As a general medical journal, The BMJ contains a wide range of subject matter, and many types of information need to be incorporated in its semi-annual index. Index Medicus vocabulary can be used for clinical articles, but non-clinical matter presents problems of ‘soft’ language. A weekly publication, the BMJ runs to about 1600 pages a volume, so succinct indexing is important, as is keeping to schedule. The number of authors and the vagueness of journal users present particular problems that can be ameliorated by the design of the index. Medline is a useful adjunct for subject access. Both the journal and the index have changed during a decade in which social and political aspects of medicine have assumed greater importance.