The "thirsty dropsy": Early descriptions in medical and non-medical authors of thirst as symptom of chronic heart failure

Background Patients with chronic heart failure may suffer from severe thirst, even if mechanisms that cause thirst in subjects affected by this condition are not clear. Medical and non-medical authors may have already recognized this symptom during the classical age. Methods We analyzed association between thirst and dropsy (an ancient medical term used to indicate different conditions including chronic heart failure) in past medical and non-medical literature. Results Hippocrates and Celsus first recognized thirst as a symptom of dropsy in the classical age. Greco-Roman intellectuals (Polybius, Ovid, Horace) and theologians belonging to the first years of the Christian era (Augustine, Caesarius, Gregory I) showed to know that dropsy people were often thirsty. These authors also influenced medieval poets and writers, including Dante Alighieri. In the Renaissance, the physician and alchemist Paracelsus again evidenced this symptom and the iatrochemist Robert Fludd tried to explain pathophysiology of dropsy, basing on thirst. Conclusions The relationship between thirst and dropsy was well known by physicians and intellectuals in the classical age and in the first years of the Christian era, so influencing the Renaissance physicians