A HIGH FLUID INTAKE IN THE MANAGEMENT OF EDEMA, ESPECIALLY CARDIAC EDEMA. II. CLINICAL OBSERVATIONS AND DATA
Journal: Annals of Internal Medicine (1944)

Article1 December 1944A HIGH FLUID INTAKE IN THE MANAGEMENT OF EDEMA, ESPECIALLY CARDIAC EDEMA. II. CLINICAL OBSERVATIONS AND DATAF. R. SCHEMM, M.D., F.A.C.P.F. R. SCHEMM, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-21-6-937 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is only in the last 50 years that the limitation of fluids in the presence of edema has been taught and practiced so universally. Earlier clinicians noted that the theoretical fear of water in dropsy was not justified by close bedside observation.42-45In 1772 Sir George Baker reported that dropsy clears in patients given large amounts of water, and comments: "I much wish to see an indulgence of this kind extended to poor thirsty dropsical patients. In making such an experiment, indulge the patient to the utmost extent. A limited permission may be pernicious."In 1777 William Withering said...Bibliography1. NEWBURGHLASHMET LHFH: A comparative study of the excretion of water and solids by normal and abnormal kidneys, Jr. Clin. Invest., 1932, xi, 1003-1009. Google Scholar2. NEWBURGHLASHMET LHFH: The importance of dealing quantitatively with water in the study of disease, Am. Jr. Med. Sci., 1933, clxxxvi, 461-470. Google Scholar3. FREYBERGLASHMET RHFH: A quantitative study of renal injury in a case of acute poisoning by bichloride of mercury with a note regarding treatment, Am. Jr. Med. Sci., 1935, clxxxix, 392-399. CrossrefGoogle Scholar4. NEWBURGHMACKINNON LHF: The practice of dietetics, 1934, The Macmillan Co., New York, pp. 7-20, 86-97, 225-244, 253-258. Google Scholar5. ADDIS T: The osmotic work of the kidneys and the treatment of glomerular nephritis, Trans. Assoc. Am. Phys., 1940, lv, 223-229. Google Scholar6. COLLERMADDOCK FAWG: A study of dehydration in humans, Ann. Surg., 1935, cii, 947-960. CrossrefGoogle Scholar7. COLLERMADDOCK FAWG: Water and electrolyte balance, Surg., Gynec., and Obst., 1940, lxx, 340-354. Google Scholar8. NADALPEDERSENMADDOCK SWSWG: Two contrasting types of dehydration, Univ. Hosp. Bull., Ann Arbor, 1941, vii, 53-55. Google Scholar9. STARLING EH: The fluids of the body, 1900, W. T. Keener & Co., Chicago, pp. 152/154, pp. 163-164, pp. 175-177. Google Scholar10. DARROWYANNET DCH: The changes in the distribution of body water accompanying increase and decrease in extracellular electrolyte, Jr. Clin. Invest., 1935, xiv, 266-275. CrossrefGoogle Scholar11. HASTINGSEICHELBERGER ABL: Exchange of water and salt between muscle and blood, Jr. Biol. Chem., 1937, cxvii, 73-93. Ibid.: 1937, cxviii, 197-218. CrossrefGoogle Scholar12. GAMBLE JL: Extracellular fluid, Bull. Johns Hopkins Hosp., 1937, lxi, 151-197. Google Scholar13. BESTTAYLOR CHNB: The physiological basis of medical practice, 1937, Wm. Wood, Baltimore. Google Scholar14. GOODMANGILMAN LA: The pharmacological basis of therapeutics, 1941, The Macmillan Co., New York. Google Scholar15. MILBERT AH: Infusion reactions with special reference to "speed shock," Am. Jr. Surg., 1934, xxvi, 479-485. CrossrefGoogle Scholar16. WARTHEN HJ: Massive intravenous injections, Arch. Surg., 1935, xxx, 199-227. CrossrefGoogle Scholar17. CUTTING RA: Cause of death resulting from massive infusions of