In Reply.—Dr Leung's frustrations with what may be lax procedures in some editorial offices and negligent or even discourteous treatment of authors are easy to sympathize with. An author thus treated is justified in withdrawing his manuscript and resubmitting it somewhere else. A letter of withdrawal takes less time to prepare than the cosmetic revamping of an article usually seen in repetitive publications. There is no justification in failing to inform the next editor about prior submission while the manuscript is still, at least technically, under consideration by the first editor.
Finally, Dr Leung's experience illustrates numerically what can be safely said about scientific journals in general, namely, that such cases of cavalier treatment of authors by the editors appear to be by far the exception rather than the rule, much less the cause, of duplicate publication. If in a series of "more than 60" patients you fail to