CSR Press Release

SAN DIEGO,CA. - September 18, 2008 - The Merck Manual of Patient Symptoms, a new guide for medical students, residents, nurse practitioners, and physician assistants, and one that serves as a useful refresher for clinicians, was introduced today at the annual meeting of the American Academy of Family Physicians.

Compact enough to carry in a lab coat pocket, the paperback helps health care practitioners, particularly those who are newcomers to clinical diagnosis, understand and evaluate a wide range of symptoms.

"The Merck Manual of Patient Symptoms is intended for medical students and residents, as well as nurse practitioners and physician assistants, who increasingly are the first health care professionals to see patients," said Editor Robert S. Porter, M.D. "The book will make it easier to sort through patients’ varied sensations and physical findings, and create an effective diagnostic plan."

Common Symptoms
Organized alphabetically, 88 common symptoms, from abdominal pain to wheezing, are addressed in detail. Entries for each symptom begin with a list of possible causes, calling out whenever possible the ones that are more common, more dangerous or both, followed by suggestive findings.

Discussions related to evaluation provide guidelines for patient history, physical examination, interpretation of findings and testing. "Red flags" highlight indications of serious health conditions. Treatment guidelines cover common therapies, drugs, and dosages for symptom relief. "Key points" summarize the most important information for each symptom.

Not-for-Profit Service
The Merck Manual of Patient Symptoms complements The Merck Manual of Diagnosis and Therapy, the oldest of several books published as a not for profit service to the medical community by Merck & Co., Inc. First published in 1899, The Merck Manual is the most widely used medical reference in the world and has been translated into 17 languages.

Merck also publishes The Merck Manual of Medical Information – Home Edition, which was first introduced in 1997. This consumer-friendly book translates the medical terminology contained in the doctors’ version into everyday language. Listed by The New York Times as a best seller, The Merck Manual of Medical Information is in its second edition. Also, Merck publishes The Merck Manual of Health & Aging as well as The Merck Index, (a one-volume encyclopedia of chemicals and biologicals), The Merck Veterinary Manual and The Merck/Merial Manual for Pet Health (for pet owners). All of the manuals have strict editorial independence and do not include marketing information or promote pharmaceutical medicines.

Buying the Book
The Merck Manual of Patient Symptoms (ISBN#: 978-0-911910-11-7) costs $24.95 and is available for purchase online and wherever books are sold. For more information, visit www.merckbooks.com.

About Merck
Merck & Co., Inc. is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, Merck currently discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs. The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them. Merck also publishes unbiased health information as a not-for-profit service. For more information, visit www.merck.com.

Forward-Looking Statement
This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements are based on management's current expectations and involve risks and uncertainties, which may cause results to differ materially from those set forth in the statements. The forward-looking statements may include statements regarding product development, product potential or financial performance. No forward-looking statement can be guaranteed and actual results may differ materially from those projected. Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the many uncertainties that affect Merck's business, particularly those mentioned in the risk factors and cautionary statements in Item 1A of Merck's Form 10-K for the year ended Dec. 31, 2007, and in any risk factors or cautionary statements contained in the Company's periodic reports on Form 10-Q or current reports on Form 8-K, which the Company incorporates by reference.