The article considers certain characteristics of 74 Brazilian medical journals listed in the Index Medicus Latino-Americano (IMLA) compiled by the Regional Library of Medicine and Health Science (BIREME). After remarking on the low survival rate of these publications, of which other studies list almost 2,000 titles between 1827 and 1978, the author cites the coverage of too many specialties, a lack of planning and of adherence to publishing schedules, and an overproportion of papers of dubious quality to promote sales of medical products as some of the reasons for the flight of Brazilian scientific articles to foreign publications. He also notes that, despite the disregard in which Brazilian journals are widely supposed to be held in the international scientific community, those that maintain acceptable standards of scientific quality, are published regularly and comply with international standards for the presentation of articles are cited often in collections of abstracts and indexes of international standing. Another aspect considered is the emergence in the structure of biomedical information in Brazil of an alternative medical press for the discussion of problems in the delivery of health services.