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Authors: Nora Ephron

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“The reason I did that ad had absolutely nothing to do with Pristeen,” said Judith Crist, the film critic. “It was extremely naïve of me and it was two years ago and I’m ashamed to admit I’m that naïve. They were doing a two-page spread that would have eight pictures of me taken by Richard Avedon, with a two-page headline
saying ‘Today’s Woman.’ Then I had approximately eight hundred words to write what I wanted to say about women. I decided to write about women in communications. In the final column, there was a cutoff line and about four inches of space, and then it said something like, ‘The modern woman who chooses to be immaculate will use Pristeen, a feminine-hygiene deodorant.’ It was going to run in eight women’s magazines in one month. It boggled the mind. You were reaching a hundred and twenty-five million people, an audience you couldn’t reach even if you were a movie for television. Then there were the photographs with Avedon and the negatives were mine if I wanted them—which was the kind of sitting you could never otherwise afford. And then came a huge fee in addition, and I saw my son getting an extra inning in camp, redoing the living room.” The fee for the ad was $5,000.

“What did bother me,” Mrs. Crist went on, “was the idea of it being a vaginal deodorant. So I consulted some friends. They said, ‘Boy are you ever being sexist. If it were Bond Bread, you’d do it. College presidents do commercials for the right Scotch. Why because it is a feminine-hygiene spray—what difference is a mouthwash from a vaginal wash? This is small, unenlightened thinking if we’re going to get silly about vaginas.’ But the essential thing was,
I
didn’t say, in the ad, ‘If you want to be a modern women, use Pristeen.’ What I was saying had nothing to do with Pristeen. Well, it was the dumbest decision I’ve ever made. It was as if I had waltzed out like Dorothy Provine and said, ‘Have you used this marvelous vaginal spray?’ Which I hadn’t. I thought I would get responses about what I had said about women in the media—to hell with the money, the Avedon pictures,
what I said
. Instead, I got tied up with the spray. There were so many gags I could have thrown up. The students in one of my witty classes gave me an enormous box with a can of Pristeen at the bottom. The
Esquire
thing, which was quite
embarrassing. Then Rex Reed, feeling betrayed because of my review of
Myra Breckinridge
, retaliated with thorough justification and said, ‘Now when she walks down the aisle, people will think, Does She Or Doesn’t She.’ Which obliged me to retaliate. I got right down to those lower depths, which was the worst part.

“But it was a very educational experience. If Mrs. Gandhi or Golda Meir had posed for a
Playboy
foldout, the results could not have been as bad. It was a learning experience. At my age you don’t think you have those.”


The first hint from the critics that the sprays might not be merely useless but actually dangerous came in November, 1970, when a Montreal gynecologist named Bernard Davis reported in the
Journal of Obstetrics and Gynecology
that he had treated some twenty to twenty-five patients who had itching, burning sensations in the vulvar area. All of them used the sprays daily. One of the patients, a fourteen-year-old girl, developed “incredibly” swollen labia, and after being treated, the doctor reported, her clitoris and labia remained “peculiarly” abnormal. Davis’s letter was answered six months later by Lawrence J. Caruso, a New York gynecologist, who claimed that he had seen many cases of irritation caused by soaps and oils but none whatsoever from the sprays. Caruso conducted a study on twenty-nine of his patients, all of whom used the sprays for six months, and no abnormalities resulted. The study, Caruso said, was conducted “at the request of one manufacturer of a feminine-hygiene-deodorant spray.”

The second salvo came in a long, breezily written article in
Medical Aspects of Human Sexuality
in July, 1971. In it, Bernard Kaye, an Illinois gynecologist, announced that “the great American persuader has struck again!” and went on to report that several of his patients who used the sprays had developed vulvitis; the condition
did not recur, he reported, when use of the spray was discontinued. “As an added dividend of the female genital cosmetic industry,” Kaye concluded, “it is to be expected that physicians will be seeing
male
genital irritations in greater numbers … from exposure to ‘Gynacosmetics’ [and] … from the use of the masculine version of the ‘private deodorant.’ ”


“Honey,” said Bill Blass when asked to explain why his line of cosmetics included a so-called private deodorant, “if there’s a part of the human body to exploit you might as well get onto it.”


