The Action and Excretion of Nitrates

Nitrates have long been recognized as effective diuretics. Thomas Willis,¹in 1679, used potassium nitrate or "the salt of niter" in the treatment of dropsy. Jörg,²in 1825, administered increasing doses of potassium nitrate to a normal man and noted its diuretic effect. Wood,³in 1856, confirmed the therapeutic action of nitrates, emphasizing the fact that an adequate dose was important in order to produce effective diuresis. Wilks and Taylor,⁴in 1863, gave as much as 18 Gm. of potassium nitrate a day to a patient with renal dropsy, obtaining satisfactory results. About twenty-five years ago the toxicity of nitrates became a practical problem because of the rather extensive use of bismuth subnitrate in diagnostic roentgen procedures. Cases presenting methemoglobinemia were reported⁵and consequently the possible toxic action of nitrates was overemphasized, with the resultant use of small and inadequate doses. Our previous experiments⁶and those of Gamble⁷showed that