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The Merck Manuals Have a New Editor-in-Chief

Commentary
02/03/22 Sandy J. Falk, MD, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA|Adult Survivorship Program, Dana Farber Cancer Institute|Harvard Medical School;

“My hand fell on The Merck Manual. I knew the moment I saw it that I had found something belonging to an entirely different order of knowledge: calm, magisterial…”.

—Dr. Terrence Holt, “The Merck Manual of Diagnosis and Therapy” in Bound to Last: Thirty Writers on their Most Cherished Book

 

The Merck Manuals play an integral role the field of medicine, past, present, and future. In 1899, a slim volume, Merck’s Manual of the Materia Medica, gave rise to the longest continuously published general textbook of medicine in the English language. In doing so, The Manuals created the blueprint for providing useful medical information. Since 1899, The Manuals have evolved and adapted in many ways, while still fulfilling this core mission.

I am honored to become the new Editor-in-Chief of The Manuals. As with any change in leadership, first steps are to evaluate where we are, what should stay the same, and what should change. Change is already here. Medical diagnosis and treatment are advancing at breathtaking speed. Health care has undergone a digital revolution, for both clinicians and patients. Communication is global. Personalized medicine takes many forms, from genomics to awareness of individual differences.

The Manuals are always changing, they are digital and global. They are for consumers, not just clinicians. They are not limited by species; The Merck Veterinary Manual was introduced in 1955. As with any organization that has survived for more than a century, we have not done so by standing still. Charles Darwin said, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

The most important elements will not change, these include:

Excellent quality. The content is correct, current, and evidence based. Content is written and peer reviewed by leading medical experts and edited by inhouse physicians. This is a model that ensures quality.

Comprehensive. If there is a medical issue you need to look up, you’ll find it in The Manuals.

Clear and concise. This emphasis on clarity and brevity should not be underestimated. The Manuals are written in a style that allows a reader to go from a question to a useful level of understanding in few minutes. There is an art to this; it is more difficult to communicate well in a few words than in many. This is the work of our experienced and talented editorial team.

As I write this in 2022, still in the midst of the COVID-19 pandemic, the need for accurate health information is front and center. We hear a lot about the 1918 influenza pandemic, and I was interested to see how The Manuals responded at that time. Here is the coverage in the editions of The Manual before and after:

INFLUENZA.—GRIPPE.—An epidemic disease with cold in the head, pains over the body, fever and other uncomfortable symptoms. (4th ed., published 1911)

INFLUENZA.—GRIPPE.—A pandemic disease caused by the Influenza Bacillus. Incubation: 1 to 4 days. (5th ed., published 1923)

In a few words, we see a significant shift in medical knowledge. The understanding that influenza was not just epidemic, but that it could be pandemic, came at the cost of 50 million lives worldwide. We also see that it was not yet known that influenza was caused by a virus, not a bacterium – the virus identified in 1930.

At that time, it took years to bring updates to The Manuals’ readers. Now we can update our content as fast as new information emerges. We are living in an era when new medical discoveries are emerging so quickly; the speed itself makes it hard to stay current and can even be concerning to people. What is known about a new disease or treatment? Is a new treatment safe, can you trust it?

The Manuals are a resource that provide trustworthy information to clinicians and to any person interested in good health. I am delighted to become the Editor-in-Chief of this wonderful institution. The motto of the original edition still holds true today, “Every addition to true knowledge is an addition to human power.”

Sandy j Falk MD

Test your knowledge
Residual Limb Pain
After amputation, over 70% of people have pain in the residual limb (stump). Residual-limb pain should be evaluated and treated aggressively. Of the causes of residual-limb pain, which of the following is the most serious and requires immediate consultation with a doctor?