isotonic solutions, Arch. Surg., 1939, xxxviii, 599-616. CrossrefGoogle Scholar18. SMYTH FS: Studies in so-called water intoxication, Jr. Clin. Invest., 1930, xii, 55-65. Google Scholar19. COPE CL: Alkali poisoning (Abst.), Jr. Am. Med. Assoc., 1937, cviii, 336. Google Scholar20. WARRENMERRILLSTEAD JVAJEA: The role of extracellular fluid in the maintenance of a normal plasma volume, Jr. Clin. Invest., 1943, xxii, 635-641. CrossrefGoogle Scholar21. SEAMANPONDER BWE: The estimation and control of post-operative dehydration with the aid of hemoglobin and plasma protein determinations, Jr. Clin. Invest., 1943, xxii, 673-685. CrossrefGoogle Scholar22. LANDIS EM: Vascular physiology and clinical medicine, Ann. Int. Med., 1936, x, 290-298. Google Scholar23. PETERS JP: Total acid base equilibrium of plasma in health and disease, X, Acidosis of nephritis, Jr. Clin. Invest., 1929, vi, 517. CrossrefGoogle Scholar24. MOORESTEWART NSHJ: Variation of specific gravity of plasma of blood and the means available for altering it, Jr. Clin. Invest., 1930, ix, 423. CrossrefGoogle Scholar25. STEWART HJ: Mechanism of diuresis; alterations in specific gravity of blood plasma with onset of diuresis in heart failure, Jr. Clin. Invest., 1941, xx, 1-6. CrossrefGoogle Scholar26. WHIPPLE GH: Protein production and exchange in the body, including hemoglobin, plasma protein and cell protein, Am. Jr. Med. Sci., 1938, cxcvi, 609-621. CrossrefGoogle Scholar27. STADLERSTENGER HD: A case of Pick's syndrome as the basis for a study of hypoproteinemia, Jr. Pediat., 1941, xviii, 84-94. CrossrefGoogle Scholar28. JACOBSON SD: The effect of phlebotomy on the blood volume, read at the meeting of The American Federation for Clinical Research, Chicago, Nov. 4, 1943 (unpublished). Google Scholar29. LYONSJACOBSONNEERKIN RHSDJ: The relationship between changes in the plasma volume and changes in the hematocrit and serum protein concentrations, Proc. Central Soc. Clin. Res., 1943, xvi, p. 17. Google Scholar30. ROWNTREE LG: The effects of experimental passive congestion in renal function, Arch. Int. Med., 1913, xi, 120-147. CrossrefGoogle Scholar31. TOTH LA: Urine excretion during anoxia from normal and denervated kidneys in dogs with and without adrenal glands, Am. Jr. Physiol., 1940, cxxix, 532-538. CrossrefGoogle Scholar32. LANDIS EM: Micro-injection studies of capillary permeability: III. The effect of lack of oxygen on the permeability of the capillary wall to fluid and to plasma proteins, Am. Jr. Physiol., 1928, lxxxiii, 528. CrossrefGoogle Scholar33. CUSICKBENSONBOOTHBY PLOOW: Effect of anoxia and high concentration of oxygen on the retinal vessels, Proc. Staff Meet Mayo Clin., 1940, xv, 500. Google Scholar34. ALTSCHULEBLUMGART MDHL: The circulatory dynamics in tricuspid stenosis, Am. Heart Jr., 1937, xiii, 589-598. CrossrefGoogle Scholar35. WIGGERS CJ: Cardiac adaptations in acute progressive anoxia, Ann. Int. Med., 1941, xiv, 1237-1247. Google Scholar36. POLLSTERN DJE: Untoward effects of diuresis (with special reference to mercurial diuretics), Arch. Int. Med., 1936, lviii, 1087-1094. CrossrefGoogle Scholar37. TYSON MC: Danger of intravenous mercurial injections in nephrosis, Jr. Am. méd. Assoc., 1941, cxvii, 998-999. CrossrefGoogle Scholar38. DICKWARWEGANDERSCH MWEM: Acacia in the treatment of nephrosis, Jr. Am. Med. Assoc., 