when I was in medical school, the only diuretic for congestive heart failure was a mercury based injection that had limited success.
Mercurial diuretics are a form of renal diuretic[1] containing mercury. Although previously widely used, they have largely been superseded by safer diuretics such as thiazides, and are now rarely used....Inorganic mercury compounds, such as mercury(I)chloride (calomel), were found to have diuretic properties when they were used to treat syphilis.[2] Proposed use of these compounds date back at least to the 16th century, shortly after the beginning of the syphilis epidemic in 1497 following Columbus' return to Europe.[3];;;needless to say, they were very toxi.,
Warkany and Hubbard noted in their seminal 1953 paper establishing mercury as the cause of infantile acrodynia that "... in modern times the capricious behavior of mercurial diuretics has been rather disturbing to those who use them frequently. Thousands of injections are given without untoward effects but occasionally a therapeutic dose results in sudden death. Only rarely is this caused by the first dose. More often the patient tolerates several—in one case 164—doses before the fatal reaction occurs.
we used them early in my medical school training once or twice, but by the time I did clinical rotations in the late sixties, they had been replaced with thiazide diruetics.
Again wikipedia
Because of their weak effect on edema they are mainly used for high blood pressure nowadays, but we still used them for mild edema, but for congestive heart failure, we switched to lasix etc.
When I was in medical school up until the mid seventies, it was common for people to come into the ER in the middle of the night unable to breathe: Cardiac asthma. Usually they cheated on their low salt diet and when they laid flat, the edema switcched into their lungs.
We actually treated these cases of acute pulmonary edema with morphine, since the diuretics were slow.
giving morphine to a person short of breath doesn't make sense since it decreases your breathing ability, so is rarely used today. But in the past, when mercury diuretics were slow, it worked: Because it cause the blood to pool into the veins so cut the burden on the heart pump and moved the fluid elsewhere.
but it did work.
as does Digitalis (foxglove) whic has been used in medicine despite problems of dosing etc for 200 years.
the amount of digitalis in the leaf (and even in the sixties we were using the leaf in pill form) was to give it until fluid appeared: The person started to urinate their fluid, or started vomiting, or got diarrhea.
we still use it but not for congestive heart failure due to it's toxicity (digitalis overdose was once the most common cause of hospitalization and death from medications).
Well, anyway, I am old enough to remember seeing patients with acute pulmonary edema, and with dropsy: Where not only your legs but your entire body swells up with excess flue. this can be from kidney failure, or heart failure, and in modern days they will treat it with medicine and/or dialysis.
Indeed, I haven't seen a severe case for decades.
and I should note that another cure for shortness of breath/pulmonary edema was blood letting which like morphine cut the burden of fluid that the heart needed to pump so the heart could pump more efficiently.
and then there was cutting the legs to drain the excess fluid, which I never saw done but does make sense, since severe swelling of the legs was painful.
LINK Gives the various treatments in the good old days before modern medicine, which mentions cutting to remove edema:(anasarca).
in the anasarca it is usual to scarify the feet and legs. By this means the water is often discharged; but the operator must be cautious not to make the incisions too deep.
which brings us to Dr. Johnson, who frequently had asthma and swollen legs. I suspect this was congestive heart failure, and this article toward the end discusses the symptoms.
and the tretatment, including cutting the legs to relieve the painful swelling.
The dropsy increased, and Johnson kept on begging his physicians to make deeper incisions, both to relieve the pain and to prolong his life. “How many men,” he cried, “die through the timidity of those whom they consult for health! I want length of life, and you fear giving me pain, which I care not for.” On the day before his death he refused to take any more food or medicine, feeling that it was useless to resist the inevitable any longer. During the night the dropsy increased beyond endurance. A friend had left a servant with him, and Johnson forced the man to hand him a lancet. He had concealed a pair of scissors in his bed, and with the lancet and scissors made several deep incisions, which gave him the relief he craved. The poison which had tormented him throughout his life flowed away, and he slept tranquilly through the next day, December 13, waking once or twice to take some nourishment. At a quarter past seven, he turned to Sastres [a friend turned nurse], murmured, “Jam moriturus,” [Now I am about to die] and breathed out his last breath without any struggle or sign of pain
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