Tragedy to biotech, 1965-76 Hepatitis B virion model.  medicalgraphics.de The first cases of dialysis-associated hepatitis were reported in 1965, killing a nurse, porter, and patient, and infecting several others in Manchester. The ‘Australia antigen’ was identified in Philadelphia in the same year, and the following year associated with hepatitis. A key observation was the new…

Dropsy becomes treatable in the 1960s Failure of pharmacological therapies in a woman with heart failure in 1964, right on the verge of the introduction of loop diuretics. During the 1800s it became clear that dropsy (extensive oedema, ascites, pleural effusions) was not a single disease, but a late feature of failure of the heart,…

The first unequivocally useful drug, 1964Robust and practical sphygmomanometers (mercury and aneroid) became available in the early 1900s, but regular recording of blood pressure did not become widely routine until the 1920s and 30s. Until then, palpating the pulse offered the only insight, except that ophthalmoscopy could show severe hypertensive retinal changes, neuro-retinitis albuminurica (Figure).…

Detail at last Ambrose Tardieu for Pierre Rayer (1840) (Wellcome Images V0009820ER) For most of the first 100 years of modern nephrology, appearance by eye at autopsy was the closest you could get to seeing the structural detail of kidney disease. But between 1830 and 1870 there were key technical improvements in the quality of…

The last decade of purely clinical observation Acute glomerulonephritis with crescent formation – Volhard and Fahr 1914(one of the last renal pathology works with artwork rather than photographs) Arthur Ellis’s 1942 articles on Bright’s Disease summarised a truly impressive 20 year systematic recording of 600 patients with kidney disease at the London Hospital, followed up…

This doctor’s bag is in the London Science Museum. Though dated 1890-1930 much of its contents look very early 20th century. What it doesn’t contain is significant. It belonged to John Hill Abram (1863-1933), a Liverpool physician who later became Professor of Medicine.  He was also president of the Association of Physicians in 1928 –…

When urinary abnormalities don’t indicate renal disease From Tom Brown at Oxford (1861) illust Sydney P Hall (1903 edition) Richard Bright’s 1827 description of the association of proteinuria with dropsy and serious kidney disease led to doctors of the 1800s kitting up with apparatus to test for proteinuria, long before they could measure blood pressure.  Uroscopy…