Different Strokes: Pap-Test and Babes Method Are Not One and the Same Dear Dr. Bedrossian: We would like to thank Dr. Pampuccian for his chal- lenging criticism on our article, and must acknowledge that Dr. Aurel Babes did indeed make an important con- tribution to the methodology of his times while research- ing cervical cancer. However, we are not fully convinced that Aurel Babes should be credited along with George Papanicolaou in the development of the Pap-test. As Dr. Pampuccian states, techniques for studying cells from imprints and secretions had already been described before Babes and Papanicolaou’s publications on cervical cytological preparations. For that reason, Babes’ tech- nique was not innovative in relation to his era’s previ- ously published studies. On the contrary, Papanicolaou’s method was indeed innovative. It concerned a palpably different approach based not on scrapings but on smears from aspiration of vaginal fluid. The method initially aimed at the dating of the female hormonal cycle and later for the diagnosis cervical lesions and for the screen- ing of cervical precancer and cancer lesions. The tech- nique suggested by Ayre was not an abrasive method and does not involve scraping of visible lesions, as it was the method suggested by Aurel Babes who used clearly a platinum loop. For the aforementioned reasons, such an abrasive method that Babes and Daniel suggested could never be used as a screening method for cervical cancer. Dr. Pampuccian compares the two papers of George Papanicolaou and Aurel Babes. We believe that Dr. Pam- puccian make some unfortunate comments regarding Dr. Papanicolaou’s paper. The quality and importance of the study is not always connected with the journal in which it is published or whether it contains grammar and spelling errors. By 1928, Dr. Papanicolaou had already published three major papers in prestigious journals such as Science and the American Journal of Anatomy. Also, Dr. Pampuc- cian assumes that the sample size presented by George Papanicolaou is very small, although there is no support for that argument. On the contrary, Dr. Papanicolaou made it clear in his Battle Creek presentation the exten- siveness of his work on vaginal smears: ‘‘I studied smears from various pathological cases, including all kinds of infections staphylococcus, streptococcus, gonococcus, var- ious inflammatory conditions of the vagina, of the uterus, of the tubes, cases of tubercle abscesses, cases of ovarian cysts and other conditions of the ovaries, and also cases of pregnancy and of tubal pregnancy, of abortions and finally cases of benign and malignant tumor.’’ Dr. Papani- colaou extended his studies beyond diagnosed cases of cancer to other non-malignant cases showing that he al- ready confirmed that his method successfully screened of asymptomatic cases. Moreover, Papanicolaou worked on vaginal smears for almost a decade before presenting his results in the Battle Creek conference, as we prove below, and from 1923 already with human vaginal smears. To dismiss his paper because of an supposedly small sample size is a curious historical interpretation. A careful study of Papanicolaou’s papers proves that he started working on vaginal smears long before Aurel Babes. Babes presented his findings on 20 cases in Roma- nia in a local conference of the Bucharest Gynecological Society in 1927 1 and published 20 cases in Presse Medi- cale in 1928, 2 3 months after the presentation of Papani- colaou’s paper in the Battle Creek conference. (The pro- ceedings of the 1927 Bucharest conference were not widely disseminated.) In addition, Papanicolaou had been working with and on his method for more than 10 years. His first two publications with Stockard in 1917, entitled ‘‘The existence of a typical oestrous cycle in the guinea pig: with a study of its histological and physiological changes’’ and ‘‘A rhythmical ‘heat period’ in the guinea pig,’’ involved the use of vaginal smears for the study of the oestrous cycle in guinea pigs. 3,4 Unlike Babes’ work, Papanicolaou efforts on vaginal smears shows a remark- able continuum. In 1923, Papanicolaou told an incredu- lous audience of physicians about the technique of gath- ering cellular debris from the lining of the vaginal tract *Correspondence to: E. Magiorkinis, B.Sc., M.D., Ph.D., L. Aianteiou 3-PB 1541, Salamina 18900, Greece. E-mail: mayiork@med.uoa.gr Received 17 December 2009; Accepted 28 December 2009 DOI 10.1002/dc.21347 Published online 6 May 2010 in Wiley Online Library (wileyonlinelibrary.com). ' 2010 WILEY-LISS, INC. Diagnostic Cytopathology, Vol 38, No 11 857