[The Early Years of Nephrology at Molinette Hospital in Turin Told by Those Who Lived and Built Them]

This article, written by several authors, describes the birth and early development of the nephrology at Molinette Hospital in Torino, Italy. In particular, it supplies important information on Antonio Vercellone, very motivated and innovative clinician and one of the fathers of Italian nephrology, and on Giuseppe Piccoli, his right-hand man and then his successor. This article also shows the strong professional and human engagement that was requested to the young doctors who, in the early Sixties and Seventies of the past century, had chosen to devote their professional lives to the patients with kidney diseases: from endless workdays without schedules to the anguish caused by the shortage of artificial kidneys to the cure of very fragile and unfortunate patients, and much more.

Mozart's Illnesses and Death1

Throughout his life Mozart suffered frequent attacks of tonsillitis. In 1784 he developed post-streptococcal Schönlein-Henoch syndrome which caused chronic glomerular nephritis and chronic renal failure. His fatal illness was due to Schönlein-Henoch purpura, with death from cerebral haemorrhage and bronchopneumonia. Venesection(s) may have contributed to his death.

Momir H. Polenakovic - Founder of the Nephrology Associations in the Republic of Macedonia

Acad. Momir Polenakovic has devoted his life and work in the diagnosis and treatment of kidney patients, as well as in research of kidney disease. The great experience he has acquired in the work with kidney patients, and after the visit to the most renowned nephrology centers in Europe and the world, he has transferred it to his colleagues through the work in the medical and nephrology associations. The work of the associations was in fact a successful education of young doctors and specialists. Among his most distinguished positions, we can mention: President of the Macedonian Medical Association, founder and President of the MSNDTAO, President of the Yugoslav Society of Nephrology, founder and President of BANTAO, as well as member of the Boards of ESAO and ERA-EDTA. He has received a lot of recognitions for his work achievements.

The martyrdom of St. Zoilus, a urological issue. History and development of the tradition

OBJECTIVES

To highlight, for its urological importance, the martyrdom of St. Zoilus. To elaborate on the tradition of invocation and worship of the saint and to establish their historical bases.

MATERIAL AND METHODS

We conducted a study of the images of the martyrdom of St. Zoilus, with a detailed review of the history and tradition of the saint and performed a comparative study of the various saints known as patrons of kidney pain and disease.

RESULT

We found three paintings in different churches and locations depicting the kidney extraction of St. Zoilus. In addition to the three pieces, a preserved chest at the National Archaeological Museum and 2 tapestries in the sacristy of the church of the monastery of St. Zoilus in the Palencian town of Carrion de los Condes provided abundant information on the circumstances in which they were made. By analysing the style, we can deduce its affiliation to a specific artistic milieu and thereby propose a timeframe.

CONCLUSION

Without meaning to dethrone St. Liborius as the patron saint of urologists, an office claimed earlier by colleagues from various European countries, the martyrdom of St. Zoilus is, in light of the tradition and images provided, an unquestionable urological issue. The tradition is vindicated from a new viewpoint 1,712 years later.

Disease of the kidney and of the urinary tract in De Medicina Methodica (Padua, 1611) of Prospero Alpini (1563-1616)

AIM

The study was devised to understand the contribution to nephrology ofDe Medicina Methodicaof Prospero Alpini published in 1511, at a time when the fame of the professor reached the azimuth.

METHOD

We have analyzed the contents of chapters devoted to nephrology in that book of Prospero Alpini and the novelties of his message.

