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To the Editor:—
I do not differ with Dr. Karnaky in as many respects as it would seem from a first reading of his letter. I agree that cancer must be ruled out in all cases of leucorrhea. We attempt to do this with every patient.My paper is clinically oriented, and that is the reason for the statement, "Determination of pH is moderately useful." I doubt if pH determination, as Dr. Karnaky pursues it, is necessary in everyday clinical practice. I concur that there is a relationship between the vaginal pH concentration and the type of flora. However, using Rakoff electrodes and a pH meter, taking midvaginal determination, our pH values with candidal infections, analyzed statistically, are lower than Dr. Karnaky reports (Lang, Rakoff, and Menduke, J Obstet Gynec7:378, 1956).Dr. Karnaky says, "One will not find pathogens in a normal vagina." In general that is true.
Lang WR. Experiences in a Vaginitis Clinic. JAMA. 1961;176(4):389–390. doi:10.1001/jama.1961.03040170135029
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