Nephrology – Hektoen International

Korotkov’s Sound

Joseph deBettencourt Chicago, Illinois, United States     A portrait of Nikolai Sergeevich Korotkov I’m watching, knees bending, Looking meek, my heart quiet, Drifting away are the shadows Of fussy world affairs While I’m envisioning, dreaming of voices from other worlds -Aleksandr Blok, untitled poem, July 3, 1901a   Stepping off the train in northern […]

Sir William Gull, polymath and pioneer physician

William Gull (1816-1890) is remembered by nephrologists as one of the prominent Guy’s Hospital physicians who worked to extend the seminal observations first made by Richard Bright. These investigators worked at a time when blood measurements were not available in clinical medicine and the role of hypertension in causing disease was not appreciated. They tried […]

History of nephrology vignettes

Hippocrates: “Those whose urine is merely blood-stained have suffered in the veins. When urine is thick, and there are passed with it small pieces of flesh like hair, you must know that these symptoms result from the kidneys and arthritic complaints.” Bubbles appearing on the surface of the urine indicate disease of the kidneys and […]

High blood pressure and the kidney: the forgotten contribution of William Senhouse Kirkes

Excerpt from: “High blood pressure and the kidney: The forgotten contribution of William Senhouse Kirkes” by J. Stewart Cameron and Jackie Hicks The realization of the key role for raised intra-arterial pressure as a pathogenetic agent in hypertension is usually credited to Ludwig Traube.  But Traube in his writings gives credit for the idea to a […]

The true discoverer of essential hypertension

Frederick Akbar Mahomed (1849–1884) may justly be deemed the true discoverer of essential hypertension and the originator of the concept that high blood pressure could damage the kidneys and blood vessels. Grandson of an Indian immigrant and physician at Guy’s hospital, he unfortunately died of typhoid fever at the early age of 35. Using a […]

Jean-Baptiste de Sénac

Jean-Baptiste de Sénac (1693–1770) is believed to have studied medicine at the University of Leyden and in London. He began to practice medicine in Paris in 1723 and served as the personal physician to King Louis XV. He studied the heart in an era when cardiology was rudimentary. In 1749 he published a book on cardiology in which  he described […]

Pierre Rayer (1793- 1867) – first to use microscopy to study kidney disease

Pierre Rayer occupies a special place in the history of nephrology for his attempt to classify the various diseases that Richard Bright had described in his monumental publication of 1827. With his intern Eugene Napoleon Vigla, he revolutionized the study of kidney diseases by using microscopy to analyze urinary sediments, describing crystals, cells, casts, and […]

A fatal and mysterious illness

Michael D. Shulman Philadelphia, Pennsylvania, United States      Scans, like  those above, showing reflux and stasis of cerebrospinal fluid (CSF) in patients with dialysis dementia prompted placement of a CSF shunt in at least one patient before intriguing new diagnostic clues emerged. In late 1972, a flurry of letters began to appear in the […]

Robert M. Kark (1911-2002)

In the 1950’s, Robert Kark and his team of Robert C. Muehrcke, Victor Pollak, and Conrad Pirani became, for a short time, the dominant force in American nephrology by popularizing the use of kidney biopsy as a diagnostic tool. This technique had first been described by Scandinavian investigators with somewhat limited success, but the Kark team […]

Death from uremia

“Your grandmother is doomed,” [the doctor] said to me. “It is a stroke brought on by uremia. In itself, uremia is not necessarily fatal, but this case seems to me hopeless. I need not tell you that I hope I am mistaken.” [Then] there was a moment when the uremic trouble affected her eyes. For […]