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The Trusted Provider of Medical Information since 1899

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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" loading="lazy"/></noscript></span><figure class="LandingEdition_versionFigure__gao54 LandingEdition_versionFigurePro__Ruwgo"><a class="LandingEdition_versionLink__gnPy7" href="https://www.msdmanuals.com/professional"><div class="LandingEdition_versionContainer__GsT2X"><div class="LandingEdition_versionCompany__r_iXg">MSD Manual</div><figcaption class="LandingEdition_versionCaption__vCKqL"><h3 class="LandingEdition_versionName__ngtMJ false">Professional Version</h3><div class="LandingEdition_versionArrow__BZ7Vy"></div></figcaption><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionDesktop__kKVG0">For Medical Professionals and Students, more advanced content and features</h3><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionMobile__hwjxg">I’m a medical professional or student.</h3><div class="LandingEdition_versionBtnWrapper__37xcd"><h3 class="LandingEdition_versionButton___Aqh5">Go To Professional Version</h3></div></div></a></figure></div><div class="LandingEdition_versionMore__hlnoL"><div class="LandingEdition_versionMoreRight__7AIfp"><div><ul> <li>1000s of Topics</li> <li>“How-To” Videos</li> <li>Numerous Photos</li> <li>Clinical Calculators</li> <li>Quizzes</li> <li>3D Models</li> <li>News and Editorials</li> </ul></div></div></div></div><div class="LandingEdition_versionType__iahHV LandingEdition_versionTypeHome__ejMZJ"><div class="LandingEdition_versionTop__sAtsZ"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="Consumer" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img alt="Consumer" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=480&amp;q=75 480w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fconsumer.jpg%3Fh%3D482%26iar%3D0%26w%3D725&amp;w=3840&amp;q=75" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" loading="lazy"/></noscript></span><figure class="LandingEdition_versionFigure__gao54 LandingEdition_versionFigureHome__PYV7e"><a class="LandingEdition_versionLink__gnPy7" href="https://www.msdmanuals.com/home"><div class="LandingEdition_versionContainer__GsT2X"><div class="LandingEdition_versionCompany__r_iXg">MSD Manual</div><figcaption class="LandingEdition_versionCaption__vCKqL"><h3 class="LandingEdition_versionName__ngtMJ false">Consumer Version</h3><div class="LandingEdition_versionArrow__BZ7Vy"></div></figcaption><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionDesktop__kKVG0">For the General Public, information that is clear and easy to understand</h3><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionMobile__hwjxg">I’m a patient, parent or caregiver.</h3><div class="LandingEdition_versionBtnWrapper__37xcd"><h3 class="LandingEdition_versionButton___Aqh5">Go To Consumer Version</h3></div></div></a></figure></div><div class="LandingEdition_versionMore__hlnoL"><div class="LandingEdition_versionMoreRight__7AIfp"><div><ul> <li>1000s of Topics</li> <li>100s of Animations</li> <li>Numerous Photos and Illustrations</li> <li>Self-Assessment Tools</li> <li>Quizzes</li> <li>3D Models</li> <li>Common Medical Tests</li> </ul></div></div></div></div><div class="LandingEdition_versionType__iahHV LandingEdition_versionTypeVet__O4glK"><div class="LandingEdition_versionTop__sAtsZ"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="Veterinary" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img alt="Veterinary" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fveterinary.jpg%3Fh%3D483%26iar%3D0%26w%3D724&amp;w=480&amp;q=75 480w, 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/_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fveterinary.jpg%3Fh%3D483%26iar%3D0%26w%3D724&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fveterinary.jpg%3Fh%3D483%26iar%3D0%26w%3D724&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fveterinary.jpg%3Fh%3D483%26iar%3D0%26w%3D724&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fedge.sitecorecloud.io%2Fmmanual-ssq1ci05%2Fmedia%2Fmanual%2Flanding%2Feditionboxes%2Fveterinary.jpg%3Fh%3D483%26iar%3D0%26w%3D724&amp;w=3840&amp;q=75" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" loading="lazy"/></noscript></span><figure class="LandingEdition_versionFigure__gao54 LandingEdition_versionFigureVet__YLTT9"><a class="LandingEdition_versionLink__gnPy7" href="https://www.msdvetmanual.com"><div class="LandingEdition_versionContainer__GsT2X"><div class="LandingEdition_versionCompany__r_iXg">MSD Veterinary Manual</div><figcaption class="LandingEdition_versionCaption__vCKqL"><h3 class="LandingEdition_versionName__ngtMJ false">Veterinary Manual</h3><div class="LandingEdition_versionArrow__BZ7Vy"></div></figcaption><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionDesktop__kKVG0">For Veterinary Professionals and Students, the world&#x27;s most widely used veterinary reference</h3><h3 class="LandingEdition_versionDescription___N8sm