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The transformation of the Merck Manual of Diagnosis and Therapy from a “doctors-only” reference into a consumer health bible illuminates a critical era in the history of the twentieth-century medical book. Merck and Company restricted sales of its Merck Manual, first published in 1899 to offer up-to-date information for the busy practitioner, to physicians and other health care professionals until the 1970s. As more laypeople sought to get involved in their own health care decision making, the Merck Manual developed a devoted following. In the late 1980s, with almost a quarter of its sales going to nonphysicians, Merck and Company decided to put out a home edition of its famous manual. This evolution provides important insights into both the history of the medical book and the doctor-patient relationship in the United States.