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Summary of Stock Option Grants (Detail) - USD ($)
$ / shares in Units, shares in Millions, $ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Stock options grant shares      
Outstanding at beginning of year 18.9 21.5 21.9
Granted 2.7 4.0 4.3
Exercised (4.5) (5.6) (4.0)
Forfeited/expired (0.5) (1.0) (0.7)
Outstanding at end of year 16.6 18.9 21.5
Exercisable at end of year 10.0 11.3 13.4
Stock options grant weighted-average exercise price      
Outstanding at beginning of year $ 101.55 $ 92.25 $ 84.76
Granted 157.95 128.74 117.10
Exercised 89.31 81.77 75.30
Forfeited/expired 137.08 118.38 106.50
Outstanding at end of year 113.06 $ 101.55 $ 92.25
Exercisable at end of year $ 98.65    
Stock options grant Weighted-average remaining contractual life      
Outstanding at end of year 6 years 2 months 12 days    
Exercisable at end of year 4 years 10 months 24 days    
Stock options grant aggregate intrinsic value      
Outstanding at end of year $ 1,073.4    
Exercisable at end of year $ 792.0