History of the youngest medical specialty : nephrology (Part 2 of 4 parts)

Yves Pirson Published in the journal : April 2018 Category : Ama Contacts

Summary :

During the two centuries running from about 1650 to 1850, two scientific innovations account for key achievements in nephrology : new microscopes, which open the door to extending anatomical knowledge to physical processes, and the emergence of chemistry revealing the composition of stones as well as providing the measurement of albumin and urea levels.

Well known for the description of the glomerular capsule, William Bowman (1816-1892) also establishes, by injection techniques, the existence of glomerular filtration. Another major contribution in the morphological field is Jacob Henle (1809-1885) whose name is perpetuated by the tubular loop joining the proximal and distal parts of the nephron.

Within four decades, the composition of urinary stones is clearly defined with attendant first therapeutical implications. Albuminuria is recognized but hardly understood. Antoine Fourcroy (1755-1809) and Nicolas Vauquelin (1763-1829) call « urée » a molecule excreted by the kidney representing the end-product of nitrogenous metabolism.

This chapter ends with a vignette focused on to three leading figures of the time : Herman Boerhaave (1668- 1738), the so-called Hippocrate from Leiden ; Richard Bright (1789-1858), considered by many of us as the pioneer of clinical nephrology and Pierre Rayer (1793- 1867) who signs the first exhaustive textbook devoted to kidney diseases.