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May 22, 1948


JAMA. 1948;137(4):401-402. doi:10.1001/jama.1948.02890380071024

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To the Editor:—  In connection with the resume on diuretics by Dr. De Graff (The Journal, April 17, p. 1025) attention may be called to a simple and useful expedient to enhance the diuretic effect of mercurial compounds, namely, that the patient rest in the recumbent position for eight to twelve hours following administration of the drug.Newer physiologic investigations are providing clearer insight into the mechanism of congestive heart failure and a better rationale for therapeutic procedures whose value has long been recognized. The beneficent effect of bed rest in cardiac decompensation is due not only to decreasing the work of the heart but in important measure as well to an improvement in the renal circulation. The studies of Warren and Stead (Arch. Int. Med. 73: 138, 1944) and others have shown a striking decrease in renal blood flow and glomerular filtration in cardiac failure, with the consequent retention

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