(Bethesda, Md.)-It's certainly true that the phrase, "You've come a long way, baby," can be applied to MEDLINE, the National Library of Medicine's premier bibliographic database of 4,500 biomedical journals published in the United States and 70 foreign countries. This month, MEDLINE celebrates its 30th birthday. Its offspring, MEDLINEplus, a source of reliable consumer health information available on the World Wide Web, celebrates its third birthday this month.

In 1971, when doctors dressed in bell-bottom pants relied on trained librarians to do their searches, MEDLINE could "support 25 simultaneous users." Today MEDLINE is the world's largest medical database, accessible to all via the Internet, and it supports users who do 400 million searches each year. It began as a service for instantaneously searching medical literature for workers in medical schools, medical libraries, hospitals, and research institutions. At that time MEDLINE consisted of articles in the top 239 medical journals, 130,000 citations in all. There were search fees, limited access to computers, and cumbersome search engines that excluded public access - and most researchers and physicians as well.

From the "NLM News" in October 1971: " Each user of the service will pay for his own terminal and telephone costs. The system will be accessible by teletype, TWX, IBM 2741, and other terminals operating at 100, 148, or 300 words per minute... The institution will be required to send at least one person for training in the use of the system, and further, to provide bibliographic services to health professionals beyond their normal service responsibilities."

By 1972, the system was already expanding. Its database included 400,000 citations from 1,100 of the leading journals. The communications network began to provide toll- free telephone access in about 35 cities which all connected to NLM's new IBM 370/155 computer.

The 1980s ushered in the era of the personal computer. It was the low cost mini- and microcomputers that prompted the NLM to offer subsets of MEDLINE for use on personal computers. By then, the database had increased its holdings to 4 million citations. There was a charge for service that varied based on the size of the subset as well as other variables.

Another innovative feature was added in 1986 to enhance MEDLINE's appeal. Known as Grateful Med, this PC-based, user-friendly software program let health professionals and others use their personal computers to search MEDLINE. For $29.95, even a non-health care provider could purchase Grateful Med software to call up the Library's computers, enter a query and receive the references or abstracts for downloading on a floppy disk. More than 6 million references and abstracts for journal articles starting in 1966, and 600,000 catalog records for books could be searched.

Physicians began to use the software for practice-related problems. It helped them make diagnoses, but it was the means by which the information was obtained that transformed the practice of medicine. In 1988, more than 4 million searches were done, and health professionals as well as health writers and editors were using the software.

By 1992, while there was still a fee for searching MEDLINE, special arrangements were being made with the American College of Physicians, so that its 72,000 members had virtually unlimited access to MEDLINE's 7 million references and abstracts.

The next logical step was to offer MEDLINE on the Web. The Library launched Internet Grateful Med on April 16, 1996, with pioneering heart surgeon Michael DeBakey, Senator (and surgeon) Bill Frist (R-TN), and NLM Director Donald A.B. Lindberg, M.D., to show off the new software and to discuss the role MEDLINE plays in medicine and the delivery of health care.

Lindberg foresaw the amazing potential of the new technology, and in June 1997, helped make it possible for MEDLINE, which now contained over 9 million medical articles from 70 different countries, to be offered free on the Web. At an announcement attended by then-Vice President Al Gore and Senators Arlen Specter (R-PA) and Tom Harkin (D-PA), Lindberg helped launch the new MEDLINE. The NLM Director emphasized that not only did MEDLINE deliver the most easily accessible medical information web site, it tapped into the latest medical research, just as soon as it came out of the laboratory and was published in the literature.

Recognizing the need to help consumers find answers to medical questions, the Library launched MEDLINEplus in October 1998. MEDLINEplus is the Library's consumer- friendly source of up-to-date health information, with countless resources on health and wellness topics. Consumers and health professionals began using MEDLINEplus as the source of the most reliable and most accurate health information available on the World Wide Web. It now receives some 70 million hits each year.

MEDLINE and MEDLINEplus are changing health care delivery and educating patients with information that will make them better informed and ready to participate with physicians in making critical decisions.

The National Library of Medicine, the world's largest library of the health sciences, is part of the National Institutes of Health in Bethesda, Maryland. The Library has an extensive Web site at www.nlm.nih.gov, with a great variety of information for the general public and for health professionals.