Colleen Smith, Allan D. Marks, and Michael A. Lieberman, Lippincott Williams & Wilkins, Philadelphia, 2005, 977 pp., ISBN 0-7817-2145-8, $59.95 The first edition of this well liked book (among medical students) appeared in 1996, authored by Allan Marks, Dawn Marks, and Colleen Smith. Their worthy aim was “to simplify the complex” for the benefit of medical students trying to cope with biochemistry. A second edition had long been planned, but the plans sadly were thwarted and delayed by the untimely death of one of the original authors, Dawn Marks, in 2000, and that of a second, Colleen Smith, in 2002. Nevertheless, it is pleasing to note that the original format and aims have been retained and extended. All chapters have been updated, and nucleotide metabolism has been given its own chapter (“because of the importance of understanding the various types of drugs that interfere with DNA metabolism”), and the Molecular Endocrinology chapter has been eliminated because it overlaps to a great extent what is taught in physiology courses (the authors say), with some of the material being relegated to other chapters. There is a whole new chapter on ethanol metabolism, and there are a lot of other rearrangements with the addition of new material on, for example, xenobiotics, blood cell differentiation, the regulation of energy use by muscle, and an expansion of the section on connective tissue proteins. The whole book is divided into eight sections each containing five or six chapters: Fuel Metabolism; Chemical and Biologic Foundations of Biochemistry; Gene Expression and the Synthesis of Proteins; Fuel Oxidation and the Generation of ATP; Carbohydrate Metabolism; Lipid Metabolism; Nitrogen Metabolism; and Tissue Metabolism (this includes hormones, blood cells, plasma, liver metabolism, muscle, nervous system, extracellular matrix, and connective tissue). Although separated out from the main text in this way (for example, perhaps some of this material might have been inserted earlier into the text at some appropriate place), these chapters seem to work. (There is always the danger of teaching medical students a load of biochemistry and requiring them to memorize it, without explaining its medical relevance in context, thus making learning biochemistry a chore; here, the clinical cases establish this relevance almost from page one.) The clinical case studies are for me the most attractive feature of the book and indeed the most useful in terms of teaching biochemistry to medical students. They are described as patients presenting in the clinic, and their symptoms are described. The patients have names that provide clues as to their problems; thus it can be guessed that “Jean-Ann Tonich” might have alcohol problems. Similarly, it may be concluded that “Lotta Topaign” might be suffering from gout! However, a serious educational point is that the patients (who are based on real but “composite” patients from Dr Allan Marks' medical practice) appear, some diagnoses are made, some conclusions are reached, but then they appear again and again later on in the text, as their cases (and presumably students' knowledge of biochemistry) develop. Sections have summaries, and chapter summaries have keywords highlighted in bold. At the end of chapters, there are multiple choice questions with answers given at the back of the book. I thought these were mostly rather trivial, but they are in the format required by the Board of Examiners in the U.S. Most of the end-of-chapter references (aside from historical ones) are post-2002. The print is two-color, and U.S. units are used for laboratory quantities with no translation for European users of the book. There is a CD (inserted into the back cover), which is easy to use. It contains about 60 “patients” as PDF files (in typescript format), five images as JPG files, and nine Flash animations. These are quite imaginative and detailed, and students can study them at their leisure. There are a few proofreading errors (trivial, but actually rare these days) such as “CO2” rather than “CO2” and cysteine misspelled, and some recent issues seem to have been missed, such as problems with the Cox2 inhibitor Vioxx (p. 661), but these are minor quibbles. I have used the first edition of this book for many years with medical students. The case studies are ingenious, amusing, and well thought out and immediately show the relevance of biochemistry to medicine, and the diagrams are eminently clear and simple. I look forward to using this second edition with this year's new entrants.