Home health guides a family medical reference

Imagine treating a pregnant woman’s morning sickness with an injection of cocaine. How about prescribing cannabis for epilepsy? Or tobacco smoking for asthma?

The cover of The Merck Manual

The cover of The Merck Manual

TORONTO — Imagine treating a pregnant woman’s morning sickness with an injection of cocaine. How about prescribing cannabis for epilepsy? Or tobacco smoking for asthma?

These are but a few of the strange recommendations found in the first Merck Manual for physicians, a 192-page, pocket-sized reference book of the “chemicals and drugs usual in modern medical practice,” published in 1899.

How medicine has changed.

That the healing arts of Hippocrates and Galen have undergone a radical transformation even in the last century is no more evident than within the pages of Merck’s most recent offering, the revised Home Health Handbook for consumers.

At more than 2,300 pages, the hefty tome details the symptoms, causes and treatments of thousands of conditions — from eye and lung disorders to cancers and infectious diseases — as well as health issues specific to men, women and children.

The third edition of the Merck home health guide, first introduced in 1997, took three years to update and called on the expertise of more than 300 medical specialists, says editor-in-chief Dr. Robert Porter.

“What I think that illustrates as far as what’s really changed between 1899 and 2009 — or 1969, for that matter — is how we tell what works,” says Porter, contrasting the contents of the pharmaceutical company’s inaugural reference book to its latest one.

That first slim, black-covered volume provided an alphabetical listing of common diseases, each with its own often lengthy column of drugs and chemicals recommended for treatment, but no explanation of the disorder or how to diagnose it.

“Yes, there were quite a number of very, shall we say, curious remedies then, and some things that were clearly toxic,” concedes Porter, citing uranium to treat diabetes as one example.

“They did get a few things right or that we still think are right. They had salicylates (like ASA) for fever, digitalis for heart failure, intravenous saline solution for people with cholera who were dehydrated. So there are a few things that are still actually used.”

“Obviously there is a lot more information now than there used to be,” says Porter. “And the other thing that’s changed is how much information people as patients want to know themselves and are, in fact, expected to know.”

The Merck manual is just one of a slew of medical reference books aimed at consumers. They include the American Medical Association Family Medical Guide, the Mayo Clinic Family Health Book and the Canadian Medical Association Complete Home Medical Guide.

Dr. Cathy Younger-Lewis, the editor-in-chief who oversaw the 2001 and 2005 revisions of the CMA guide, agrees that many patients given a diagnosis will want to research the illness or condition beyond what they’ve been told by their doctor.

While she strongly endorses patient self-education, the former family practitioner advises Canadians to be careful when reading editions written and published outside Canada.

“The basic information of what is rheumatoid arthritis, what is a heart attack, that’s going to be the same,” she said. “But the medical guidelines are often different, the drugs are often different and our health-care system is very, very different.”

“It can be very frustrating as a family doctor … to prescribe something or say something and the person would go off and they often come back and say, ‘But in this source it says this’ and ‘why can’t I get that?”’

Still, Younger-Lewis believes it’s important for consumers to have a medical reference at the ready, and not just for an unhurried perusal. Most books contain advice on dealing with potentially life-threatening situations, such as recognizing the signs of a heart attack or what do when someone has ingested poison, reacted to a bee sting or been bitten by an animal.

While the Internet has lots of information, being able to thumb through to the critical information in a subject-indexed book would likely be quicker in an emergency than firing up a computer and searching online, she said.

“I think there’s still a big place for a book like this in someone’s house.”

Porter likes to think of the Merck Manual as the first stop on the medical information highway.

“So when something first comes up, so when the doctor says: ‘Oh, your mother’s had a stroke’ … the manual is the place where you can go to get a full but concise soup-to-nuts description of what that medical condition is, how doctors recognize it, what they do for it, what the prognosis is,” he says.

“What we do is make it much easier for you to understand more detailed or more complicated information, because with the manual you’ve got full background and you really are starting to speak the language of that disease.”

Porter says such guides, written and reviewed by top medical experts, provide an all-in-one source of trustworthy, validated content.

“With the Internet, you can do a Google search and you can get just about anybody’s site and they could be good, they could be bad, they could be biased. And it’s a little hard to tell, so having everything in one source is still helpful.”

That’s not to say only bibliophiles can access the information. With another nod to changing times, Merck is offering its Home Health Handbook as a downloadable iPhone application, which can be purchased through iTunes for about a quarter of the cost of the hardcover.

