Editing Merck Manual of Diagnosis and Therapy

{{Short description|Medical textbook}}{{italic title}}
[[File:Merck Materia Medica 1899 ed facsimile cover page PS2.jpg|thumb|Coverpage of facsimile edition of 1899 ''Merck's Manual of the Materia Medica'']]
'''''The Merck Manual of Diagnosis and Therapy''''', referred to as ''The Merck Manual'',<ref name="about">{{cite web|title=About the Merck Manuals|url=https://www.merckmanuals.com/professional/resourcespages/about-the-merck-manuals|website=Merck Manuals - Professional Version|access-date=21 May 2016}}</ref>
is the world's best-selling medical textbook,<ref name="Fool">{{cite web|last1=Planes|first1=Alex|title=Here's What You Don't Know About Merck & Co. Inc.|url=https://www.fool.com/investing/general/2014/04/29/heres-what-you-dont-know-about-merck-co-inc-todays.aspx|website=The Motley Fool|access-date=21 May 2016|date=29 April 2014}}</ref> and the oldest continuously published English language medical textbook.<ref name="Lane">{{cite journal|last1=Lane|first1=Keryn AG|last2=Berkow|first2=Robert|title=The Merck Manual: A Century of Medical Publishing and Practice|journal=CBE Views|date=1999|volume=22|issue=4|pages=112–113|url=https://www.councilscienceeditors.org/wp-content/uploads/v22n4p112-113.pdf|access-date=21 May 2016|publisher=Council of Science Editors}}</ref> First published in 1899, the current print edition of the book, the 20th Edition, was published in 2018. In 2014, Merck decided to move ''The Merck Manual'' to digital-only, online publication, available in both professional and consumer versions; this decision was reversed in 2017, with the publication of the 20th edition the following year.<ref>{{Cite web|url=https://www.facebook.com/MerckManual/photos/a.426222710742715.99920.298183310213323/1504237522941223/?type=3&comment_id=1504736889557953&reply_comment_id=1505307616167547 |archive-url=https://ghostarchive.org/iarchive/facebook/298183310213323/1504237522941223 |archive-date=2022-02-26 |url-access=limited|title=Merck Manual Facebook page|website=[[Facebook]] |date=May 1, 2017}}{{cbignore}}</ref>  ''The Merck Manual of Diagnosis and Therapy'' is one of several medical textbooks, collectively known as ''[[The Merck Manuals]]'', which are published by Merck Publishing,<ref name="mpabout">{{cite web|title=About the Merck Publishing Group|url=https://merckbooks.com/mpabout.html|website=merckbooks.com|access-date=21 May 2016}}</ref> a subsidiary of the [[pharmaceutical company]] [[Merck & Co.|Merck Co., Inc.]] in the United States and Canada, and MSD (as ''The MSD Manuals'') in other countries in the world. Merck also formerly published ''[[The Merck Index]]'', ''An Encyclopedia of Chemicals, Drugs, and Biologicals.''