LandingEdition_versionDescriptionMobile__hwjxg">I’m a vet or pet owner. </h3><div class="LandingEdition_versionBtnWrapper__37xcd"><h3 class="LandingEdition_versionButton___Aqh5">Go to Veterinary Manual</h3></div></div></a></figure></div><div class="LandingEdition_versionMore__hlnoL"><div class="LandingEdition_versionMoreRight__7AIfp"><div><ul> <li>1000s of Topics  </li> <li>Dozens of Species</li> <li>Numerous Videos and Photos</li> <li>Clinical Calculators</li> <li>Quizzes</li> <li>Reference Guides</li> <li>Case Studies, News and Editorials</li> </ul></div></div></div></div></div></div><div data-testid="landingMissionContainer" class="LandingMission_missionContainer___dOe1 false"><div class="LandingMission_buttonContainer__4WXJo"><a tabindex="0" role="link" aria-label="mission"><div class="LandingMission_arrowIcon__TcEkT"></div></a></div><div class="LandingMission_landingMission__q5grB"><div class="LandingMission_pictureWrapper___VLV9"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27180%27%20height=%27188%27/%3e"/></span><img alt="Global Medical Knowledge" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Global Medical Knowledge" srcSet="https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/landing/msd_gmk_vertical_sm.gif?h=188&amp;iar=0&amp;w=180&amp;mw=256 1x, https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/landing/msd_gmk_vertical_sm.gif?h=188&amp;iar=0&amp;w=180&amp;mw=384 2x" src="https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/landing/msd_gmk_vertical_sm.gif?h=188&amp;iar=0&amp;w=180&amp;mw=384" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" loading="lazy"/></noscript></span></div><div class="LandingMission_missionContent__JFcmA"><div class="LandingMission_designText__5SI7L"><h2 class="content__title">Our mission is simple:</h2> <p class="content__paragraph"><span>The Manuals, first published in 1899 and now known as MSD Manuals outside the United States and Canada</span>, are one of the world&rsquo;s most widely used medical information resources. The Manuals are committed to making the best current medical information accessible to health care professionals and patients on every continent.</p> <p class="content__paragraph">We believe that health information is a universal right and that every person is entitled to accurate and accessible medical information. We have a responsibility to protect, preserve and share the best current medical information to enable more informed decisions, enhance relationships between patients and professionals, and improve health care outcomes around the world. </p> <p class="content__paragraph">That&rsquo;s why we are making the Manuals available for free in digital form in multiple languages to professionals and patients around the world.</p></div></div></div></div><div data-testid="LanguageSelectorPopup"></div><noscript id="gtn"><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-5MKXR9" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><section data-testid="landingAboutContainer" class="LandingAbout_aboutContainer__vjlEo false" aria-label="About"><div class="LandingAbout_landingAbout__hMo2D"><div class="LandingAbout_aboutContent__NwphF"><div class="LandingAbout_contentLeft__Y6GCI"><div class="LandingAbout_designText__6IuGE"><p><span><strong>MSD&nbsp;and the MSD Manuals</strong></span></p> <p> <div class="content__paragraph"> <p>At MSD we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world &ndash; and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals.</p> <p>First published in 1899 as a small reference book for physicians and pharmacists, The Manual grew in size and scope to become one of the world's most widely used comprehensive medical resources for professionals and consumers. As The Manual evolved, it continually expanded the reach and depth of its offerings to reflect the mission of providing the best medical information to a wide cross-section of users, including medical professionals and students, veterinarians and veterinary students, and consumers. Learn more about our commitment to&nbsp;<a href="https://www.msdmanuals.com/professional/resourcespages/global-medical-knowledge">Global Medical Knowledge.</a></p> <div>&nbsp;</div> </div> </p></div><div class="LandingAbout_logoWrapper__9s3i8"><div class="LandingAbout_logoFirst__J8KaG"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27189%27%20height=%2771%27/%3e"/></span><img alt="msd" 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src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="MSD" srcSet="https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/brand-logos/mm_logo.svg?h=52&amp;iar=0&amp;w=52&amp;mw=32 1x, https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/brand-logos/mm_logo.svg?h=52&amp;iar=0&amp;w=52&amp;mw=64 2x" src="https://edge.sitecorecloud.io/mmanual-ssq1ci05/media/manual/brand-logos/mm_logo.svg?h=52&amp;iar=0&amp;w=52&amp;mw=64" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" 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