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June 2, 1956


JAMA. 1956;161(5):475. doi:10.1001/jama.1956.02970050077025

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To the Editor:—  There is a flagrant misuse of acetazolamide (Diamox) and mercury. We know that serious consequences may occur after the use of both in persons with cardiac disease. However, no mention has been made of the routine misuse of acetazolamide or mercurial diuretics in heart failure. When patients have diabetes we never routinely place them on insulin therapy without testing the urine sugar level. Yet most clinicians and internists will not hesitate to prescribe daily use of acetazolamide or weekly injections of mercury in cases of cardiac failure without finding out whether the patient who is edematous has or has not a low urine salt level. If a patient has hypochloremia or hypochloruria he definitely may be seriously hurt by these remedies. Persons with edema must be studied for salt in the blood and urine before prescribing medication to correct edema. Patients who administer to themselves any of

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