Mezzogiorno V, Mezzogiorno A, Passiatore C
Istituto Anatomia umana normale, Università degli Studi di Napoli, Italy.
Ann Anat. 1993 Oct;175(5):395-401. doi: 10.1016/s0940-9602(11)80102-0.
This work documents the progressive gain in knowledge on renal anatomy acquired by anatomists from Galen to Malpighi. Galen, with albeit his rather imaginative explanations, was the first anatomist to recognize the urine producing function of the kidney. His influence was felt up to the Middle Ages; his followers imagined the presence of two cavities within the kidney that were separated by a porous membrane that they called the "colatorium" which was capable of filtering the urine from the blood. It was only later that Berengario da Carpi, divorcing himself from Galenic dogmatism, finally dismissed the presence of the colatorium. He described the renal papillae and gave the first elementary model of renal vascularization. Further important progress was due to the studies of Falloppius and Eustachius who brought contemporary understanding of renal structure to the limit of what could be seen with the unaided eye. They distinguished the difference between the unilobar canine kidney and the human multilobar organ, they also described the minor and major calyces and, furthermore, guessed at the canalicular structure of its parenchyma. Highmore was then responsible for the description of the archiform vessels which he hypothesized as an arterio-venous anastomotic net between the renal cortex and medulla. With the invention of the microscope, new doors opened for the study of renal structure. Bellini proved the canalicular organization of the parenchyma and, moreover, described the interlobular vessels. Malpighi then described the glomerulus and its relation to the intrarenal excretory ducts. The basis had now been laid for the beginning of modern nephrology.
这项工作记录了解剖学家从盖伦到马尔皮基在肾脏解剖学知识上的逐步积累。盖伦尽管有相当富有想象力的解释,但他是第一个认识到肾脏产生尿液功能的解剖学家。直到中世纪,他的影响力仍能被感受到;他的追随者想象肾脏内有两个腔,由一层多孔膜隔开,他们称之为“滤器”,能够从血液中过滤尿液。直到后来,贝伦加里奥·达·卡尔皮摆脱了盖伦的教条主义,最终否定了滤器的存在。他描述了肾乳头,并给出了第一个肾脏血管形成的基本模型。进一步的重要进展归功于法洛皮奥和尤斯塔基奥的研究,他们将当时对肾脏结构的理解推到了肉眼所能看到的极限。他们区分了单叶犬肾和人类多叶肾的差异,还描述了小盏和大盏,此外,还猜测了其实质的小管结构。海莫尔随后描述了弓形血管,他假设其为肾皮质和髓质之间的动静脉吻合网。随着显微镜的发明,肾脏结构研究的新大门打开了。贝利尼证明了实质的小管组织,此外,还描述了小叶间血管。马尔皮基随后描述了肾小球及其与肾内排泄管的关系。现代肾脏病学的开端现在已经奠定了基础。