RESULTS

Prospero Alpini (1563-1616) taught at the University of Padua (1594-1616), at the same time of Galileo Galilei, Santorio Santorio, and Girolamo Fabrizi dAcquapendente, when measurements (pulse, temperature, perspiration) were introduced into medicine. He was a travelling physician to whom we owe fundamental contributions to the use of urine to prognosticate life and death (De Praesagienda vita et morte aegrotantium libri septem, Venetiis, apud Haeredes Melchioris Sessae,1601). As prefect of the Botanical Garden - the first ever and a model in the world - he could turn the study of simples into cures(De Medicina Methodica Libri Tredecim. Patavi, apud Franciscum Bolzettam, 1611. Ex typographia Laurentij Pasquali, is anin foliovolume of XLVII + 424 pages, 54 lines per page), wherein Alpini aimed to rejuvenate antique medical Methodism. It is a testimony of the interest of medicine philosophers of the modern era for the corpuscular and atomic ideas (Nancy Siraisi). Methodists (2ndCentury BC) refused anatomy and physiology as unique guidelines to the interpretations of diseases and gave importance to the development of a pharmacological science and alternative medicine. The book begins with a 3 page letter to Francis Maria della Rovere Duke of Montefeltro, and a 2 page letter to the readers. We discuss the novelties of the chapters on renal colic (de dolorerenum), hematuria (de sanguinis profluvium), pyuria, anuria (de urina suppressa) and its cure, polyuria (de urina profluvio), renal abscesses, hydrops and its treatment by skin incisions. We also analyze the chapter on kidney and bladder stones (Book X, Chapter XVIII, pp. 354-356) - a masterpiece of scholarly teaching - encompassing localization of stones, their formation and shape, renal colic and its irradiation according to the site and gender, the best antalgic position to pass stones, the use of laxatives, cathartics, warm baths, the plants to be used, their preparation and quality, the waters to be drank and their quantity (up to 15 pounds a day), the removal of bladder stones without surgery (methods learned in Cairo and described in Aegyptyan Medicine), and lithotomy and its feasibility even in old people.

CONCLUSION

De Medicina Methodicawas a modern monograph devoted to clinical medicine including urinary disease. The book reflected the polyhedral personality of the author, his experience as physician of the Republic of Venice at Cairo, and his capabilities as a director of the Botanical Garden of the University of Padua, a unique research centre in those times.

On pains of the kidney and the bladder in Kitāb al-Tajārib by Rhazes

Abū Bakr Muḥammad ibn Zakariyyā al-Rāzī (865-925), known in the West as Rhazes, was one of the pioneer figures of the golden age of Islamic science and medicine during the middle ages. Kiṭab al-Ḥāwī fī al-Ṭibb (Liber Continens), Kitāb al-Ṭibb al-Manṣūrī (Liber Medicinalis ad Almansorem) and Kitāb al-Judarī wa al-Ḥaṣba (Liber de Pestilentia) are his very well-known works in medicine. One of his books Kitāb al-Tajārib (The Book of Experiences/The Casebook), was written in Arabic and one of its copies is Ahmed III, Nr. 1975 manuscript in Topkapı Palace Library in Istanbul. A physician, Ali Munshi of Bursa, translated Kitāb al-Tajārib into Turkish in the 18th century and Hamidiye, Nr. 1013; Veliyuddin Efendi, Nr. 2487 and orum, Nr. 2909 manuscripts are the copies of its Turkish translation in different libraries in Turkey. Both the book and its Turkish translation contain 31 chapters; 30 of them concerning diseases from head to heel and the last one on pharmaceutics. The 21st chapter, fī awjā' al-kulā wa al-mathāna wa al-bāh, of Kitāb al-Tajārib is on pains of the kidney, and the bladder, and coitus. Evaluation and presentation of the cases in this chapter regarding the kidney and the bladder are the aims of this report.

