Franklin IC-118 User manual


Digital Book System
For use with the Franklin

IC-118
DIGITAL BOOK
F
User’s Manual

Electronic Publishers
Mount Holly, NJ 08060
FCR-28018-00 A PN 7201760 Printed in China
FOLD

Electronic Publishers

THE
MERCK
MANUAL
SIXTEENTH EDITION

1
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.
License Agreement

2
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

3
NOTE: This foreword of the 16th Edition of THE MERCK
MANUAL contains page references not applicable to the digi-
tal book.
It has been 93 years since THE MERCK MANUAL first ap-
peared in 1899 as a slender 262-page text titled MERCK’S
MANUAL OF THE MATERIA MEDICA. It was expressly de-
signed 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 re-
minder “to make him at once master of the situation and en-
able 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 estab-
lished 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 re-
mains 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 spec-
trum of current and accurate information. Specialists require
precise information about subjects outside their areas of ex-
pertise. 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 cel-
lular 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

4
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 seri-
ous 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 disor-
ders due to physical agents), or on the basis of disciplines
(e.g., gynecology, obstetrics, pediatrics, genetics, psychia-
try). In addition, THE MANUAL contains information for spe-
cial circumstances, such as radiation reactions and injuries,
problems encountered in deep-sea diving, and dental emer-
gencies. 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 medi-
cine, cross-cultural issues in medicine, anabolic steroid
abuse, and special considerations in performing cardiopul-
monary resuscitation on infants and children. This edition has
140 more pages of text (approximately 5%) than the preced-
ing edition. We therefore urge you to check the Index when-
ever 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 de-
scribed, 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

5
dures are also described, with comments on their uses, inter-
pretations, and limitations.
Current therapy is presented for each disorder and supple-
mented with a separate section on clinical pharmacology that
describes general principles, new advances, (e.g., the role of
drug receptors, plasma concentration monitoring), and de-
tails of pharmacologic groups and specific agents; it even
discusses the uses of placebos. The use of complex equip-
ment (e.g., respirators) is also described. Prophylaxis is em-
phasized 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 ac-
ceptance. Sections of that book were then sent to outside ex-
perts 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 elimi-
nating sometimes elegant but unneeded words. Each manu-
script 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

6
objective of all these reviews was to ensure accuracy, ade-
quate 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 un-
common. 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 MAN-
UAL 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 bold-
faced terms in the text will reveal a pattern of outlining intend-
ed to aid study of the text.
The foregoing description is a simplified review of the com-
plex and arduous but rewarding 5-year enterprise that culmi-
nated in the presentation of the 16th Edition of THE MERCK
MANUAL. The members of the Editorial Board, special con-
sultants, contributing authors, and in-house staff and their af-
filiations 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
Foreword

7
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.

8
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.
✓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.
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
.

9
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
.

10
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
UP
or
DN
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.

11
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-
play 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.
✓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
ENTER
.
To stop the demonstration, press
CLEAR
.
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.

12
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.

13
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
or type a section number (e.g., 5).
To type a number, press plus a numbered key.
3. Press
ENTER
.
4. Press to highlight a chapter
or type a chapter number (e.g., 50).

14
Using the Outline
5. Press
ENTER
.
6. Press 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
UP
or
DN
page down
SPACE
view the next or +
DN
or
UP
previous paragraph
view the next or + or
previous heading
8. Press
BACK
to return to the Outline.

15
Using the Outline
To continue backing up, press
BACK
repeatedly.
To go directly to the highest Outline level (i.e.,
section headings), press plus
BACK
.
9. To return to the default state, press
CLEAR
.
✓Moving To and From the Outline
When you have gone to text from the Outline, you
can go to the lowest Outline level by pressing
BACK
.When you have gone to text from the Index
or from a word search, you can go to the lowest
Outline level by pressing
SPEC
.
A quick way to go from any Outline level to text is
to press plus
ENTER
.
✓Where in the Book Am I?
You can always see the Outline location of the text
in view by pressing
? *
.
The section (at top), chapter, subchapter, and sub-
subchapter, if applicable, of the text are listed. The
lowest Outline level is highlighted. To return to the
text, press
BACK
. Note: When you press
? *
, you
are not in the Outline itself.

16
Using the Index
You can use the Index to quickly find specific topics.
Simply type a topic at the Index menu. Usually you
need to type only the first few letters to highlight one.
1. Highlight the Index menu.
• If Index menu is the default state, press
CLEAR
.
• If another default state is selected, first press
CLEAR
, then press
MENU
, then highlight Index.
2. Start typing a topic (e.g., hernia).
To erase typed letters, press
BACK
. The slanted
arrow to the right of the entry indicates subentries.
3. Press
ENTER
.
4. Highlight a subentry and then press
ENTER
.
5. Highlight a sub-subentry, if any,
and then press
ENTER
to go to text.
6. To return to the Index, press
BACK
.

17
Viewing References
References appear throughout the text and in tables.
Their places are marked by these symbols:
bibliographic reference
cross-reference
footnote
Whenever you see a symbol, you can view its
reference.
Note: Cross-references take you to the
cross-referenced text or table. Follow these steps.
1. At text or a table with a reference,
press
ENTER
to start the highlight.
2. Press the arrow keys to highlight the symbol.
3. Press
ENTER
.
4. Press
BACK
to return to the text or table.
5. Press
BACK
again to turn off the highlight.

18
Viewing Tables
Many of the chapters have tables. Tables are listed
at the bottom of the subchapter headings in the
Outline.
Tables are displayed at the end of chapters in text.
To learn how to view tables, try this example.
1. Under the Outline menu,
highlight 1: Infectious Disease.
2. Press
ENTER
.
3. Highlight 3: Prevention of Infection.
4. Press
ENTER
.
5. Press plus to highlight the last
subchapter of Chapter 3.
6. Press
ENTER
.
These are the row headings for Table 3-3.

19
Viewing Tables
7. Press
ENTER
.
These are the row and column headings and text
of Table 3-3. See “Understanding Tables” below.
8. Press the direction keys to view the table.
9. Press
BACK
to return to its row headings.
✓Understanding Tables
In this digital book, table rows and columns are
displayed as indented text.
Generally, the main headings of a table are row
headings, preceded by bullets. Column head-
ings are included in each row in boldface type.
When you select a table from the Outline, you
can view a menu for each level of rows.
✓Viewing Figures
In this digital book, figures are referenced in text
but are not displayed. To view a figure, please
refer to it in the appropriate printed edition of
The Merck Manual .