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October 1953


Author Affiliations

Medical Division, Montefiore Hospital, N. Y.

AMA Arch Intern Med. 1953;92(4):459-463. doi:10.1001/archinte.1953.00240220007003

DURING the past fifteen to twenty years, studies of the pathogenesis of congestive heart failure have been directed primarily at the mechanisms responsible for the impaired renal excretion and/or retention of extracellular electrolytes and water. As a result, most advances in therapy have been concerned with the prevention of fluid accumulation and the facilitation of removal of excessive fluid. Since the organic mercurial diuretics provide the most rapid and efficient means of removing salt and water, their use has increased considerably. The availability of subcutaneously administerable preparations1 whose ease of administration and predictability of action have led to the advocacy of self administration in selected patients2 has contributed further to the growing use of these agents. The promise of oral mercurial diuretics, as yet unfulfilled, may lead to still greater usage.

Certain properties common to the presently used mercurials contribute to their inherent safety. Intravenous administration is now

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