Treatment of kidney diseases in the thermal springs of Pithecusa during the XVIII Century

The island of Pithecusa (Ischia) is a volcanic island in the Tyrrhenian Sea in the north end of the Gulf of Naples at about 30 kilometers from the same city. Pithecusa is very popular for its hot springs which even the ancients used. This report aims to analyze the renal therapeutic benefits of the Pithacusa thermal mineral spring through a review of two different manuscripts: i) "Di Napoli il seno cratero"(The gulf of Naples) of Domenico Antonio Parrino (1642-1708) and ii) "De' rimedi naturali che sono nell'isola di Pithecusa oggi detta Ischia"(On the natural cures of the island of Pithecusa known today as Ischia)of Giulio Iasolino (1583-1622). These two manuscripts published during the 18th century and both manuscripts highlight the thermal virtues of the thermal springs of Pithecusa. In the past natural remedies were important in the treatment of different diseases including that of thermal springs dating back to ancient Rome. Thermal springs were used to treat spasms, skin diseases, hair loss and various renal ailments. Both manuscripts describe the thermal springs in Ischia and their therapeutic benefits in medical diseases.

Stephen Hales: the contributions of an Enlightenment physiologist to the study of the kidney in health and disease

Stephen Hales (1677-1761) was an English clergyman who made major contributions to a wide range of scientific topics such as botany, chemistry, pneumatics, and physiology. Early in his career he developed a keen interest in medicine through his association with his younger physician friend at Cambridge, William Stukeley (1687-1765), with whom he dissected animals and attended experiments in the laboratory of Isaac Newton. His fame as a scientist grew and by the end of his life he had achieved an international reputation as a major scientist of the Enlightenment. He is best known for his 1733 Statical Essays, in the second part of which he describes his studies in animal physiology. Most famous amongst those are his assessments of the force of the blood, which he measured in horses and dogs. Less well known and often unrecognized are his studies on the kidney in health and disease, which are the focus of this review. Amongst others Hales described the effects of hemorrhagic shock which he observed as he bled his animals while measuring their blood pressure; he then studied the effect of increasing saline perfusion pressures on the renal secretion of urine; and delved into biochemistry in exploring the composition of and solutions to dissolve bladder stones. His 1733 statement in the introduction to his hemodynamic studies that the healthy State of the Animal principally consists, in the maintaining of a due Equilibrium between the body solids and fluids literally predicts the milieu intrieur that would ultimately be formulated in 1854 by Claude Bernard (1813-1878).

Contribution of Academician Momir Polenakovic to the Development of Nephrology in the Republic of Macedonia

Academician Momir H. Polenakovic, MD, Ph.D. is an outstanding researcher, educator and scientist, one of the founders of the nephrology in the Republic of Macedonia. With more than 500 published papers in national and international journals, of which more than 189 are on the PubMed, he is one of the most fruitful medical worker in our country. With his participation in national and international congresses he has contributed to the transfer of the world nephrology in Macedonia, as well as, to the dissemination of the reputation of the Macedonian nephrology and science in the world. He has educated a number of specialists in internal medicine and subspecialists in nephrology. He has introduced new tests and methods in diagnosis and treatment of renal disease, which was a basis for his research and publication. Analyzing the life opus of Academician Momir Polenakovic we can say that he has dedicated his life and work to the research, diagnosis and treatment of kidney patients.

Wars, disasters and kidneys

This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes.

Living "anyway:" stories of access

Elana Dykewomon's 1974 novel, Riverfinger Women, was among the first lesbian books with a "happy ending." Her seven books of fiction and poetry include the Lambda Award winner Beyond the Pale (now an audio and e-book) and Lambda nominee, Risk. She was an editor of the lesbian-feminist journal, Sinister Wisdom, for eight years. Her literary work foregrounds the lesbian heroic as integral to women's communities. As a social justice activist, she has organized and participated in anti-war, anti-racist, anti-classist, fat and disability rights work since the 1970s. She is now working with Old Lesbians Organizing for Change. She is happy to live embedded in dyke community as a lesbian radical committed to a loving justice. While she suffered psychiatric abuse at 13 (and acknowledges long-term adaptive behavior on that account), she has not experienced disabling mental illness since. Her primary disabilities are mobility impairment through severe, progressive arthritis and constant low-to-powerful pain, sometimes diagnosed as fibromyalgia. Her acute illnesses include pancreatitis and a rare-in-adults kidney disease currently in remission.

