The thalidomide letter

The X-ray image of a woman in late pregnancy showed a fetus without arms. “Once in a lifetime, we are supposed to see something like this, but I have seen it twice in a couple of months,” said one radiologist. Rumors of an increase in similar defects were frequent – the cause unknown.

About two months later, in December 1961, a letter appeared in The Lancet stating that women receiving thalidomide in early pregnancy for morning sickness frequently had babies with missing or deformed limbs (McBride 1961). The letter, comprising only 15 lines, ended with the following question:

The response was overwhelming. Eventually more than 10 000 babies in almost 50 countries were born with such defects (Thalidomide UK 2006). After the publication of the letter, the drug was immediately withdrawn worldwide. This letter counts as the first milestone for The Lancet (www.thelancet.com, accessed 9 December 2006) since its announcement of the value of penicillin in 1940.

Format and size of a letter

Just as in the thalidomide letter, you should be brief and to the point. The format of a letter is almost always the same: a title; a salutation, for example, “To the Editor”; the letter itself without subheadings; and a list of references. You may include one figure or one table, though such additions will be published only if they add substantially to the letter.