BAL Inhibition of Mercurial Diuresis in Congestive Heart Failure.*

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Abstract
Patients in congestive heart failure with known diuretic response to mercuhydrin varying from l3/4-53/4 lbs. wt. loss in 48 hrs. were primed with BAL (2,3-dimercaptopropanol) in oil (10% BAL in benzyl benzoate and peanut oil) for 24 hrs. before an injn. of 2 ml. of mercuhydrin. The BAL was administered intra-musc, every 6 hrs. in doses of 2.5 mg./kg. body wt., 24 hrs. prior to, and usually 12 hrs. after, the introduction of mercuhydrin. The 48 hr. wt. loss in patients thus treated never exceeded 1/2 lb. Usually a gain in wt. occurred. Evidence is presented which indicates that BAL in oil completely annuls the diuretic effect of mercuhydrin. It is suggested that BAL inhibition of mercurial diuresis results from the formation of a stable mercury-thiol complex, binding free Hg which no longer is able to produce the systemic effects which result in dimesis. Forty-eight hrs. after the final injn. of BAL, mercuhydrin is again able to exert its diuretic effect.