Franklin IC-118 User Manual
Electronic Publishers
For use with the Franklin
Digital Book System
IC-118
F
DIGITAL BOOK
THE
MERCK
MANUAL
SIXTEENTH EDITION
User’s Manual
License Agreement
READ THIS LICENSE AGREEMENT BEFORE USING THE
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BOOK means the software product and documentation found in
this package and FRANKLIN means Franklin Electronic Publishers,
Inc.
LIMITED USE LICENSE
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FRANKLIN if you fail to comply with any provision of this license.
This digital book was developed for use by medical professionals.
No other use of this digital book can substitute for consultation with
your physician.
1
Contents
Getting Started .............................................7
Installing Digital Books.......................... 8
Using Menus ........................................... 9
Changing Settings.................................. 11
Viewing Text ...............................................12
Using the Outline.................................... 13
Using the Index....................................... 16
Viewing References................................ 17
Viewing Tables........................................18
Searching for Words..................................20
Entering Search Words.......................... 21
Picking Search Words............................ 24
Fine-tuning Searches ............................. 26
Expanding Searches .............................. 28
Finding Words in Other Books.............. 29
Taking Notes...............................................30
Placing Notes.......................................... 31
Viewing Notes ......................................... 32
Removing Notes ..................................... 33
Appendixes/Index ......................................34
Abbreviations and Symbols .................. 35
Digital Book System®............................. 38
Key Guide................................................ 42
Index ........................................................ 43
2
Foreword
NOTE: This foreword of the 16th Edition of
MANUAL
tal book.
peared in 1899 as a slender 262-page text titled MERCK’S
MANUAL OF THE MATERIA MEDICA. It was expressly designed to meet the needs of general practitioners in selecting
medications, noting that “memory is treacherous” and that
even the most thoroughly informed physician needs a reminder “to make him at once master of the situation and enable him to prescribe exactly what his judgment tells him is
needed for the occasion.” It was well received and, by the 6th
Edition (1934), THE MERCK MANUAL had become highly
valued by medical students and house staff as well; by the
end of World War II the pocket-sized manual was an established favorite ready—reference book. Today THE MANUAL
is the most widely used medical text in the world. While the
book has grown to about 2800 pages, its primary purpose remains the same—to provide useful clinical information to
practicing physicians, medical students, interns, residents,
and other health care professionals.
of medical disorders that can occur in infants, children, and
adults, but those who do must have available a broad spectrum of current and accurate information. Specialists require
precise information about subjects outside their areas of expertise. All physicians need more and more information for
study and examination purposes, as well as for patient care.
Keeping up with the rapid and extraordinary advances in cellular and molecular biology, molecular genetics, and medical
technology is more challenging that ever, but THE MERCK
MANUAL continues to try to meet these needs, excluding
only details of surgical procedures.
contains page references not applicable to the digi-
It has been 93 years since THE MERCK MANUAL first ap-
Fewer physicians now attempt to manage the whole range
Precisely how to we attempt to meet these needs? First,
THE MERCK
3
Foreword
from a disease orientation, THE MANUAL covers all but the
most obscure disorders of mankind, not only those that a
general internist might expect to encounter but also problems
associated with pregnancy and delivery; common and serious disorders of neonates, infants, and children; and many
special situations. Disorders are organized mainly according
to the organ systems primarily affected, on the basis of their
etiology (as with most of the infectious diseases and disorders due to physical agents), or on the basis of disciplines
(e.g., gynecology, obstetrics, pediatrics, genetics, psychiatry). In addition, THE MANUAL contains information for special circumstances, such as radiation reactions and injuries,
problems encountered in deep-sea diving, and dental emergencies. The entire book is updated for each new edition,
and new subjects are added, such as discussions of genetic
evaluation and counseling, human immunodeficiency virus
(HIV) infection in children, sports medicine, hospice medicine, cross-cultural issues in medicine, anabolic steroid
abuse, and special considerations in performing cardiopulmonary resuscitation on infants and children. This edition has
140 more pages of text (approximately 5%) than the preceding edition. We therefore urge you to check the Index whenever you need information, even on unusual subjects or
those not commonly found in other texts.
