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How long does it take to become an Institution? When a group of amateur musicians, high school drama students, or editors of a learned journal plans an annual event, at what point can they consider that they "have it made"? Certainly, an organization should be cautious of predictions. At the very first production (whether in music, drama, or journalism), to talk boldly of "The First Annual..." may seem unduly optimistic. And to beat the drums at the second or third anniversary may represent pious wishes for the future, rather than solid prospects. But "Fourth Annual..." has a sound of gratifying solidity; it radiates confidence for the future; it can justifiably look both backwards and forwards.
With this, our fourth Special Book Issue, we believe we have firmly established an annual event. The present issue is the largest so far. And we are particularly pleased that many of the essays were
THE FOURTH ANNUAL... JAMA. 1967;200(1):66. doi:10.1001/jama.1967.03120140124027
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