1935, cv, 654-657. CrossrefGoogle Scholar39. WILSONSUNDERMAN DMFW: Studies in serum electrolytes; XII. The effect of water restriction in a patient with Addison's disease receiving sodium chloride, Jr. Clin. Invest., 1939, xviii, 35. CrossrefGoogle Scholar40. ANDERSONBETHEA WAWR: Renal lesions following the administration of hypertonic solutions of sucrose, Jr. Am. Med. Assoc., 1940, cxiv, 1938. Google Scholar41. WITHERLY T cited in SIR JOHN FLOYER and EDW. BAYNARD'S History of cold bathing both ancient and modern (4th ed.), 1715, Wm. Innys, London, ii (Baynard), pp. 449-454. Google Scholar42. BAKER G: Medical transactions, 1772, ii (Article xvii), p. 235, published by the Royal College of Physicians. Google Scholar43. WITHERING W: An account of the foxglove (1785) in the miscellaneous tracts, 1822, Longman, et al., London, ii, p. 127, 137, 287 and 289. Google Scholar44. MILMAN F: Animadversions on the nature and cure of the dropsy, 1786, J. Walker, London, p. 122. Google Scholar45. DARWELL J: Dropsy, in John Forbes' "Cyclopedia of practical medicine," 1845, Lea and Blanchard, Philadelphia, p. 720. Google Scholar46. FLINT A: In Napheys' Modern medical therapeutics (5th ed.), 1878, D. A. Brinton, Philadelphia, p. 418. Google Scholar47. FLINT A: A treatise on the principles and practices of medicine (6th. ed.), 1886, Lea Bros. and Co., pp. 33, 64: 873. Google Scholar48. OSLER W: Principles and practice of medicine (2nd. ed.), 1896, D. Appleton, New York, p. 787. Google Scholar49. CHRISTIAN HA: In Osler's Principles and practice of medicine, 1938, D. Appleton Century Co., New York, p. 1036. Google Scholar50. LEVINE SA: Clinical heart disease, 1936, W. B. Saunders, Philadelphia, pp. 301-302. Google Scholar51. FARR LE: Conference on therapy; treatment of edema, Jr. Am. Med. Assoc., 1939, cxii, 837-843. Google Scholar52. WILLIUS FA: Regulation of diet in heart disease, Proc. Staff Meet. Mayo Clin., 1936, xi, 202-206. Google Scholar53. BINGER MW: General treatment of edema, Proc. Staff Meet. Mayo Clin., 1936, xi, 648-650. Google Scholar54. BINGER MW: Edema (editorial), Ann. Int. Med., 1941, xv, 617. LinkGoogle Scholar55. LEHNHOFFBINGER HJMW: Treatment of edema of renal origin, Jr. Am. Med. Assoc., 1943, cxxi, 1321-1325. CrossrefGoogle Scholar56. DRY TJ: Congestive heart failure: Factors influencing the ultimate prognosis, Jr. Am. Med. Assoc., 1942, cxviii, 263-266. CrossrefGoogle Scholar57. DESNOO K: The prevention of eclampsia, Am. Jr. Obst. and Gynec., 1937, xxxiv, 911-939. CrossrefGoogle Scholar58. MCPHAIL FL: The toxemias of pregnancy, Jr. Am. Med. Assoc., 1938, cxi, 1894-1897. CrossrefGoogle Scholar59. MCPHAIL FL: Water exchange in toxemias, West. Jr. Surg., Obst. and Gynec., 1939, xlvii, 306-317. Google Scholar60. CHESLEYANNITTE LCJE: A study of salt restriction and of fluid intake in prophylaxis against pre-eclampsia in patients with water retention, Am. Jr. Obst. and Gynec., 1943, xlv, 961-971. CrossrefGoogle Scholar61. GOODMANCORSARO JIJR: The basal weight level in the treatment of congestive heart failure, Am. Heart Jr., 1943, xxvi, 338-342. CrossrefGoogle Scholar62. SCHROEDER HA: Personal communication, 1939. Google Scholar63. SCHROEDER HA: Studies on congestive heart failure. I. The importance of the restriction of salt as compared to water, Am. Heart Jr., 1941, xxii, 141-153. CrossrefGoogle