A completely disease-oriented compendium, however,
would have serious limitations. Since patients usually present
with complaints or concerns that must be meticulously described, sorted, and deciphered, many chapters are devoted
to discussions of symptoms and signs and of how to elicit the
historical and physical data required for diagnosis. Common
clinical procedures and laboratory tests used as diagnostic
and management aids are described, with emphasis on their
indications, contraindications, and possible complications.
New and sophisticated laboratory and technologic proce-
4
Foreword
dures are also described, with comments on their uses, interpretations, and limitations.
Current therapy is presented for each disorder and supplemented with a separate section on clinical pharmacology that
describes general principles, new advances, (e.g., the role of
drug receptors, plasma concentration monitoring), and details of pharmacologic groups and specific agents; it even
discusses the uses of placebos. The use of complex equipment (e.g., respirators) is also described. Prophylaxis is emphasized wherever possible. Finally, reference guides are
provided for checking normal values, for calculating dosages,
and for converting weights, measures, and volumes to metric
equivalents.
Can so many subjects by adequately covered in a single
book? You, the reader, must be the ultimate judge, but we
believe the answer is in the affirmative. This edition required
a concerted effort by many people, beginning with an internal
analysis and critique of the previous edition, even though it
enjoyed highly favorable reviews and outstanding reader acceptance. Sections of that book were then sent to outside experts who had had nothing to do with its preparation, to solicit
their most candid criticism. Published reviews and letters
from readers were analyzed. Next, the Editorial Board met to
compare reviews and critiques and to plan this 16th Edition.
Distinguished special consultants were enlisted to provide
additional expertise. Then, 290 authors with outstanding
qualifications, experience, and knowledge were engaged.
Their manuscripts were painstakingly edited by our in-house
staff to retain every valuable morsel of knowledge while eliminating sometimes elegant but unneeded words. Each manuscript was then reviewed by a member of the Editorial Board
or a consultant. In many cases, additional special reviewers
were invited to comment. Every mention of a drug and its
dosage was reviewed by still another outside consultant. The
5
Foreword
objective of all these reviews was to ensure accuracy, adequate and relevant coverage of each subject, and simple and
clean exposition. The authors then reworked, modified, and
polished their manuscripts. Almost all of the manuscripts
were revised at least 6 times; 15 to 20 revisions were not uncommon. We believe that no other medical text undergoes
as many reviews and revisions as THE MERCK MANUAL
does.
Owing to the extensive subject matter covered and to a
successful tradition, the style and organization of THE MANUAL have some unique characteristics. Readers are urged to
spend a few minutes reviewing the Guide for Readers (p.
viii), the Table of Contents at the beginning of each section
(indicated by a thumb tab), and the Index (p. 2717). Scrutiny
of the arrangement of subject headings within each section,
of internal headings within a subject discussion, and of boldfaced terms in the text will reveal a pattern of outlining intended to aid study of the text.
The foregoing description is a simplified review of the complex and arduous but rewarding 5-year enterprise that culminated in the presentation of the 16th Edition of THE MERCK
MANUAL. The members of the Editorial Board, special consultants, contributing authors, and in-house staff and their affiliations are listed on the pages that follow. They deserve a
degree of gratitude that cannot adequately be expressed
here, but we know they will feel sufficiently rewarded if their
efforts serve your needs.
We hope this edition of THE MERCK MANUAL will be a
welcome aid to you, our readers—compatible with your
needs and worthy of frequent use. Suggestions for improve-
ments will be warmly welcomed and carefully considered
Robert Berkow, M.D., Editor-in-Chief
MERCK RESEARCH LABORATORIES
West Point, Pa. 19486
6
Getting Started
If you have never used this digital book,
read this section first.