Department of Nephrology at the Medical Faculty, Ss. Cyril and Methodius University, Skopje--creating nephrology protection for the citizens of the Republic of Macedonia

In January 1975, de facto, the Nephrology Department was founded at the Medical Faculty in Skopje as the first institution of such a type in former Yugoslavia. The Nephrology Department was the driving force for the further development of nephrology in the Republic of Macedonia. D. Hrisoho was the first Director of the Department, and its subsequent Directors were G. Masin, M. Polenakovic, K. Zafirovska and currently A. Sikole. Prior to the establishment of the Nephrology Clinic there had been considerable experience in the diagnosis and treatment of renal patients. The first haemodialysis (HD) in the Republic of Macedonia (RM) was performed in 1959 on a patient with acute renal failure (ARF) using a Kolff-Brigham rotating drum artificial kidney at the Blood Transfusion Institute in Skopje. In 1965 the Renal Unit at the Department of Medicine, Medical Faculty, Skopje obtained a new, modern "Websinger" artificial kidney with a sigma motor pump and possibilities for the use of a disposable Kolff "twin coil" dialyser. Between 1959 and 1971, HD was performed only on patients with ARF. In May 1971, a Unit for Chronic HD was founded at the Renal Unit and the programme of maintenance haemodialysis (MHD) was started with five Stuttgart Fresenius machines and 12 patients dialysed on twin coil dialysers. That was a great incentive for the development of HD in the Republic of Macedonia enforced by the great number of patients with end stage renal disease. Thus in 2007 we have 18 HD centres in the Republic of Macedonia, with 1183 patients. Treatment of the patients with MHD is the greatest success achieved in the Republic of Macedonia in nephrology concerning patients with end stage renal disease. Prior to the treatment with MHD patients were destined to die, whereas now, with this type of treatment, they have a normal life and families. Patients with kidney diseases are examined in outpatients clinics as well as treated in the wards of the Department. All types of vascular accesses, renal biopsies, bone biopsies, kidney ultrasound, plasmapheresis and other investigations are performed every day at the Nephrology Department of the Medical Faculty. On the basis of the results of renal biopsy, a classification of parenchymal renal diseases has been established, as well as appropriate immunosuppressive and other treatments. The nephrology doctrine for primary, secondary and tertiary healthcare has been prepared and has been distributed to all medical centres in the Republic of Macedonia. The first (living donor) renal transplantation was performed in July 1977. Later, living and cadaver donor transplantations were performed, so the Department of Nephrology was complete concerning dialysis and renal transplantation, and it became part of the European centres for diagnosis and therapy of kidney disease. Doctors from the Nephrology Department are among the most productive scientific workers in the Republic of Macedonia and their papers can be found on the internet Pub Med. The Department of Nephrology, together with the Nephrology Association, was the source of knowledge in the area of nephrology and the transfer of knowledge from abroad into Macedonia and vice versa. The Nephrology Association has made a great contribution in the development of nephrology in our country. The most famous European and world nephrologists have participated in the work of our association and have contributed to the development of nephrology not only in Macedonia, but on the Balkans as well.

The inception and formation of the theory of hyperfiltration through the ages

With the rising incidence of metabolic syndrome and progressive kidney disease, efforts to halt this progression have become the mainstay of therapies in the era of modern nephrology. The necessity of one versus two kidneys has occupied the minds of leading scientists and philosophers throughout the ages and has laid the foundation for our understanding of progressive kidney disease. This review focuses on the major discoveries of the leading thinkers who with their paradigm shifting ideas and skepticism pushed the boundaries of our knowledge and shaped the theory of hyperfiltration.

