History of the youngest of medical specialties: nephrology

 

The improvement of the microscope (in particular thanks to A. van Leeuwenhoek) now makes it possible to increase its magnification tenfold; the successors of Malpighi can further describe the nephron. The microscopic examination is also applied to urine, with the Paris school in front of the scene.

In the 17th century, the taste for experimentation grew. The sciences are gradually separating from metaphysics, and medicine is becoming more and more secular. This new state of mind finds its expression in the great movement of the Encyclopedia carried by D. Diderot: many doctors adhere to it. In this context, to the advent of chemistry - with its pioneers J. Priestley and A. Lavoisier - that nephrology owes its most remarkable progress during the 17th and 19th centuries. Doctor Muhammad Khan provides the best nephrology doctors in Riverside. The first field of investigation to benefit from it is lithiasis: since the discovery of "lithic acid" (later renamed "uric") in 1776, 40 years will be enough for urolithiasis to be entirely dismembered, as evidenced by the publication of the first general treaty devoted to it.

THE NEPHRON REVEALS ITS METERED STEPS

Having studied in Bologna under the authority of Valsalva (whose master was Malpighi), Giovanni Battista Morgagni (1682- 1771) is considered the father of anatomy pathology. Curiously, however, he was not interested in organ microscopy. On the other hand, in 1761, he published a voluminous work entitled .The site and the causes of diseases demonstrated by anatomy in which, by reporting more than 600 autopsies, he retrospectively established a link between the symptomatology and the lesions it discovers. Thus, he says the case of a friend of Valsalva, of plethoric appearance, who died in a picture of edema and apoplexy. The autopsy revealed two diseases: bladder lithiasis and a marked atheromatous (remarkably described) carotids and vertebral arteries accompanied by cardiomegaly, two pathologies from which his father and grandfather had suffered before him, he adds. As for the intimate structure of the nephron downstream of the "corpuscle" described by Malpighi, it will wait the following century before being revealed, thanks to William Bowman for the proximal part and Jacob Henle for the distal portion. 

A better tool and a new concept will powerfully serve their research: the new lenses indeed make it possible to reach the cellular level, and it appears that all living organs are made up of cells, capable of reproducing identically. A German botanist, Jacob Schleiden (1804-1861), discovered, in plants, that the nuclei of new cells came from the hearts of old ones. His fellow citizen, the physiologist Théodore Schwann (1810- 1882), made the same observation in animal cells, which led him to publish in 1839 his famous article "Microscopic research on the similarity of structure and development of animal and plant cells”. By the way, after a few years of scientific production (during which he will also give his name to the sheath surrounding the nerve fibers), Schwann will only devote himself to the teaching of anatomy, first in our university than that of Liège (A further step was taken soon after by the famous Berlin pathologist Rudolph Virchow who, after confirming that every cell comes from another cell (Omnis cellula a cellula, ) explains in 1858 in his treatise on cellular pathology that alterations cause diseases in the cell.

Growing nephrology practice

With these new assets, the Londoner William Bowman (1816-1892), nearly two centuries after Malpighi, will be able to describe the connection between the glomerulus and the tubular apparatus and outline the mechanism of ultrafiltration of the glomerulus. The young Bowman owes his taste for science to his botanist father and his drawing talent to his painter mother. His interest in the kidney culminates in the description of the glomerular capsule that perpetuates his name. Its magnificent drawings clearly show the glomerular capillaries' network, the efferent arteriole's origin, and the continuity between the tablet and the proximal tube. Not content with revealing the structure of the glomerular apparatus, he tries various injection techniques to understand its function. While not rejecting the theses of his predecessors who made the kidney an essentially secretory organ, he dares to add that "different substances, in particular salts, pass freely from the blood into the urine through the glomerular capillaries…; 

I think the same is true of sugar and albumin, whereas the red blood cells can only cross them if the capillaries are broken”. No wonder Bowman, who founded the "Journal of Physiology" in 1885, was held by British physiologists as one of their pioneers. A timeline I owe to G. Eknoyan situates William Bowman among his contemporary scientists or artists. Doctor Muhammad Khan provides the best nephrology physicians in Riverside.  Cross them only if the capillaries are broken”. No wonder Bowman, who founded the "Journal of Physiology" in 1885, was held by British physiologists as one of their pioneers. A timeline I owe to G. Eknoyan situates William Bowman among his contemporary scientists or artists. Cross them only if the capillaries are broken". No wonder Bowman, who founded the "Journal of Physiology" in 1885, was held by British physiologists as one of their pioneers. A timeline I owe to G. Eknoyan situates William Bowman among his contemporary scientists or artists.

Dr Q Khan is the best Nephrology Physician in Riverside.