Milk or albumin? The history of proteinuria before Richard Bright

Nephrology Dialysis Transplantation

Volumn 18, Issue 7, 2003, Pages 1281-1285

  Cameron, J Stewart ^a  

^a KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ALBUMIN;

ARTICLE; ASCITES; CHEMICAL ANALYSIS; CLINICAL EXAMINATION; HUMAN; KIDNEY DYSFUNCTION; KIDNEY FUNCTION; PRIORITY JOURNAL; PROTEIN ANALYSIS; PROTEINURIA; SYMPTOM; URINALYSIS;

EID: 0037817488     PISSN: 09310509     EISSN: None     Source Type: Journal    
DOI: 10.1093/ndt/gfg130     Document Type: Article

References (24)

1. Dekkers F. Exercitationes practicae circa Medendi Methodum. Boutensteyn and Luchtmans, Leiden: 1694: 338-339. This book was popular, and ran to several editions up to 1717
2. Dock W. Some early observers of proteinuria. Ann Med Hist 1922; 4: 287-290
3. Leube W. Ueber die Bedeutung der Chemie in der Medizin. August Hirschwald, Berlin 1884. Leube had also published in 1882 Die Lehre vont Harn. Ein Handbuch für Studierende und Ärzte. August Hirschwald, Berlin
4. Eknoyan G. On the contributions of Paracelsus to nephrology. Nephrol Dialysis Transplant 1996; 11: 1388-1394
5. Pagel W. Paracelsus. An Introduction to Philosophical Medicine in the Era of the Renaissance, 2nd edn. Karger, Basel, 1982 (Book 2 Tract 3 Chapter 3)
6. Schena PF. The role of Domenico Cotugno in the history of proteinuria. Nephrol Dial Transplant 1994; 9: 1344-1345
7. Cotugno D. Cap XVIII. Sic etiam urina inventa particeps coaguli. In: De ischiade nervosa commentarius. Graeffer, Vienna: 1774: 28-29. This book ran to several editions during the following decade
8. Langrish B. The Modern Theory and Practice of Physic etc. etc. A. Bettesworth and C. Hitch, London: 1735: 90-91
9. Nor did any of the other pioneers of proteinuria discussed here (Brande, Wells, Blackall). John Bostock (1773-1846) the clinician-chemist working with Bright, and Bright himelf used heat, in 1825-1826 but Bostock also studied the effects of mercuric chloride, hydrochloric acid, potassium ferricyanide and tannic acid, which appeared to enhance the ability of heat to reveal small quantities of albumin. He mentioned also that acetic acid would aid separation of the coagulum. He speculated and demonstrated that this urinary albumin appeared identical to that in the blood, and in eggs, in all its chemical reactions that he was capable of testing, and noted diminution of albumin in the blood as it increased in the urine. Nor did Pierre Rayer employ acid then heating during the 1830s-although he used nitric acid as an alternative to heat. In 1851, Sir Robert Christison advocated "you should always employ both heat and nitric acid as tests; the best way is to heat the urine first and then try whether the coagulum resists nitric acid... heat alone may separate earthy salts when these abound, but a coagulum which resists both heat and nitric acid can be nothing other than albumin". The nitric acid test was standardized in 1852 by Johann Florian Heller (1813-1871) of Vienna, using diluted urine and careful layering of acid and urine to produce a disk of coagulum whose thickness reflected the quantity of proteins (all proteins are precipitated by nitric acid, including Bence Jones proteinuria and tubular proteinuria). The custom of first adding acetic acid, and then heating, seems to have appeared after 1860, and is recommended in most texts in the second half of the 19th century. e.g. Samuel Wilks, Writing in 1891
10. Dar-win E. Zoonomia, or the Laws of Organic Life. Johnson, London, 1794: Vol. I: 467-468. Apart from his illustrious descendents, Darwin was best known during his life as a botanist and scientist as well as a popular physician, and was one of the 'lunar men' of the Lunatick Society, who met monthly at the full moon in Birmingham (so they could see to get home) and whose other members included Josiah Wedgewood, Joseph Priestley, James Watt and William Withering.
11. (see Uglow J. The Lunar Men. The Friends who Made the Future. Faber and Faber, London, 2002)
12. Martin Solon (F). De l'albuminurie ou hydropisie causée par maladie des reins etc. Béchet Jeune, Paris, 1837. This work included, as well as extensive material on urine testing and chemistry, five coloured plates depicting diseased kidneys
13. The exception to this statement is, of course, the peculiar urinary protein described by Henry Bence Jones (1814-1873) first in 1847 and then definitively in 1848 (On a new substance occurring in the urine of a patient with mollities ossium. Philos Trans 138: 55-62). He used however the term 'myelopathic albumosuria' to describe it
14. Neild GH. William Cruickshank (FRS-1802): clinical chemist. Nephrol Dial Transplant 1996; 11: 1885-1889
15. Coutts A. Ann Sci 1959; 15: 121-123. [cited in 11]
16. Experiments on urine and sugar by Mr Cruickshank. In: An Account of Two Cases of Diabetes etc. by John Rollo. J Dilly, London: 1797: 443-448
17. Brande T. An account or some changes from disease in the composition of the urine. Trans Soc Improv Med Chir Knowl 1812; 3: 187-193 (delivered 3 February 1807)
18. George CRP. William Charles Wells (1757-1815)-a nephrologist of the Scottish enlightenement. Nephrol Dial Transplant 1996; 11: 2513-2517
19. Wells WC. Observations on the dropsy, which succeeds scarlet fever. Trans Soc Improv Med Chir Knowl 1812; 3: 167-186. (given November 4 1806)
20. Wells WC. On the presence of the red matter and serum of blood in the urine of dropsy, which has not originated from scarlet fever. Trans Soc Improv Med Chir Knowl 1812; 3: 194-240. (read June 4th 1811). Wells states that 1/640 dilution of normal serum will just give a visible precipitate on heating: this is equivalent to 110 mg/1-the first definition of the limits of normal albuminuria and similar to the figures used today. Wells observed U/P ratios of greater than 1/5 in his worst cases, i.e. > 1 g/1
21. Blackall J. Observations on, the Nature and Cure of Dropsies etc.etc. Longman, Hurst, Rees, Orme and Brown, London, 1814
22. Fine L, English JA. John Blackall (1771-1860): failure to see the obvious in dropsical patients with coagulable urine? Am J Nephrol 1994; 14: 371-376
23. Venables R. Clinical Report on Dropsies; With Observations Explanatory of Their Pathology and Therapeutics; With an Appendix on the Theory and Treatment of Organic Disease in General. T. and G. Sherwood, London, 1824
24. Cameron JS. John Bostock MD FRS. Physician and chemist in the shadow of a genius. Am J Nephrol 1994; 14: 365-370