A critical review of the works of pioneer physicians on kidney diseases in ancient Iran: Avicenna, Rhazes, Al-akhawayni, and Jorjani

The history of kidney and urologic disorders dates back to the dawn of civilization. Throughout history of medicine, urine, the first bodily fluid to be examined, has continuously been studied as a means of understanding inner bodily function. The purpose of this review was to appraise the contributions of the ancient Iranian physician pioneers in the field of kidney and urological disorders, and to compare their beliefs and clinical methods with the modern medicine. We searched all available reliable electronic and published sources for the views of ancient Iranian physicians, Avicenna, Rhazes, Al-Akhawayni, and Jorjani, and compared them with recent medical literature. Our findings showed that ancient Iranian physicians described the symptoms, signs, and treatment of kidney and urological disorders; addressed bladder anatomy and physiology; and performed bladder catheterization and stone removal procedures in accordance with contemporary medicine. Ancient Iranian physicians pursued a comprehensive scientific methodology based on experiment, which is in compliance with the bases of modern medicine.

[Biographical update of Licentiate Martín de Castellanos de Maudes (1545?-1614). New documented information]

INTRODUCTION

The semblance and facts of licentiate Martín de Castellanos from Maudes (1545-1614?), a novelist surgeon specialized in treating urological diseases and who due to his merits and prestige was appointed professor of 'Urology' by Philip II, were almost definitively profiled in 1994 through the publication of his biography in a exhaustive piece of work.

MATERIALS AND METHODS

Thorough review of new documentary findings at the Santa Cruz Church in Madrid and at the Simancas General Archive regarding new biographical information on Martín de Castellanos.

RESULTS

It demonstrates the existence of other children from his marriage and that his eldest son, a collegiate at the University of Salamanca died as a result of the injuries he sustained following a sword fight among students on 13 November 1595. The work provides abundant information on the process that occurred at the University of Salamanca as a result of the death of Castellanos' son, of the lawsuit he filed against the culprits, and of the intervention of Philip II himself at the request of the surgeon, by means of a written order to the city magistrate.

CONCLUSION

Although the transcription of the documents does not modify the fundamental facts of his life, they do give information on this occurrence, which updates his biography and directly associates the urologist with the king.

Georg Philip Nenter and medicine "by notes" in the 18th century

Even though it is true that the medical historiography of the 18th century is lacking in great scientific personalities, it is equally true that the entire century is characterized by continuous efforts to encapsulate the medical area of knowledge, acquired until then, in precise and systematic outlines, to serve the academic teaching of the subject of medicine. Georg Philip Nenter, a pupil of Georg Ernst Stahl and a professor of medicine in the University of Strasburg, could not help being influenced by that atmosphere. He added though, in our opinion, a touch of remarkable modernity. In fact his volume Fundamenta medicinae teoretico-pratica (Venice, 1735) is a wonderful collection of the notes taken during his lectures. The description of various diseases - renal diseases in particular - maintains a very systematic development of the subject through various chapters (definition, clinical manifestations, differential diagnosis, prognosis, treatment and examples of specific prescriptions), as if students were being addressed.

Francophone clinical nephrology from 1945 to 1960

After the Second World War, clinical nephrology in Francophone countries had 4 leaders: in Paris, P. Vallery Radot with his assistants P. Milliez and J. Hamburger and their own groups; and also in Paris, M. Dérot with J. J. Bernier and M. Legrain; in Bruxelles, P. Govaerts with P. P. Lambert; and in Genève, R. Mach. To these one must add J. Traeger of Lyon and J. M. Suc of Toulouse who later joined the group. It all started in 1947-1948 around the Societé de Pathologie Rénale. In the current paper, the author describes the main 4 fields of development: water and electrolyte balance, acute anuria and dialysis, renal biopsy and classification of nephritides and finally transplantation under the direction of J. Hamburger and R. Küss both closely linked with J. Dausset and G. Mathé. These contributions had a broad impact on the history of modern clinical nephrology, which was acknowledged and crowned by the organization of the first Congrès International de Néphrologie by Hamburger and Mach, the development by which the specialty was acknowledged and the International Society of Nephrology (ISN) created with its first journal, Nephron. Hamburger, the first president of the ISN, had many difficulties to overcome to carry this goal through.

