The second Wiggers Bernard conference took an interdisciplinary approach and addressed three topics with a view to gaining increased understanding of the development of the multi-organ failure syndrome. These were, gut as a source of organ failure; metabolic aspects of the liver in sepsis; and endothelium as a target in sepsis. Eighteen contributors addressed these questions from a number of directions, including operational mechanisms, metabolic response, source and action of endotoxin and endotoxin-derived mediators. This book of proceedings on internal medicine, infectious diseases and emergency medicine is intended for the use of specialists and clinicians in these fields as well as for anaesthetists and surgeons.