The first account of that exchange was scheduled to be published in next week's U.S. News and World Report, and the White House said it had learned of her comments only when told about that article on Thursday night.

Associates of Dr. Elders said today that Donna Shalala, the Secretary of Health and Human Services, had recently warned her to be more discreet in her public remarks, and they said it was the third time that top Administration officials had so cautioned her. But in a note to Ms. Shalala released by the department tonight, Dr. Elders did not mention the precipitating incident and expressed no regret about any past statements.

"While some Administration officials and I have some honest differences over the issue," Dr. Elders said, "President Clinton and I maintain our strong mutual respect for each other -- a respect and friendship that has endured for many years."

In a telephone interview tonight from her home outside Washington, Dr. Elders told The Associated Press that she had intended to relate that masturbation is a natural part of human sexuality -- not that schoolchildren should be taught how to masturbate.

Dr. Elders said she was not bitter about her dismissal but expressed surprise at the way her remarks were interpreted. "People have taken a lot of things I've said in a most unusual way," she said.

White House officials said the abruptness of Dr. Elders's dismissal meant that it was too soon to say who might be named to replace her.

The President's decision to force Dr. Elders from office was immediately applauded by Republican lawmakers, conservatives outside Congress and leaders of anti-abortion organizations. Representative Newt Gingrich, the Georgia Republican who will be the next Speaker of the House, said: "It's good for the country and good for the President that she's departed."