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With the current emphasis on updated information, this loose-leaf book revives an important concept: each year the subscriber receives revised material. He snaps open the five-ring binder, discards the old pages, and locks in the new. Medical books no longer have to stagnate for four or more years. Indeed, the authors might include information they gather at meetings, and, theoretically, this new material could reach the subscriber about the same time it appears in a journal—all of this because of new computer-assisted printing technology. Almost any number of changes in the text or in the references can be made while leaving the body of the book intact.
For example, I received 14 basic chapters (448 pages) along with five revised chapters. Dr Block updates his excellent chapter on endocrinology by inserting transphenoidal microdissection of pituitary adenomas (to replace heavy particle irradiation) as the preferred treatment for Cushing's disease. Similarly, Dr
R. Dale Liechty. General Surgery. JAMA. 1980;243(14):1470. doi:10.1001/jama.1980.03300400054036