One other change Porter has made is to integrate all the material from another title dealing strictly with geriatric medicine, so all stages of life are now covered between the handbook’s covers.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

COVID-19. (Image courtesy CDC)
Alberta reports 1,731 new COVID-19 cases on Saturday

The province’s central zone has 992 active cases

Collin Orthner, manager at McBain Camera in downtown Red Deer, stands behind the store’s counter on Saturday. (Photo by Sean McIntosh/Advocate staff)
A few Red Deer businesses happy with Black Friday results

While this year’s Black Friday wasn’t as successful as it was in… Continue reading

Le Chateau Inc. is the latest Canadian firm to start producing personal protective equipment for health care workers, in a July 3, 2020 story. (Photo by THE CANADIAN PRESS)
Hundreds of millions of dollars for frontline workers yet to be released, says Alberta Federation of Labour

Information recently released by the Alberta Federation of Labour suggests more than… Continue reading

Red Deer RCMP say a 30-year-old man faces sexual charges against a teen. (File photo by Advocate staff)
Man killed in two-vehicle collision near Penhold, says Blackfalds RCMP

A 46-year-old man is dead following a two-vehicle collision on Highway 42… Continue reading

Banff National Park. (The Canadian Press)
Study finds train speed a top factor in wildlife deaths in Banff, Yoho national parks

EDMONTON — A study looking at 646 wildlife deaths on railway tracks… Continue reading

Cows on pasture at the University of Vermont dairy farm eat hay Thursday, July 23, 2020, in Burlington, Vt. Canadian dairy farmers are demanding compensation from the government because of losses to their industry they say have been caused by a series of international trade deals. THE CANADIAN PRESS/AP-Lisa Rathke
Feds unveil more funding for dairy, poultry and egg farmers hurt by free trade deals

OTTAWA — Canadian egg and poultry farmers who’ve lost domestic market share… Continue reading

Chief Public Health Officer of Canada Dr. Theresa Tam speaks during a news conference on the COVID-19 pandemic in Ottawa, on Friday, Nov. 20, 2020. Canada's top doctor says the country is still on a troubling track for new COVID-19 infections as case counts continue mounting in much of the country. THE CANADIAN PRESS/Justin Tang
COVID-19 cases in Canada remain on troubling course, Tam says, amid rising numbers

Canada’s top doctor says the country is still on a troubling track… Continue reading

hay
Hay’s Daze: Giraffe knows filling wishes can sometimes be a tall order

Last weekend, I had a lovely breakfast. “So what?” you may say.… Continue reading

A person enters a building as snow falls in Ottawa, Sunday, Nov. 22, 2020. Ottawa has been successful in limiting the spread of COVID-19 during its second wave thanks to the city’s residents who have been wearing masks and staying home, said Ottawa’s medical officer of health Dr. Vera Etches. THE CANADIAN PRESS/Justin Tang
People to thank for Ottawa’s success with curbing COVID-19: health officer

The city’s chief medical officer said much of the credit goes to the people who live in Ottawa

NDP Leader Jagmeet Singh asks a question during question period in the House of Commons on Parliament Hill, in Ottawa, Thursday, Nov. 26, 2020. NDP Leader Jagmeet Singh says tonight's public video gaming session with Alexandria Ocasio-Cortez is about reaching young people where they hang. THE CANADIAN PRESS/Sean Kilpatrick
NDP leader stoked over ‘epic crossover’ in video gaming sesh with AOC

Singh and AOC discussed importance of universal pharmacare, political civility, a living wage

A south view of the Ward Hunt Ice Shelf breaking apart is seen from Ward Hunt Island, Nunavut, in an Aug. 20, 2011, handout photo. The remote area in the northern reach of the Nunavut Territory, has seen ice cover shrink from over 4 metres thick in the 1950s to complete loss, according to scientists, during recent years of record warming. Scientists are urging the federal government to permanently protect a vast stretch of Canada's remotest High Arctic called the Last Ice Area. THE CANADIAN PRESS/HO-CEN/Laval University, *MANDATORY CREDIT*
Scientists urge permanent protection of Last Ice Area in Canada’s High Arctic

Tuvaijuittuq has the thickest and oldest ice in the Arctic

In this file photo, a lotto Max ticket is shown in Toronto on Monday Feb. 26, 2018. (By THE CANADIAN PRESS)
No winning ticket for Friday night’s $55 million Lotto Max jackpot

No winning ticket was sold for the $55 million jackpot in Friday… Continue reading

Most Read