2006/05/01 by Héctor O. Ventura · 1 citation
Medicine · Biochemistry, Genetics and Molecular Biology · #Electroconvulsive Therapy Studies #Poisoning and overdose treatments #Blood disorders and treatments #Medicine #Heart failure #Syphilis #Diuretic #Internal medicine #Virology
paper · pdf · doi:10.1111/j.1527-5299.2005.04956.x
published in Congestive Heart Failure 12(3), 178 (Wiley)
openalex publication_date 2006/05/01 · openalex created_date 2022/05/12 · openalex updated_date 2026/07/29
“…Soon afterwards there was admitted to our wards a boy with a huge rheumatic heart and tricuspid insufficiency, in severe, water-logged failure, almost anuric and obviously terminal. The case seemed hopeless and he suffered cruelly. In sympathy and desperation, we tried our wonder drug. He received this injection and unfortunately expired the following day. Before his death, however he passed three liters of urine. Post mortem examination confirmed the clinical diagnosis and revealed no evidence of syphilis.”1 It was not until 1920 that, in a classic manuscript, Saxl and Heilig2 reported the diuretic effect of merbaphen, which contained mercury in complex organic combination and was originally introduced as an antisyphilitic agent. Alfred Vogl,1 who was an American student in the Wenckebach Clinic in 1919–1920, described the manner that this finding was accomplished. He and the nurse noticed that when merbaphen was given in two patients with syphilis, it produced an increase in urinary output. After this observation, Vogl proceeded to give merbaphen, now called “the wonder drug,” to a patient with heart failure. He states, “This case represents the first use of an organic mercurial agent for the treatment of heart failure.” Merbaphen was painful and toxic and soon replaced by the more potent, yet more benign, salyrgan. These agents became widely used in the 1940s as an adjunct therapy in heart failure, but they were given only parenterally, a major drawback for patients who needed long-term therapy. Inconvenient reactions associated with the use of the organic mercurial diuretics were very similar to the old inorganic compounds. These included stomatitis, colitis, albuminuria, hematuria, and sudden death. A test dose of 0.5 cc was utilized 24 hours before the full therapeutic dose was given, and the patients were observed for side effects.