To the Editor:— I have been following your series of papers on medical writing, but I doubt that these articles will have much effect on improving the quality and clarity of clinical manuscripts. The problem seems more basic than one that can be solved by writing lessons. Yes, clinical papers are laiden with cliches, do lack style, and are burdened with long cumbersome sentences. And yes, they are forced to adhere to the introduction, methods, results, and discussion (IMRAD) form ( Ann Intern Med 67 :1117, 1967) which makes redundancy in expression inescapable. But I think a physician's ability or inability to express himself clearly in technical writing relates directly to his ability or inability to express himself in terms of thought content and speech. This in turn relates to his understanding not only of scientific discourse but also to his understanding of the arts, viz, literature, logic, and rhetoric. The