Serious untoward effects from the use of mercurial diuretics in congestive heart failure have been relatively rare. Although some immediate fatalities have been reported from the intravenous use of these agents, it is generally recognized that the incidence of such reactions must be extremely low. Nevertheless, routine administration by the intramuscular route has been advocated as a means of preventing fatalities of this type.
Regardless of the method of administration, however, severe diuresis occasionally causes weakness, anorexia, mental confusion, apathy, restlessness, delirium, hallucinations and more rarely coma and death. It has been observed, moreover, that such manifestations of dehydration, which generally develop six to twelve hours after injection, are more prone to arise in the elderly patient.
In analyzing the toxic reactions to mercurial diuretics encountered at the United States Marine Hospital, Staten Island, during the past ten years, we observed a side effect heretofore not reported, namely, cerebral thrombosis.