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Quotation marks are sometimes used around words for special effect or to indicate irony. In most instances, however, they are unnecessary.Using their own finances and being informed about the economics of the approach, some may opt for the “boutique class” of health care. | Less

If material quoted from texts or speeches is longer than 4 lines of text, the material should be set off in a block, ie, in reduced type and without the quotation marks. Paragraph indents are generally not used unless the quoted material is known to begin a paragraph. Space is often added both above and below these longer quotations. If the block quotation appears in a section to be set in reduced type, do not reduce the type size of the quoted material further. If another quotation appears within a block quote, use double quotation marks around the contained quotation, Less

Coined words, slang, nicknames, and words or phrases used ironically or facetiously may be enclosed in quotation marks at first mention. Thereafter, omit quotation marks. (See also , Typography, Specific Uses of Fonts, Italics.)We further hope that, above all, those who have been fed only “docufiction” on this matter, as if it were truth, will cease to be misled. Nelson Essentials of Pediatrics is not a … synopsis of or a companion to the Nelson Textbook of Pediatrics, although initially our associates dubbed it “Baby Nelson,” “Half Nelson,” and “Junior Nelson.” It has been said that shoes and latrines are Less

Enclose in quotation marks a common word used in a special technical sense when the context does not make the meaning clear. (See also , Definition or Translation of Non English-Language Words.)In many publications, “running feet” on left-hand pages face the “gutter” at the bottom of the page. “Coma vigil” (akinetic mutism) may be confused with conscious states. | Less

The literal translation of a non English-language word or phrase is usually enclosed in quotation marks if it follows the word or phrase, whereas the simple definition of the word or phrase is not. (See also , Non-English Words, Phrases, and Accent Marks, Accent Marks [Diacritics].)Hysterical patients may exhibit an attitude termed la belle indifférence (“beautiful indifference” or total unconcern) toward their condition. | Less

With conversational dialogue, enclose the opening word and the final word in quotation marks.“Please don't schedule the surgery for a Tuesday.” “OK, if that’s inconvenient for you, I won't.” |

After indirect discourse, do not use quotation marks.The nurse said he would be discharged today. Do not use quotation marks with yes or no.His answer to the question was no. In interview or discussion formats when the name of the speaker is set off, do not use quotation marks.Dr Black: Now let us review the slides of the bone marrow biopsy. Dr Smith: The first slide reveals complete absence of granulocytic precursors. | Less

The opening quotation mark should be omitted when an article beginning with a stand-up or dropped initial capital letter also begins with a quotation. It is best, however, to avoid this construction.octors need some patients,” a sage had said. When excerpting long passages that consist of several paragraphs, use opening double quotation marks before each paragraph and closing quotation marks only at the end of the final paragraph. (See also , Ellipses, and , Block Quotations.) | Less

Place closing quotation marks outside commas and periods, inside colons and semicolons. Place question marks, dashes, and exclamation points inside quotation marks only when they are part of the quoted material. If they apply to the whole statement, place them outside the quotation marks.Why bother to perform autopsies at all if the main finding is invariably “edema and congestion of the viscera”? The clinician continues to ask, “Why did he die?” “I'll lend you my stethoscope for clinic” then she remembered the last time she had lent it and said, “On second thought, I'll be needing it myself.” (Note: Commas Less

Quotation marks are used to indicate material that is taken directly from another source. | Use quotation marks to enclose a direct quotation of no more than 4 lines from textual material or speeches (for longer material, see also , Quotation Marks, Block Quotations). When the quotation marks enclose conversational dialogue, there is no limit to the length that may be set in run-on format. In all quoted material, follow the wording, spelling, and punctuation of the original exactly. The only time this rule does not apply is when the quoted material, although a complete sentence or part of a Less