It explains how to install
and start using this digital book.
7
Installing Digital Books
You must install this digital book before you can use
it.
Warning:
Digital Book System is on.
1. Turn the Digital Book System off.
2. Install the digital book in a slot on the back.
3. Press
4. To adjust the contrast, turn the wheel
on the side of the Digital Book System.
If the screen is still blank, check the batteries.
5. Press
6. Press
digital book symbol.
Never install a digital book when the
ON/OFF
.
CARD
.
or to highlight the appropriate
7. Press
ENTER
.
✓ Protecting Your Digital Books
If you install or remove a digital book while the
Digital Book System is on, information that you
entered in other installed digital books may be
erased.
8
Using Menus
To begin most functions of this digital book, you must
use menus. This lesson shows how to move around
the main menus and select menu items.
1. Press
2. Press
CLEAR
MENU
.
.
3. Press the arrow keys to highlight menus
and menu items.
The flashing arrows at the bottom of the screen
show which arrow keys you can press.
A slanted arrow to the right of a menu item shows
that a submenu exists.
4. To select a highlighted item, press
5. Press
BACK
to return to the main menus.
ENTER
✓ Help is at Hand
Except during the self-demonstration, you can
always view an appropriate help message by
BACK
HELP
.
.
or DN. To exit it,
pressing
To read the message, press
press
.
9
Using Menus
✓ Viewing Full Menu Items
Some items are too long to fit on a menu. To view
the full menu item, highlight it and then press
? *
✓ Scanning Menus
Use these keys to move quickly around menus.
To… Press…
page up or down
DN
or
UP
zoom to the top or + or
bottom of a menu
✓ Resuming Where You Left Off
While using this digital book, you can turn off the
Digital Book System at any time.
When you turn the Digital Book System on again,
you return to the screen that you last viewed.
.
10
Changing Settings
You can change its type size, default state, or shutoff
time of this digital book. The type size is how large
letters appear on screen. The default state is the dis-
CLEAR
play that appears when you press
time is how long the Digital Book System stays on
when you forget to turn it off.
. The shutoff
1. Press
MENU
.
2. Highlight the Other menu.
3. Highlight Set Type Size, Set Default State,
or Set Shutoff.
ENTER
4. Press
.
5. Highlight a setting.
ENTER
6. Press
to select it.
✓ Viewing a Demonstration
You can view a brief demonstration of this digital
MENU
book. First press
Demo under the Other menu and press
To stop the demonstration, press
. Then highlight View
ENTER
CLEAR
.
.
11
Viewing Text
This section shows you how
to find and view the text of this digital book
using its Outline and Index.
You will also learn how to view
references occurring in text,
such as footnotes ,
as well as tables and figures.
12
Using the Outline
The Outline is organized into more than 20 sections,
numbered serially from the start of the book. Those
sections are divided into nearly 300 chapters, which
are also numbered serially. For example, Section 2:
Immunology; Allergic Disorders begins with Chapter
18: Biology of the Immune System.
To find a specific chapter in the Outline, you must first
locate the section containing that chapter. Then you
can go to subchapters, sub-subchapters, and text.
Here is how.
1. Highlight the Outline menu.
• If Outline menu is the default state, press
• If another default state is selected, first press
CLEAR
2. Press
, then press
to highlight a section
MENU
, then highlight Outline.
or type a section number (e.g., 5).
To type a number, press plus a numbered key.
3. Press
4. Press
ENTER
.
to highlight a chapter
or type a chapter number (e.g., 50).
CLEAR
.
13
Using the Outline
5. Press
6. Press
ENTER
.
to highlight a subchapter
or type its first letters (e.g., sym).
7. Press
ENTER
to go to text.
To view the text, use these direction keys:
To… Press…
scroll up or down or
page up or down
page down
or
UP
SPACE
DN
view the next or + DN or
previous paragraph
view the next or
+ or
previous heading
8. Press
BACK
to return to the Outline.
14
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