Scholar64. SCHROEDERFUTCHER HAPH: Studies on congestive heart failure. II. Impaired excretion of sodium chloride, Am. Jr. Med. Sci., 1942, cciv, 52-62. Google Scholar65. JACOBSONLEICHTENTRITTLYONS SDBRH: The effect of acid and alkaline salts on some patients with rheumatoid arthritis, Am. Jr. Med. Sci., 1942, cciv, 540-546. CrossrefGoogle Scholar66. PELNER L: The rapid removal of excess joint fluid by acid salts, Am. Jr. Med. Sci., 1943, ccvi, 498-503. CrossrefGoogle Scholar67. SCHEMM FR: A high fluid intake in the management of edema, especially cardiac edema. I. The details and basis of the régime, Ann. Int. Med., 1942, xvii, 952-969. LinkGoogle Scholar68. SCHEMM FR: The loss of edema without loss of weight, read at the Meeting of The American Federation for Clin. Research, Chicago, Nov. 4, 1943 (unpublished). Google Scholar69. CONNELL WF: (Ontario) Personal communication, 1943. ASKEY J. M.: (California) Personal communication, 1943. KURTZ C. M.: (Wisconsin) Personal communication, 1943. LYON, R.: The Schemm treatment of chronic heart failure with edema, Jr. of Med. Assoc. of Alabama, August, 1944.* Google Scholar70. WARRENSTEAD JVEA: Fluid dynamics in chronic congestive heart failure, Arch. Int. Med., 1944, lxxiii, 138-147. CrossrefGoogle Scholar71. STEAD EA: Care of the patient with chronic heart disease, Med. Clin. of North America, 1944, xxviii, 381-387. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Great Falls, Montana*Received for publication December 23, 1943.Read at the St. Paul meeting of the American College of Physicians April 22, 1942.From the Medical Department of the Great Falls Clinic, Great Falls, Montana. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byGemeinschaftsstudie �ber die Wirkung diuretischer Ma�nahmen bei hydropischen Zust�ndenDie Verteilung von Natrium und ChloridKaliumverteilungRenal Aspects of Cardiac DiseaseRenal function and renal impairment in congestive heart failurePathophysiologie der HerzinsuffizienzTherapie der HerzinsuffizienzThe alkali metal ions in the organismMineralstoffwechselstörungen bei HerzinsuffizienzErnährungstherapieDie Krankheiten der Leber und der GallenwegeThe Nephrotic Syndrome: Pathogenesis, Diagnosis and TreatmentElectrolyte and Fluid Disturbances in Congestive Heart FailureThe Distribution of Body Fluids In Congestive Heart FailureTypes and Treatment of Nephritis in ChildrenToleration of a high water intake by patients with high-grade mitral stenosis in the last trimester of pregnancySome Applications of Ion exchange Resins to Medical Problems†Further Comparative Studies on Ascites in Liver and Heart DiseaseChronic Nephritis and Nephrosis in ChildrenDietary Management in Heart Disease with Particular Reference to Congestive Cardiac FailurePathogenesis of peripheral cardiac edemaClinical Management of Edema in Bright's DiseaseManagement of Chronic Congestive Heart FailureLow-Sodium Diet and Free Fluid Intake in the Treatment of Congestive Heart FailureDiet and Diuretics in the Treatment of Congestive Heart FailureThe Heart in Rheumatic Fever 1 December 1944Volume 21, Issue 6Page: 937-976KeywordsEdemaFallsFearNephritisResearch laboratoriesTechnicians ePublished: 1 December 2008 Issue Published: 1 December 1944 Copyright & PermissionsCopyright, 1944, by The American College of PhysiciansPDF downloadLoading ...