Therapeutic Notes and the Outline of Medical Therapeutics

Printed in-house by Washington University’s department of medicine in the 1940s and 1950s, Therapeutic Notes and the Outline of Medical Therapeutics served as the precursors to what evolved into the famous Washington Manual of Medical Therapeutics.

The earliest versions of the manual were called Therapeutic Notes, which included step-by-step instructions for standard inpatient treatments at the Washington University medical center. Beginning with Dr. Wayland MacFarlane in 1942, these notes were compiled by the chief resident at Barnes Hospital, printed on a typewriter, and then distributed in very small numbers to residents, interns, faculty, and students who were treating patients at the campus hospitals.

The present-day Washington Manual of Medical Therapeutics is now in the 38th edition. However, it should be noted that edition numbers did not appear on the manual until the 17th edition in 1964. The absence of edition numbers on the earlier manuals, along with the very limited distribution of Therapeutic Notes in the 1940s, has led to uncertainty about the total number of different editions that were created in the manual’s earliest years.

Of the editions of Therapeutic Notes that were believed to have been created in the 1940s (unofficially, known as editions 1 through 6 of the Washington Manual), only the manual printed in 1945 is available at the Becker Archives. It is not known if any of the other five editions supposedly printed in the 1940s exist elsewhere today.

In the 1950s, the manual was given a new name, the Outline of Medical Therapeutics. The responsibility for compiling the manual still fell to the chief resident(s) at Barnes Hospital, but it was printed and distributed in larger numbers. The manual was also provided in a durable spiral bound enclosure, but it did not come in the familiar “pocket-sized” format until the 1960s. The Becker Archives has all nine of the manuals printed from 1950-1960 (unofficially, known as editions 7 through 15 of the Washington Manual).

The “unofficial” 16th edition of the Washington Manual printed in 1962 is notable for several reasons. Most importantly, 1962 was the first year it came to be known as the Washington Manual of Medical Therapeutics. The “unofficial” 16th edition was also the last year for the manual to be internally printed by Washington University’s department of medicine.