==History and editions==
The first edition of ''The Merck Manual'' was published in 1899 by Merck & Co., Inc. for physicians and pharmacists and was titled ''Merck's Manual of the Materia Medica''.<ref name="history">{{cite web|title=History of the Merck Manuals|url=https://www.merckmanuals.com/professional/resourcespages/history|website=Merck Manuals - Professional Version|publisher=Merck & Co.|access-date=21 May 2016}}</ref><ref name="Merck 1899">[https://archive.org/details/mercksmanualofma00newy  Merck's manual of the materia medica, together with a summary of therapeutic indications and a classification of medicaments. New York, Chicago: Merck & Co., 1899]</ref> The 192 page book which sold for US $1.00, was divided into three sections, Part I ("Materia Medica") was an alphabetical listing of all known compounds thought to be of therapeutic value with uses and doses; Part II ("Therapeutic Indications") was an alphabetical compendium of symptoms, signs, and diseases with a list of all known treatments; and Part III ("Classification of Medicaments ''(sic)'' According to their Physiologic Actions") was a listing of therapeutic agents according to their method of action or drug classification.<ref name="Lane"/> Many of the terms used are now considered archaic, such as [[abasia]], [[astasia]], [[Insufflation (medicine)#Nasal drug administration|errhines]] and [[rubefacients]] - [[Sneeze|sternutatories]], and many of the agents listed are now not considered to be standard  therapeutic agents but were considered useful at the time, including poisonous compounds such as [[Mercury (element)|mercury]], [[lead]], [[strychnine]] and [[arsenic]]. There were 108 remedies listed for [[indigestion]] (dyspepsia), including [[Alcoholic beverage|alcohol]], arsenic, [[cocaine]], [[gold chloride]], mercury, [[morphine]], [[nux vomica]], [[opium]], [[silver nitrate]], strychnine, and "[[Turkish baths]] (for malaise after dining out)".<ref name="Merck 1899"/>{{rp|118}} [[Bismuth]], [[calcium]], [[magnesium]] [[salts]] were also on the list, which are ingredients found in many modern gastrointestinal treatments available today. Arsenic was recommended for over 100 illnesses including [[anemia]], [[diarrhea]], [[Rabies|hydrophobia]], [[elephantiasis]], and [[impotence]]. The formulas include "aletris cordial", a "uterine tonic and restorative", which contained "[[aletris farinosa]] or True Unicorn combined with [[Aroma compound#Aromatic|aromatics]]".<ref name="Merck 1899"/>{{rp|15}} The manufacturer, Rio Chemicals of St. Louis was clear to differentiate the inclusion of true unicorn rather than false unicorn in its preparation.<ref name="Rio">{{cite book|title=An index of diseases in which Aletris Cordial has been found useful.|date=1890|publisher=Rio Chemical Co.|location=St. Louis, MO|page=1|edition=USC School of Medicine Digital Collections|url=http://digital.tcl.sc.edu/cdm/ref/collection/med/id/5874}}</ref>
{{efn|The [[root]] of the ''[[Aletris farinosa]]'' is an [[alternative medicine|alternative]] herbal remedy used as for digestive problems, and for relief of gynecologic disorders.<ref>{{cite web|title=Aletris Uses, Benefits & Dosage - Drugs.com Herbal Database|url=https://www.drugs.com/npp/aletris.html|website=www.drugs.com|access-date=21 May 2016}}</ref><ref>{{cite web|title=Aletris - Uses, Side Effects, Interactions and Warnings - WebMD|url=https://www.webmd.com/vitamins-supplements/ingredientmono-605-aletris.aspx?activeingredientid=605&activeingredientname=aletris|website=www.webmd.com|access-date=21 May 2016}}</ref>}}

The earliest versions did contain drugs that are still in use today for the same purposes, for example [[digitalis]] for [[heart failure]];,<ref name="Merck 1899"/>{{rp|90}}<ref name="Merck 1901"/> {{rp|166}} [[salicylates]] for [[headache]]<ref name="Merck 1901"/>{{rp|166}} [[rheumatism]]<ref name="Merck 1901"/>{{rp|225}} and [[fever]],<ref name="Merck 1899"/>{{rp|124}}<ref name="Merck 1901"/>{{rp|227}} [[nitroglycerin]] for cardiac [[angina pectoris]];,<ref name="Merck 1899"/>{{rp|88}} and [[Bismuth subsalicylate|bismuth salicylate]] for [[diarrhea]]<ref name="Merck 1899"/>{{rp|114}}

Merck also began publishing ''Merck's Archives of the Materia Medica'', a monthly journal consisting of papers related to drugs and uses, which was available for an annual subscription of [[United States dollar|US $]]1.00.<ref name="Merck 1899"/><ref name="Merck 1901"/>
[[File:Merck's Archives, January 1906.jpg|right|140px|Ad for the January 1906 edition of the ''Merck's Archives'']]

