THIS BOOK represents the evolutionary outgrowth of a procedures manual first developed in 1977 at Baylor College of Medicine for the

teaching of medical students and house staff. The need for such a manual was felt because of the existing discrepancy in the way

trainees upon assuming clinical responsibilities were learning, performing, and acquiring competence in the various procedures that an internist often uses to practice his "trade." This has classically been an unstructured process, revolving around the principle of "see one, do one, then teach one," with no standard required reading or