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January 26, 1957


JAMA. 1957;163(4):303. doi:10.1001/jama.1957.02970390079027

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To the Editor:—  In a recent article entitled "Causes and Prevention of Developmental Defects" (J. A. M. A.161:1047 [July 14] 1956), T. H. Ingalls presents what he considers to be "an integrated theory of congenital anomalies." This theory is based on the belief that "most congenital anomalies originate as fetal manifestations of critical stress in pregnancy." The etiological explanations and preventive measures offered by Ingalls in defense of his beliefs are oversimplifications. So much so that to teratologists they will seem inadequate and in fact dangerous. That environmental influences can deform a normal embryo cannot be denied. A host of experimental evidence supports this contention. For the sake of proper historical perspective it should be stated that teratological experiments in which fish embryos were deprived of oxygen were reported by C. R. Stockard in 1921. It should also be stated that adverse environments were shown to cause congenital

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