The second edition of ''The Merck Manual'' was published in 1901, was expanded to 282 pages and included new sections on poisons and antidotes, tables and conversion charts, and a detailed explanation of the metric system.<ref name="Merck 1901">[http://www.survivorlibrary.com/library/merck_manual_1901.pdf Merck's 1901 Manual of the Materia Medica - A Ready-Reference Pocket Book for the Practicing Physician and Surgeon. New York, Chicago: Merck & Co., 1901]</ref>

The 5th edition, published in 1923 was delayed due to paper shortages caused by [[World War I]], and the release of the 6th edition was delayed until 1934 due to the [[Stock Market Crash]]. The editor of that edition, Dr. M.  R.  Dinkelspiel had overseen the growth and reorganization of the Manual to discuss specific diseases, diagnosis and treatment options, and external specialists reviewed each section. The 8th edition of the Manual was delayed by [[World War II]] until 1950. 
The 13th edition, released in 1977 was the first time the textbook was produced using [[magnetic tape]] and [[IBM]] [[punch cards]], the previous version having been typed on a manual typewriter. The Centennial (17th) Edition published in 1999 included a separate facsimile version of the 1899 1st edition.<ref name="Lane"/>{{rp| 113}}

It is reported that both Admiral [[Richard E. Byrd]] took the book with him on his expedition to the South Pole in 1929 and [[Albert Schweitzer]] had a copy of The Merck Manual with him at his hospital mission in Africa in 1913.<ref name="history"/><ref name="Ross 2013">{{cite news | last=Ross | first=Marvin | title=Don't Be Too Quick to Praise This New Treatment | work=The Huffington Post | date=11 November 2013 | url=https://www.huffingtonpost.ca/marvin-ross/schizophrenia-treatment_b_4254350.html | access-date=16 February 2017}}</ref><!-- It is likely that one of these sources is dependent on the other, or both on a third source. -->

The recommended doses given in Part 1 of 1901 edition of ''The Manual'' were for adults when given by mouth. It included the following dose adjustment recommendations:
{{Quote box
 |quote  = ''The DOSES, unless otherwise stated, are for adults and per os. To determine the dose for children, add 12 to the age, and divide by the age; 1 divided by the result represents the fraction of the adult dose suitable for the child. For example, a child three years old will require''
 <math display="block">\text{pediatric dose:} = \frac{1}{\left ( \frac{(age)+12}{(age)}\right )}</math>
 <math display="block">\text{e.g.:} \tfrac {3+12}{3}= 5</math>     <br />    <math>\tfrac{1}{5} = 0.2</math>   
 ''of the adult dose. Of powerful narcotics, children will require scarcely more than one-half of this proportion. Children bear opiates poorly; while they stand comparatively large doses of arsenic, belladonna, ipecac, mercurials, pilocarpine, rhubarb and some other purgatives, and squill. For hypodermic injection the dose is ordinarily about one-half of that given.''<ref name="Merck 1901"/>{{rp|7}}
 |source = ''Merck's Manual of the Materia Medica.'', 1901
 |width  = 75%
 |align  = center
}}

===Print editions of ''The Merck Manual''===
# 1899 
# 1901 
# 1905 
# 1911 
# 1923 
# 1934 
# 1940 
# 1950 
# 1956 
# 1961 (There were two printings in 1961, June and Nov; a third in Aug 1962 and a fourth in June 1963)
# 1966 
# 1972 
# 1977 
# 1982 
# 1984 
# 1992 (2 million copies sold) 
# 1999 (Centennial Edition) 
# 2006 
# 2011 
# 2018 (current print edition)

