Eknoyan Garabed, De Santo Natale G
Renal Section, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Semin Dial. 2012 Jan-Feb;25(1):74-81. doi: 10.1111/j.1525-139X.2011.00982.x. Epub 2011 Oct 13.
The intellectual movement of inquiry by direct observation and inductive reasoning to acquire new knowledge matured in the Enlightenment. In medicine, personal observation as the prime mover of investigation began in anatomy, and gradually extended into studies of function, site of disease, and composition of body fluids. This led to the generation of new information on renal structure, function, and urine composition in health and to some extent in disease. Studies on the dissected, injected, and teased kidneys have left us with many of the eponymous renal structures described by Eustachio, Bellini, Malpighi, and Ferrein. Subsequent studies by Haller of the renal circulation and scrutiny of the separation of serous fluid from blood in the renal cortical glandular components established the beginnings of renal physiology. The movement to integrate chemistry into medicine championed by Boerhaave, which launched studies of urine composition in diabetes, urolithiasis, and gout led to the exploration of a chemical basis of other diseases. Albuminous precipitate in the urine of a dropsical case was described by Cotugno, but its association with kidney disease went unappreciated. Most of the new information on the kidney was communicated to and discussed in the increasing number of new scientific societies that were being formed, and transmitted to the eager members of the learned bourgeoisie of the period in the Encyclopédie of Diderot and d'Alembert.
通过直接观察和归纳推理来获取新知识的学术运动在启蒙运动时期走向成熟。在医学领域,作为研究主要推动力的个人观察始于解剖学,并逐渐扩展到对功能、疾病部位以及体液成分的研究。这使得人们获得了关于健康状态下以及一定程度上疾病状态下肾脏结构、功能和尿液成分的新信息。对解剖、注射和分离后的肾脏进行的研究,为我们留下了许多由尤斯塔基奥、贝利尼、马尔皮基和费雷因所描述的以人名命名的肾脏结构。随后,哈勒对肾脏循环的研究以及对肾皮质腺成分中血清与血液分离情况的详细审查,奠定了肾脏生理学的基础。由布尔哈夫倡导的将化学融入医学的运动,开启了对糖尿病、尿石症和痛风患者尿液成分的研究,进而推动了对其他疾病化学基础的探索。科图尼奥描述了水肿患者尿液中的蛋白沉淀,但当时人们并未认识到它与肾脏疾病的关联。关于肾脏的大多数新信息在越来越多新成立的科学学会中进行交流和讨论,并通过狄德罗和达朗贝尔的《百科全书》传递给了当时求知欲旺盛的资产阶级学者。