Mercurial diuretics: intolerance as shown by skin sensitivity

The rarity of adverse effects following the use of mercurial diuretics is remarkable, consider-ing how widely they are now employed. Many regular recipients with heart failure and, less frequently, with renal cedema would at least be confined to their beds but for these prepara-tions. The causes of the few complications reported have been uncertain and idiosyncrasy or allergy has often been given as an explanation. Having seen many cases who receive doses of this drug with impunity for years, the temptation is to dismiss the explanation of simple accumulation. A hitch in a standard regime, however slight, is often interpreted as a contra-indication of the further use of a drug, although the cause of the untoward effect is not known. Such an abandonment in the case of mercurial diuretics frequently leads to a deterioration of the patient's health, and a fuller understanding of such reactions is therefore important. Wolf (1931) reported a case of sudden death following intravenous salyrgan in a child aged four, with nephrosis; the injection preceding the fatal one caused a chill, fever, a morbili-form rash, and anorexia; but resulted in satisfactory diuresis although previously the output had been disappointing. Keith (1936) stated that injections of organic mercury might be followed by stomatitis, diffuse dermatitis, diarrhoea, hematuria, and renal insufficiency, bu