==Content==
''The Merck Manual'' is organized, like many internal medicine textbooks, into organ systems (see  List of Medical Topics below) which discuss each major diseases of that system, covering diagnosis (signs, symptoms, tests), prognosis and treatment. It provides a comprehensive yet concise compendium of medical knowledge into about 3500 pages, by emphasizing practical information of use to a practicing physician. In addition to 24 sections covering medical topics, it includes a pharmacology section listing drugs by generic and brand name, a list of drug interactions and a pill identifier, a News and Commentary section, videos on procedures and examination techniques, quizzes and case histories, clinical calculators, conversion tables and other resources.<ref>{{cite web|title=Merck Manuals For the Professional|url=https://www.merckmanuals.com/professional|website=Merck Manuals|publisher=Merck & Co.|access-date=21 May 2016}}</ref> The text is characterized by the combination of conciseness, completeness, and being up-to-date.  It is updated continuously by an independent editorial board and over 300 peer reviewers that contribute to the textbook, which goes through an average of 10 revisions by both internal and external reviewers before publication. The internal editorial staff consists of 4 physician reviews, one executive editor and four non-medical lay editors.<ref name="Lane"/> The latest version has been translated into 17 languages. In addition to the online version, ''The Merck Manual Professional Edition'' is also available as a mobile app in both [[iOS]] and [[Android (operating system)|Android]] platforms,<ref name="history"/> produced by Unbound Medicine, Inc.<ref>{{cite web|title=The Merck Manuals Apps - Professional|url=https://www.unboundmedicine.com/merckmanual|website=www.unboundmedicine.com|access-date=21 May 2016}}</ref>

===Medical topic sections (online edition)=== 
K1.	Cardiovascular Disorders
2.	Clinical Pharmacology
3.	Critical Care Medicine
4.	Dental Disorders
5.	Dermatological Disorders
6.	Ear, Nose, and Throat Disorders
7.	Endocrine and Metabolic Disorders
8.	Eye Disorders
9.	Gastrointestinal Disorders
10.	Genitourinary Disorders
11.	Geriatrics
12.	Gynecology and Obstetrics
13.	Hematology and Oncology
14.	Hepatic and Biliary Disorders
15.	Immunology; Allergic Disorders
16.	Infectious Diseases
17.	Injuries; Poisoning
18.	Musculoskeletal and Connective Tissue Disorders
19.	Neurologic Disorders
20.	Nutritional Disorders
21.	Pediatrics
22.	Psychiatric Disorders
23.	Pulmonary Disorders
24.	Special Subjects

==Awards and recognition==
''The Merck Manual'' was listed in the 2003 [[Brandon–Hill list|Brandon Hill "Selected List of Books and Journals for the Small Medical Library"]] as a recommended medical textbook for diagnosis, geriatrics, and patient education.<ref>{{cite journal|last1=Hill|first1=Dorothy R.|last2=Stickell|first2=Henry|title=Brandon/Hill selected list of print books and journals for the small medical library|url=http://mssm.edu/library/brandon-hill/small_medical/pdf/brandon4.pdf|journal=Bulletin of the Medical Library Association|year=2001|volume=89|issue=2|pages=131–153|access-date=21 May 2016|archive-url=https://web.archive.org/web/20081003034902/http://mssm.edu/library/brandon-hill/small_medical/pdf/brandon4.pdf|archive-date=3 October 2008|location=New York|pmid=11337945|pmc=31721}}</ref>

''The Merck Manuals'' were awarded five 2015 eHealthcare Leadership Awards including a Gold Award for Best Healthcare Content for Professionals, and a Distinction Award: Best Overall Healthcare Site, Consumer<ref>{{cite web|title=The Manuals Win Internet Awards|url=https://www.merckmanuals.com/professional/news/editorial/2015/12/18/20/21/award-announcement?sc_camp=testCs123|website=Merck Manuals - Professional Version|access-date=21 May 2016}}</ref> at the nineteenth annual Healthcare Internet Conference held in November 2015 in Orlando, Florida.<ref>{{cite web|title=eHealthcare Leadership Awards|url=http://www.strategichealthcare.com/ehealthcare-leadership-awards|website=www.strategichealthcare.com|access-date=21 May 2016}}</ref>

Merck Publishing offers resources for "The Merck Manual Award" provided annually to outstanding medical students. The qualifications for the award are determined by each medical school.<ref>{{cite news|title=Students, faculty honored at School of Medicine commencement — News Room - UNC Health Care|url=http://news.unchealthcare.org/som-vital-signs/2012/may17/commencement|website=news.unchealthcare.org|access-date=21 May 2016}}</ref>  Medical schools that give this award include University of North Carolina School of Medicine, University of Central Florida School of Medicine and the University of Illinois School of Medicine.

