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Foreword
With this edition, The Merck Manual celebrates its 100th birthday. When the editors of the 1st
Edition produced their 192-page compendium, they could not have realized the extent to which
medical knowledge would explode over the next century. The Merck Manual now fills 2,655
pages and covers countless diseases that were not known 100 years ago.
Although the knowledge of medicine has grown, the goal of The Merck Manual has not
changed -- To provide useful clinical information to practicing physicians, medical students, in-
terns, residents, nurses, pharmacists, and other health care professionals in a concise, complete,
and accurate manner. The Merck Manual continues to cover all the subjects expected in a text-
book of internal medicine as well as detailed information on pediatrics, psychiatry, obstetrics, gy-
necology, dermatology, pharmacology, ophthalmology, otolaryngology, and a number of special
subjects. The Merck Manual quickly provides information that helps practitioners achieve opti-
mal care. The more specialized the practice of medicine becomes, the more important such infor-
mation becomes. Specialists as well as generalists must at some time quickly access information
about other specialties.
The 17th edition of The Merck Manual is the culmination of an arduous but rewarding 7-year
enterprise. Every topic has been updated, and many have been completely rewritten. Topics new
to this edition include hand disorders, prion diseases, death and dying, probabilities in clinical
medicine, multiple chemical sensitivity, chronic fatigue syndrome, rehabilitation, smoking cessa-
tion, and drug therapy in the elderly, among others.
Because of the extensive subject matter covered and a successful tradition developed through
trials of successes and failures, The Merck Manual has some unique characteristics. Subject head-
ings within each section, internal headings within a subject discussion, and boldfaced terms
in the text form an outline intended to help with use of the text.
We hope this edition of The Merck Manual will serve as an aid to you, our readers, compatible
with your needs and worthy of frequent use. Suggestions for improvements will be warmly wel-
comed and carefully considered.
Mark H. Beers, M.D., and Robert Berkow, M.D., Editors
