The pride in British medicine that was established by this flagship-the first edition of the Oxford textbook of medicine-is rekindled by the second edition. Some rearrangement and expansion of sections have occurred. The first edition indicated that the book was intended for anyone studying or practising clinical medicine (as a first reference source for general practitioners and specialists) and this new edition amply fulfils that challenge. A section on primary care brings this discipline into its rightful place in such a textbook and helps to break down any artificial barrier that may exist between hospital and family practice medicine. One looks for updating between the two editions and apart from increase in size there are 'improvements' throughout-almost completely new and recent references in the section on pituitary and hypothalmic disorders, an account of CT scanning in pituitary and adrenal disease, developments such as magnetic resonance imaging included in the cardiovascular disease section. The section on respiratory disease has illuminating descriptions of the pathophysiology of the airways and gas exchange. The clinical section on asthma is updated to modern concepts. Rheumatology and connective tissue disorders is expanded from eight to 15 subsections. AIDS, dealt with in only three pages, may (one hopes) be in the end a true perspective or, alternatively, this field is changing so rapidly that we can await a major assessment of this condition in a third edition.