==Other Merck manuals ==

===''The Merck Manual of Geriatrics''===
First published in 1990, sections of ''The Merck Manual'' were made into a separate volume dealing with diseases and management of illnesses in the elderly. It has gone through three print editions, the last version published in 2000.<ref name="Geriatrics">{{cite book|last1=Beers|first1=Mark H.|last2=Berkow|first2=Robert|title=The Merck Manual of Geriatrics|date=2000|publisher=Merck Research Laboratories|location=Whitehouse Station, N.J.|isbn=978-0911910889|edition=3rd|url=https://archive.org/details/merckmanualofger00beer}}</ref> Since the transition of The Merck Manual in 2015 to a web only based version, the Manual of Geriatrics is accessible through the Professional and Consumer portals of the online text.<ref name="GeriatricsOL">{{cite web|title=Geriatrics|url=https://www.merckmanuals.com/professional/geriatrics|website=Merck Manuals - Professional Version|access-date=21 May 2016}}</ref> A search engine on the Merck Manual site allows searches limited to the contents of ''The Merck Manual of Geriatrics''.<ref name="GeriatricsSearch">{{cite web|title=The Merck Manual of Geriatrics, Search|url=https://www.merck.com/mkgr/mmg/search.jsp|website=www.merck.com|access-date=21 May 2016}}</ref>

===''The Merck Manual of Patient Symptoms''===
''The Merck Manual of Patient Symptoms'' is a concise, pocket size reference guide intended for medical students and allied health care professionals in training. It covers symptoms, diagnosis and treatment.<ref>{{cite book|last1=Porter|first1=Robert S.|last2=Kaplan|first2=Justin L.|last3=Homeier|first3=Barbara P.|title=The Merck manual of patient symptoms : a concise, practical guide to etiology, evaluation, and treatment|date=2008|publisher=Merck Research Laboratories|location=Whitehouse Station, NJ|isbn=978-0911910117}}</ref>

==Consumer editions==

===''The Merck Manual of Medical Information – Home Edition''===
''The Merck Manual of Medical Information – Home Edition'' was published in 1997 and was a re-edited version of the Professional version using less technical language intended for patients, caregivers and people interested in medical topics without training in health fields. This edition sold over 2 million copies. The ''Second Home Edition'' was released in 2003, and the third edition was published in 2009 as ''The Merck Manual Home Health Handbook'', and sold over 4 million copies.<ref>{{cite book|title=The Merck Manual Home Health Handbook|publisher=Wiley|language=en|date=1 October 2011|isbn=978-1118115428}}</ref> Since 2015 the Consumer version content is available only via the online Merck Manual website.<ref name="mmabout">{{cite web |title=About The Merck Manual |url=https://www.merckmanuals.com/professional/resourcespages/about-the-merck-manuals |website=Merck Manuals - Professional Version}}</ref> A condensed consumer-oriented version was published at ''The Merck Manual Go-To Home Guide for Symptoms'' in 2013.<ref>{{cite book|last1=Porter|first1=Robert S.|last2=Kaplan|first2=Justin L.|title=Merck Manual Go-To Home Guide for Symptoms|date=2013|publisher=Merck Sharp & Dohme Corp|location=Kenilworth, N.J.|isbn=9780911910988}}</ref>

===''The Merck Manual of Women's and Men's Health''===
In 2014, ''The Second Home Edition'' was extracted from the Professional version of ''The Manual'' and published as ''The Merck Manual of Women's and Men's Health'' <ref>{{cite book|title=Merck Manual of Women's and Men's Health|date=2014|publisher=Gallery Books|isbn=978-1501104534}}</ref><ref>{{cite book|title=The Merck Manual of Women's and Men's Health|publisher=Gallery Books|language=en|date=25 October 2014|isbn=978-1501104534}}</ref>