Hygiene sprays for men, which are known in the trade as crotch sprays, were introduced in 1970. They have never been advertised on television and today industry sources estimate that $2 million worth of them are sold a year, 5 percent of the feminine-hygiene-spray market. It is commonly assumed by women’s liberationists that products that arrive on the market with the kind of minimal testing that characterized the feminine-hygiene spray would never be sold to men—the assumption here being that men, who are in charge of manufacturing and research within industry, would never exploit their fellowmen as recklessly as they do women. Their argument, however true it may be in the case of the birth-control pill, does not hold where crotch sprays are concerned. Revlon, the leading manufacturer in the men’s spray market, has three brands—Braggi’s Private Deodorant Spray, Bill Blass’s Man’s Other Deodorant, and Pub Below the Belt. It put all these products into national marketing with the three tests that are required for cosmetic products sold in spray cans—the eye-irritation, oral-toxicity, and skin-patch tests—plus usage tests. The skin-patch test, according to Dr. Earl W. Brauer, Revlon vice-president in charge of medical affairs, “was not done on the penis but on an
area where it can’t be tampered with. We do a closed-patch test. The product is kept in place under a closed patch for two days. It’s a much higher concentration and we learn much more from such a provocative test.” But isn’t the skin of the penis different from other skin on the male body? “Yes,” said Dr. Brauer. “It’s thinner skin and there are more active nerve endings. No patch tests were done on the penis. It’s not necessary.”


The Food and Drug Administration began looking into the safety of the feminine-hygiene spray on a number of fronts in 1971. It was concerned about the use of the word “hygiene” in connection with the product. There was the general question of the safety of aerosol containers. And there were increasing reports of irritation caused by the sprays. In early 1971, the F.D.A. asked the spray manufacturers for their complaint rates. Four manufacturers replied; their rates ranged from 0 per million packages sold, to 6, which was about standard, to 21 per million. (The product with the highest rate, Johnson & Johnson’s Vespré, incidentally, contained over twice as much hexachlorophene as the other sprays. It was reformulated in mid-1971.) Any complaint rate over 5 per million is considered cause for concern by the F.D.A., but it is unlikely that the agency would have moved against the sprays on the mere grounds of effectiveness or excessive irritation. What finally caused it to take action was the increasing weight of evidence against hexachlorophene.

The earliest indication that there might be serious trouble with the drug actually occurred some six years ago at the Shriners Burns Institute in Galveston, Texas. This hospital, which treats severely burned children, opened in the spring of 1966, and in the first six months six of its patients suffered seizures. “We couldn’t find any definite reason for it,” said Dr. Duane Larson, chief of
staff, “so we looked into our procedure, narrowed it down, and decided it might have something to do with the soap solution we were bathing them in—which was three percent hexachlorophene.” Laboratory scientists at the Institute took animals—rats, guinea pigs, pigs, and dogs—and burned their backs and then washed them with a 3-percent hexachlorophene solution. Day after day, the hexachlorophene blood levels in the animals rose higher and higher, and they began to exhibit signs of neurological damage. They were irritable. They all dragged their hind legs. “We tested the cerebral spinal fluid,” said Larson, “and were able to determine that hexachlorophene was in it, that it had the property of going through the blood/brain barrier. This was important—a number of drugs don’t go into the brain but just stay in the bloodstream.” When the animals were autopsied, their brains were extremely swollen.

“We found the same thing with the children,” said Larson. “As the blood level of hexachlorophene got higher, they would become irritable and have seizures. I remember one boy in particular who had a small burn on one thigh. He was having neurological problems. His serum level was extremely high—far too high for such a small burn. It turned out the nurse was soaking his dressing in a three-percent hexachlorophene solution to get it off.

“We also measured the hexachlorophene levels of doctors and nurses who scrubbed with soap containing hexachlorophene, and in none could we find a significant level. It seems to be all right for adults if you rinse it off. On the other hand, we do know it goes through normal skin as well as burned skin. We had a patient in Michigan—a baby was brought home from the hospital, a normal baby with no skin lesions, and the mother continued bathing the child in the three-percent hexachlorophene solution that was used in the hospital without rinsing it off. The baby had seizures.”

Dr. Larson reported on the Institute’s experience, and its decision to discontinue the use of hexachlorophene with burn victims, at a meeting of the American Burn Association in the spring of 1967. His findings were picked up by newspapers at the time, but within a few weeks the issue died down. Then, in 1971, three studies appeared that showed exactly what the Shriners Burns Institute had known for years. The most persuasive of the tests proved that newborn monkeys bathed in a 3-percent hexachlorophene solution for ninety days showed brain changes consisting of extreme swelling in the cerebellum, brainstem, and all the parts of the cord. The 3-percent solution was at that time used to bathe newborns at most American hospitals.

