all cranberry products was halted. Carson attended the ensuing FDA hearings on revising pesticide regulations; she came away discouraged by the aggressive tactics of the chemical industry representatives, which included expert testimony that was firmly contradicted by the bulk of the scientific literature she had been studying. She also wondered about the possible "financial inducements behind certain pesticide programs".

Research at the Library of Medicine of the National Institutes of Health brought Carson into contact with medical researchers investigating the gamut of cancer-causing chemicals. Of particular significance was the work of National Cancer Institute researcher and founding director of the environmental cancer section Wilhelm Hueper, who classified many pesticides as carcinogens. Carson and her research assistant Jeanne Davis, with the help of NIH librarian Dorothy Algire, found evidence to support the pesticide-cancer connection; to Carson the evidence for the toxicity of a wide array of synthetic pesticides was clear-cut, though such conclusions were very controversial beyond the small community of scientists studying pesticide carcinogenesis.

By 1960, Carson had more than enough research material, and the writing was progressing rapidly. In addition to the thorough literature search, she had investigated hundreds of individual incidents of pesticide exposure and the human sickness and ecological damage that resulted. However, in January, a duodenal ulcer followed by several infections kept her bedridden for weeks, greatly delaying the completion of Silent Spring. As she was nearing full recovery in March (just as she was completing drafts of the two cancer chapters of her book), she discovered cysts in her left breast, one of which necessitated a mastectomy. Though her doctor described the procedure as precautionary and recommended no further treatment, by December Carson discovered that the tumor was in fact malignant and the cancer had metastasized. Her research was also delayed by revision work for a new edition of The Sea Around Us, and by a collaborative photo essay with Erich Hartmann.Most of the research and writing was done by the fall of 1960, except for the discussion of recent research on biological controls and investigations of a handful of new pesticides. However, further health troubles slowed the final revisions in 1961 and early 1962.

It was difficult finding a title for the book; "Silent Spring" was initially suggested as a title for the chapter on birds. By August 1961, Carson finally agreed to the suggestion of her literary agent Marie Rodell: Silent Spring would be a metaphorical title for the entire book—suggesting a bleak future for the whole natural world—rather than a literal chapter title about the absence of birdsong.[35] With Carson's approval, editor Paul Brooks at Houghton Mifflin arranged for illustrations by Louis and Lois Darling, who also designed the cover. The final writing was the first chapter, "A Fable for Tomorrow", which was intended to provide a gentler introduction to what might otherwise be a forbiddingly serious topic. By mid-1962, Brooks and Carson had largely finished the editing, and were laying the groundwork for promoting the book by sending the manuscript out to select individuals for final suggestions.

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