===''The Merck Manual of Health & Aging''===
A consumer version of ''The Merck Manual of Geriatrics'' was released in print in 2004 as ''The Merck Manual of Health & Aging'', which included information on aging and the care of older people in non-technical language for the public. The content was incorporated into the Consumer version of the online Merck Manual in 2015.<ref name="Lane"/><ref>{{cite book|last1=Beers|first1=Mark H.|last2=Jones|first2=Thomas V.|last3=Berkwits|first3=Michael|last4=Kaplan|first4=Justin L.|last5=Porter|first5=Robert|title=The Merck manual of health & aging|date=2006|publisher=Ballantine Books|location=New York|isbn=978-0345482754|edition=2006 Ballantine Books mass market}}</ref>

==Veterinary medicine==

===''The Merck Veterinary Manual''===
''The Merck Veterinary Manual''<ref>{{cite book|last1=Aiello|first1=Susan E.|last2=Moses|first2=Michael A.|title=The Merck Veterinary Manual|date=2016|publisher=Merck & Co.|location=Rahway, NJ|isbn=978-0911910612|edition=11th}}</ref> has been published since 1955 for professional veterinarians and other professionals in the veterinary field. It is the most widely used veterinary medicine textbook.<ref>{{cite web|title=The Merck Veterinary Manual|url=https://merckbooks.com/mvm/index.html|website=merckbooks.com|access-date=21 May 2016}}</ref> It is still published in a print version<ref>{{cite web|title=The Merck Veterinary Manual - Book|url=https://www.merckvetmanual.com/merckmanualvet-book.htm|website=www.merckvetmanual.com|access-date=21 May 2016}}</ref> and the 11th edition is scheduled for release on July 12, 2016.<ref>{{cite book|last1=Aiello|first1=Susan E.|last2=Moses|first2=Michael A.|title=The Merck Veterinary Manual|publisher=Merck|language=en|date=12 July 2016|isbn=978-0911910612}}</ref> The ''Merck Veterinary Manual'' has been translated into seven languages, including [[Croatian language|Croatian]], [[French language|French]], [[Italian language|Italian]], [[Japanese language|Japanese]], [[Portuguese language|Portuguese]], [[Romanian language|Romanian]] and [[Spanish language|Spanish]].<ref>{{cite web|title=''The Merck Veterinary Manual'' - Translations|url=https://www.merckvetmanual.com/merckmanualvet-translations.htm|website=www.merckvetmanual.com|access-date=21 May 2016}}</ref> It is also available as a mobile app in both [[iOS]] and [[Android (operating system)|Android]] platforms, as well as an online version.<ref>{{cite web|title=THE MERCK VETERINARY MANUAL|url=https://www.merckvetmanual.com/mvm/index.html|website=www.merckvetmanual.com|access-date=21 May 2016}}</ref>

===''Merck/Merial Manual for Pet Health (Home Edition)''===
A consumer version written in non-technical language as a joint publication between Merck and [[Merial]] released as the ''Merck/Merial Manual for Pet Health (Home Edition)'' was first published in 2007.<ref>{{cite book|last1=Kahn|first1=Cynthia M|last2=Line|first2=Scott|title=The Merck/Merial Manual for Pet Health|date=2007|publisher=Merck|location=Rahway, NJ|isbn=978-0911910995|edition=1|url=https://archive.org/details/arthritishandboo00holl}}</ref>  {{ISBN|978-0911910995}}. A consumer oriented version of the Merck Veterinary Manual is available online as the ''Pet Health Edition''.<ref>{{cite web |title=THE MERCK VETERINARY MANUAL |url=https://www.merckvetmanual.com |access-date=29 Aug 2024 |website=www.merckvetmanual.com}}</ref>

==Notes==
{{notes}}

== See also ==
* ''[[Merck Index|The Merck Index]]''

==References==
{{Reflist|40em}}

==External links==
* [http://www.merckmanuals.com/ ''Merck Manuals''] full text online:
** [https://www.merckmanuals.com/professional Professional edition]
** [https://www.merckmanuals.com/home Home edition]
* [https://www.merckmanuals.com/professional/resourcespages/mobileapps ''Merck Manual'' Mobile Apps]
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