Mercurial Diuretics and Acute Urinary Retention

The treatment of congestive heart failure has undergone important changes in recent years. From an era in which prolonged rest, digitalization and severe fluid restriction constituted the basis of therapy we have passed to a phase in which the key objective is increased renal excretion of water. Thus overt edema and occult edema (as in pulmonary congestion) are treated by a salt-poor regimen, liberal fluid intake and organic mercurial agents (as well as digitalis and oxygen). The considerably increased use of mercurial compounds in congestive heart failure has added greatly to the efficacy of treatment, with resulting decrease of morbidity and mortality. As with other therapeutic agents of demonstrated potency, the administration of mercurial diuretics sometimes occasions unpleasant and even serious consequences. The fact that sudden death following intravenous injection of these drugs has been reported by several observers1has led to use of the apparently safer intramuscular route