Studies on Mercurial Diuresis

Sudden Death after Intravenous Injection of a Mercurial Diuretic

“…This has been reported four times-viz., by Sundaram (1934), Cadbury (1936), Barker et al (1942, and Volini et al (1945). These four cases are of great significance, for their occurrence excludes the possibility of cumulative poisoning with mercury as a cause of death, and also rules out anaphylaxis or sensitization, both of which have been considered (Tyson, 1941;Evans and Perry, 1943;Rennie, 1945) in spite of the absence of any clinical evidence in favour of these diagnoses.…”

“…In human cases " salyrgan " and " mercupurin " have caused most of the deaths (Ben-Asher, 1945;Sundaram, 1934;Brown et al, 1942;Barker et al, 1942), but deaths are also reported following " esidrone" (Volini et al, 1945), " mersalyl " (Evans and Perry, 1943), and neptal (Greenwald and Jacobson, 1937). Animal experiments also demonstrate variation in toxicity, esidrone and mercupurin being singled out for especially unfavourable mention by Pines et al (1944).…”

“…From his experiments on the isolated turtle heart Johnston (1941) came to the conclusion that the toxic action of the organic mercurial diuretics was a side action related to their mercury content, and consequently was not essentially different from that of inorganic salts like calomel and bichloride of mercury. However suggestive they might be, animal experiments alone could not prove that human fatalities were also the result of ventricular fibrillation. This final step has been completed by the unique studies of Volini, Levitt, and Martin in 1945 ; for in two of their three patients killed by mercurial diuretics simultaneous electrocardiograms were obtained which demonstrate that ventricular fibrillation was the cause of death.…”