Wringing Out the Water

In many disorders of the heart, lungs, liver and kidneys, one of the most troublesome symptoms is the ancient complaint "the dropsy"--retention of salt and water so that the patient becomes bloated with brine. If the victim already has heart trouble, the edema will make it worse. In the mildest cases, cutting out salt may be adequate treatment. For more severe cases, a variety of chemicals is available. But some patients become resistant to any one medicine, so they have to switch prescriptions, and doctors eventually run out of alternatives.

For all the assorted dropsy remedies at their command, doctors are delighted that they soon may have still another. Ethacrynic acid, a synthetic compound discovered in 1960, has a dramatic diuretic effect even in patients who do not respond to other drugs, says a research team at Manhattan's Columbia-Presbyterian Medical Center. It can be taken by mouth or, if necessary, injected. Its effects complement or enhance those of other diuretics, so that in critical cases doctors can give two medicines together for double the effect or more. Ethacrynic acid also seems to work in patients suffering from some degree of kidney failure. When the Food and Drug Administration approves the drug for general prescription use, Merck Sharp & Dohme expects to market it under the name Edecrin.

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