THE MERCK MANUAL OF MEDICAL INFORMATION, Robert H. Berkow, MD, Editor-in-Chief. Pocket Books, New York, 1999, by special arrangement with Merck & Co, Inc., 1997, 1620 pp., Paper $7.99. ISBN: 0-671-02727-1.

The Merck Manual of Medical Information—Home Edition has been published to meet a growing demand by the general public for highly detailed, sophisticated medical information. This book (287 chapters) is based almost entirely on the text of The Merck Manual of Diagnosis and Therapy, commonly referred to as The Merck Manual (288 chapters) first published in 1899. It is the oldest continuously published general medical textbook in the English language and the most widely used medical textbook in the world, covering almost every disease that affects humans. Although it was expressly designed to meet the needs of general practitioners in selecting medications, noting that "memory is treacherous," it was so well received that it grew from 262 pages to ten times that length because it provided useful information to practicing physicians, medical students, interns, residents, and other health care professionals. The sixteenth edition (1992) took five years to revise, with many chapters going through 6 and up to 20 separate revisions to assure accuracy and to finely hone every word and sentence for absolute precision and conciseness.

Despite a plethora of books of medical information written for the public over the last several decades, more lay people were buying the 2844 page Merck Manual, despite the fact that it was never marketed to the public, and finding it difficult to understand. Dr Berkow, the editor-in-chief of both volumes, led a team of 200 eminent experts as editorial board members, consultants, and authors to translate The Merck Manual into this Home Edition. It contains nearly all the information of the original except for physical findings, tissue descriptions, and treatments that vary too widely to be useful to the public.

The editors and authors were successful in reducing the "Manual" by 1200 pages, yet keeping it understandable for lay readers. Chapter 4 on Death and Dying is the most succinct, illuminating 9 pages on the subject that I have read. I wish all my patients that are traveling the final mile in their lives, as well as their families and loved ones, could read this chapter. It would make the journey less anxious. The five page chapter on Genetics gives an excellent summary of the subject under 13 titled paragraphs that would give patients with a genetic problem a basis for understanding his/her disease.

The section on Lung and Airway Disorders contains 15 easily readable chapters. The ten-page chapter on physiology is helpful for patient's understanding of airway problems. The five pages on diagnostic testing gives a more elucidating explanation of PFTs, sleep studies, and arterial blood gases than most pulmonary techs would be able to give. It also includes short paragraphs on chest imaging, thoracentesis, pleural biopsy, bronchoscopy, transbronchial lung biopsy, thoracoscopy, mediastinoscopy, thoracotomy, and airway suctioning. There's a two-page chapter on Acute Respiratory Distress syndrome, a three-page chapter on pulmonary embolism and a single page on bronchitis, which allows anyone to be an informed patient.

Of the several hundred books that publishers have sent to my desk during the six years that I have been reviewing books of medical interest for this journal, this manual provides the most useful information that I have seen that we can unequivocally recommend to our patients. With over 20,000 medical sites on the WEB, with the majority having doubtful medical validity, we should refer to the Merck Manual of Medical Information as the most authoritative work that is useful for patients. It would be the best $8 our patients could spend. And it is more accessible than any WEB site.

Del Meyer, MD