Richet G C
Kidney Int. 1994 Apr;45(4):1241-52. doi: 10.1038/ki.1994.164.
It was towards the end of the 18th century that a curiosity arose about what controlled the flow of urine. It was noted that though a patient's kidneys might be destroyed, the flow of urine continued until death. This puzzling phenomenon might have been understood had Ségalas's and Wöhler's observations been properly appreciated, that an extra load of urea, or any other substance that is excreted by the kidney, causes a diuresis. Nevertheless, these experiments were forgotten, and because of Bowman's and Ludwig's studies fluctuations in urine flow were ascribed to changes in blood pressure. It was not until 1870 to 1880 that Ustimowitsch, Falck and Richet stressed the role of urinary solutes on urine flow. Around 1900, Cushny also studied the diuretic effect of different solutes excreted in the urine and actually described what is now called an osmotic diuresis, though he did not use the term. These studies enabled him to deliver his "modern view" of the Secretion of the Urine. This was the first coherent concept which attempted to explain the formation of the urine and the regulation of its composition according to a pressure of a selective tubular reabsorption controlled by the needs of the "Milieu Intérieur." When glomerular and tubular functions became quantifiable, Homer W. Smith's disciples were able to define the exact nature of an osmotic diuresis and that explained the paradox of polyuria and renal failure.
18世纪末，人们开始对控制尿液生成的因素产生好奇。人们注意到，即使患者的肾脏被破坏，尿液仍会持续生成直至患者死亡。如果当时能正确认识塞加拉和维勒的观察结果，即额外摄入尿素或任何其他由肾脏排泄的物质会导致利尿，那么这个令人困惑的现象或许就能得到解释。然而，这些实验被遗忘了，由于鲍曼和路德维希的研究，尿液生成的波动被归因于血压的变化。直到1870年至1880年，乌斯季莫维奇、法尔克和里歇才强调了尿液溶质对尿液生成的作用。大约在1900年，库什尼也研究了尿液中排泄的不同溶质的利尿作用，并实际上描述了现在所称的渗透性利尿，尽管他没有使用这个术语。这些研究使他能够阐述他关于尿液分泌的“现代观点”。这是第一个连贯的概念，试图根据由“内环境”需求控制的选择性肾小管重吸收压力来解释尿液的形成及其成分的调节。当肾小球和肾小管功能变得可量化时，霍默·W·史密斯的弟子们能够确定渗透性利尿的确切性质，并解释了多尿和肾衰竭的矛盾现象。
