of the preparation selling in the neighborhood of five dollars costs but a few cents to prepare for sale. We are, therefore, very much on the alert for the certain resurgence of this ''racket,'' and you may be assured~ that when it appears the full resources of this Administration will be thro~vn into the battle to stamp it out. G. A. GRANGER, M.D. MEDICAL OFFICER. FOOD AND DRUG ADMINISTRATION \VASHINGTON, D. c. NOVEMBER 20, 1947.
Aspiration Curettage
To the Editor: In the November, 1947, issue of the JOURNAL, Williams and Stewart, writing on aspiration curettage of the endometrium in a cancer clinic, refer to a report on office curettage by the undersigned. Williams and Stewart state: "They (Israel and Mazer) subject their patients to surgical dilatation and curettement without hospitalization .... '' May we take exception to the term, ''surgical dilatation,'' which, to us, suggests a forceful act. The technique of office curettage described in the mentioned article does not include surgical dilatation. We state (AM. J. 0BST. & GYNEC. 36: 445, September, 1938): "In multiparous women, the smallest (No. 1) Sims' sharp curette may then be passed without difficulty. However, in some nulliparous women, the cervical canal is narrow and requires pre·liminary dilatation. In such instances, the smallest metal dilator, moistened by a sterile water-soluble lubricant, is passed beyond the internal os. Following this, the curette readily enters the uterine cavity.... '' Vi/e do not regard surgical dilatation of the cervix as a feasible office procedure. S. LEON ISRAEL, M.D. CHARLES MAZER, M.D. 2116 SPRUCE STREET TWENTY·FIRST AND SPRUCE STREETS PHILADELPHIA, p A. DECEMBER 1, 1947.
Estrogens in Dysmenorrhea To the Editor: In the article of Doctors Torpin, Woodbury, and Child on "The Nature of Dysmenorrhea" (AM. J. 0BST. & GYNEC., November, 1947), the authors erroneously credit Sturgis and Albrightt) with the discovery that ''large doses of estrogens administered early in the cycle abolished ovulation, and that the subsequent period was quite painless.'' The original report of Sturgis and Albright, however, refers to an earlier article by Dr. Raphael Kurzrok and mysel£,2 acknowledges our prior use of estrogens in dysmenorrhea and confirms our. observations regarding ovulation and corpus luteum function. I first began to use ·estrogens in the treatment of dysmenorrhea in 1934. The prevailing theory at the time attributed the condition to excessive estrogen action resulting :from absence or hypofunction of the corpus luteum. -Quite by accident one of my patients was given estradiol benzoate, as a result of which she experienced the first painless period of her life. Further trials convinced me that this type of therapy was not without merit and I began an investigation into its modus operandi.