"In fact, Dr Lippes had a predecessor in this field; Dr Lazar C. Margulies (Figure 4). Dr Margulies was born in Galicia (now part of Poland) in 1895. As a medical student, he had served in the Austro-Hungarian army during World War I. Following the armistice, he graduated from the University of Vienna in 1921, where he specialized in obstetrics and gynecology. He started practising in Vienna, but, expelled from the hospital, this Jewish gynecologist emigrated to the USA in 1941. In New York City he joined the staff of the Mount Sinai Medical Center in 1954 and was promoted to Associate Professor 9 years later. Dr Margulies died of a cerebral hemorrhage in 1982. His Chief at Mount Sinai, Dr Alan Guttmacher, who had opposed intrauterine contraception during Gräfenberg's life (Gräfenberg himself had practised at Mount Sinai for a decade and a ha1f) encouraged Dr Margulies to attempt to improve the Silver Ring. Most certainly, Guttmacher's change of mind was prompted by the alarm over the world's demographic surge, and was reinforced by the 1959 IUD papers from Israel and Japan. Gambling on the use of thermoplastics, Dr Margulies conceived his famous spiral-shaped IUD in 1960, the Perma-Spiral, marketed by the Ortho Pharmaceutical Company as Gynecoil. To insert the Margulies Spiral, the unwound device was introduced into a thin plastic tube and expelled with a plastic plunger. Dr Lippes later borrowed this technique for the insertion of his Loop IUD."