Franklin IC-118 User Manual

	For use with the Franklin



	Digital Book System
Electronic Publishers	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 DIGITAL BOOK. YOUR USE OF THE DIGITAL BOOK DEEMS THAT YOU ACCEPT THE TERMS OF THIS LICENSE. IF YOU DO NOT AGREE WITH THESE TERMS, YOU MAY RETURN THIS PACKAGE WITH PURCHASE RECEIPT TO THE DEALER FROM WHICH YOU PURCHASED THE DIGITAL BOOK AND YOUR PURCHASE PRICE WILL BE REFUNDED. DIGITAL BOOK means the software product and documentation found in this package and FRANKLIN means Franklin Electronic Publishers, Inc.

LIMITED USE LICENSE

All rights in the DIGITAL BOOK remain the property of FRANKLIN. Through your purchase, FRANKLIN grants you a personal and nonexclusive license to use the DIGITAL BOOK on a single FRANKLIN Digital Book System at a time. You may not make any copies of the DIGITAL BOOK or of the data stored therein, whether in electronic or print format. Such copying would be in violation of applicable copyright laws. Further, you may not modify, adapt, disassemble, decompile, translate, create derivative works of, or in any way reverse engineer the DIGITAL BOOK. You may not export or re-export, directly or indirectly, the DIGITAL BOOK without compliance with appropriate governmental regulations. The DIGITAL BOOK contains Franklin’s confidential and propriety information which you agree to take adequate steps to protect from unauthorized disclosure or use. This license is effective until terminated. This license terminates immediately without notice from 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.

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

Foreword

NOTE: This foreword of the 16th Edition of THE MERCK MANUAL contains page references not applicable to the digital book.

It has been 93 years since THE MERCK MANUAL first appeared 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.

Fewer physicians now attempt to manage the whole range 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.

Precisely how to we attempt to meet these needs? First,

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-

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

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 improvements will be warmly welcomed and carefully considered

Robert Berkow, M.D., Editor-in-Chief

MERCK RESEARCH LABORATORIES

West Point, Pa. 19486

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.

Installing Digital Books

You must install this digital book before you can use it. Warning: Never install a digital book when the 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 ON/OFF .

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 CARD .

6.Press or to highlight the appropriate digital book symbol.

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.

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 CLEAR .

2.Press 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 ENTER .

5. Press BACK to return to the main menus.

Help is at Hand

Except during the self-demonstration, you can always view an appropriate help message by pressing HELP .

To read the message, press	or DN . To exit it,
press BACK .

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…

page up or down

zoom to the top or bottom of a menu

Press…

UP or DN

+ or

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.

CLEAR .

ENTER .

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 display that appears when you press CLEAR . The shutoff time is how long the Digital Book System stays on when you forget to turn it off.

1.Press MENU .

2.Highlight the Other menu.

3.Highlight Set Type Size, Set Default State, or Set Shutoff.

4.Press ENTER .

5.Highlight a setting.

6. Press ENTER to select it.

Viewing a Demonstration

You can view a brief demonstration of this digital book. First press MENU . Then highlight View Demo under the Other menu and press To stop the demonstration, press

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.

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 CLEAR .

•If another default state is selected, first press CLEAR , then press MENU , then highlight Outline.

2.Press to highlight a section