In November, 1971, Jack Walden, a public-relations man for the Food and Drug Administration, sat down with a Washington
Post
reporter and told her that the F.D.A. was looking into the dangers of feminine-hygiene sprays in connection with hexachlorophene. An article to that effect subsequently appeared in the
Post
, and Leonard Lavin of Alberto-Culver reacted to it by demanding Walden’s resignation. Whether Lavin thought this would make the hexachlorophene problem go away is not certain; what is certain is that until the very end, every company that was directly affected by the F.D.A.’s concern about hexachlorophene looked upon the investigation as an incredible nuisance. Hexachlorophene was perfectly safe. Everyone knew that. No one had died. Thousands of newborns were bathed in it every day in hospital nurseries; as a result, there had been no staphylococcus outbreaks in American hospitals in years. Just because a few monkeys were brain-damaged did not mean that children would be. “We love hexachlorophene,” said Alberto-Culver’s Dr. Cella. “It’s very valuable,” said Warner-Lambert’s Battista.

Leonard Lavin, for his part, accepted the hexachlorophene
business as a small part of his ongoing battle. First there had been the consumerists—or, as he had referred to them in a letter, “negative-minded consumerist groups who would subject our entire economy to a Marxist purge of everything they object to.” Now it was the government, interfering in the smooth processes of private industry. It was just like the cyclamate mess a few years back—there, Lavin insisted, was another perfectly harmless product taken off the market prematurely. He Xeroxed a long article by Vermont Royster in the
Wall Street Journal
which claimed that if aspirin were introduced today, the F.D.A. would ban it. He muttered frequently about Ralph Nader, who had been outspoken on the subject of the sprays. “If Ralph Nader had his way,” Lavin said, “he would ban Fritos and soft drinks. I heard him say it myself.” He commissioned studies to show the safety of hexachlorophene. Experts pored over medical reports about the sprays and jubilantly found errors in them. (One doctor, for example, had claimed in his article to have seen anal infections he traced to the perfume used in scented toilet paper. This was absurd, said Albert-Culver’s Cella: the scent came not from the paper but from the cardboard roll within; the perfume used never came in actual contact with the body.) Gus Kass, a vice-president of Alberto-Culver, delivered a speech in Chicago decrying the attacks on the cosmetics industry by newspapers and magazines. “All of them,” said Kass, “are witches’ brews of distorted facts, half-truths, or outright falsehoods.… What all of the critics fail to understand is that there is no substance to which some person is
not
allergic.”

And so it went. There was bound to be some irritation from the feminine-hygiene sprays because there were bound to be some individuals who were allergic to them. And as to the rest of the complaints, the manufacturers said, these had nothing to do with hexachlorophene. Women using the products were simply using
them wrong—not holding the spray far enough from their bodies, or spraying just before intercourse, or spraying the actual vaginal area. (There were, to be sure, many reactions to the sprays that were caused by misuse; some manufacturers have recently inserted more explicit instructions in the spray kits.) As for hexachlorophene, most of the sprays contained less than one-tenth of 1 percent—and even if it could be shown that hexachlorophene was dangerous to humans, such a tiny amount would never hurt.

In December, 1971, the F.D.A. took its first action against hexachlorophene, announcing it was no longer recommending bathing of infants in a 3-percent hexachlorophene solution. A month later, when there was a staph outbreak in a New Haven hospital that had stopped using pHisoHex, the drug industry was as jubilant as it could be under the circumstances. But the F.D.A. claimed that the outbreak could not be traced to the ban and continued to move against the drug. It announced a three-part proposal: hexachlorophene would be banned from cosmetics except when it was used as a preservative; all drugs containing hexachlorophene would be required to carry warnings; and any drug with more than three-quarters of 1 percent hexachlorophene would be sold by prescription only. (Not until seven months later, when thirty-nine French infants died from the external use of a baby powder that contained, through a manufacturing error, 6 percent hexachlorophene, did the F.D.A. make final its over-the-counter ban on the drug.) Feminine-hygiene-spray manufacturers could have fought the proposal at this point. But since the first reports of F.D.A. concern, sales of the product had dropped off. A January, 1972, attack in
Consumer Reports
had not helped. And so, voluntarily, all the manufacturers removed the drug from the feminine-spray formulas. Alberto-Culver replaced it with another antibacterial agent, and then refused to tell the press what it was. Warner-Lambert removed it entirely (they claimed it was used only
as a preservative), and found that Pristeen continued to work exactly as it had before. The industry sat back, quietly, and consoled itself with memories of the cranberry scare. That had blown over ultimately, and this would, too. In the meantime, sales of the product, which had been expected to grow to $53 million in 1971, held firm at the $40 million mark. Still, $40 million worth of product wasn’t bad. There were women out there who were loyal, who still wanted to buy. The rest of the public would forget. It always does.

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