Kidney dysfunction, from the Arabic to the Byzantine world in 11th and 12th century southern Italy

Greek classical medicine was not transmitted directly from classical antiquity to the Western Middle Ages by a continuous tradition, but passed through the Arabic world, where it had been preserved thanks to translations from Syriac and/or Greek into Arabic. From the Arabic world, Greek medicine arrived to the West, through the Greek- or the Latin-speaking communities in Sicily and the mainland, respectively. Remarkably enough, the scientific content of the text was scrupulously respected.

"De medicina et morbis" from De rerum naturis by Rabano Mauro

De rerum naturis from the Monastery of Montecassino (MS codex 132) by Rabano Mauro, is a medieval encyclopedia issued around the year 1025, in the Abbey of Montecassino, during the period of Abbot Teobaldo. It is a copy of a more ancient text, written almost certainly in the Abbey of Fulda 2 centuries before, when Rabano Mauro was the abbot - that is, in the Carolingian age. In the Book 18 there is a chapter entitled "De medicina et morbis," in which we find related the fundamental principles on which studies of the human body, illness and the principal medicinal herbs were based. The text is not intended for teaching the medical art, but has the precise objective of helping to form the cultured Christian, trying to combine the old Greek-Roman tradition with a mystical vision, giving a moral application according to the dictates of Jewish-Christian religion. This text is indicative of the fusion of the scientific and religious worlds in the West during the Middle Ages. This interpretation of the universe will last for about a millennium, and only the Renaissance will be able to separate the 2 worlds again.

Isaac Judaeus Israeli: a Jewish founder of the origins of nephrology

This paper discusses the Book of Urine in the Opera Omnia Isaci of Isaac Judaeus Israeli. Born in Egypt in the middle of the ninth century, Isaac Judaeus was considered a genius by his peers. The book accepted Galen's ideas and expanded them. Its original contribution was in the concept of the seeping of fluid and sediment from blood into the kidney and from the kidney to the bladder. This concept corresponds to glomerular filtration and tubular secretion.

Ad vesice dolorem et ad eos qui urinam non faciunt (For bladder pain and when a person cannot urinate): nephrological disorders in Anglo-Saxon medicine

The attitude of 19th century (and even of 20th century) scholars toward medieval and, particularly, Anglo-Saxon medicine has been of severe criticism. According to them it was filled with superstition and stupidities. However, in these last fifty years research has proved that, compared with the Continent, Anglo-Saxon England was not a backwater. At the end of the ninth century, medical compendia in Old English began to appear, similar in structure and contents to the Latin dynamidia and to the Latin herbals. These medical treatises were written in the vernacular of the Anglo-Saxons, not in Latin, the western European language for all significant and valuable works on medicine. Bladder, kidney and urinating problems are mentioned throughout the Old English medical treatises together with their cures, that is remedies from herbs and animals. These texts contain no theoretical reflections, only very concise descriptions of symptoms (pain in the bladder, in the kidneys, difficulty in urinating etc.), while prognosis is limited to affirmations such as "he will heal very quickly," "soon there will be no pain," "it will soon be healed," etc. Remedies are made basically out of a body of medicinal plants and materials which can be traced to Greek and Roman medicine. The remedies from plants reflect a wide rational and practical knowledge of medicinal herbs. As a matter of fact, not only there is no amuletic use of plants, but most of the herbs that appear in these recipes have diuretic or analgesic properties and have been in use for centuries.

Armenian medicine and diseases of the kidney

The history of Armenian medicine is that of the common practice of medicine in caring for the sick through the ages, using mainly local medicinal herbs and natural products. Over the years, its practitioners persistently collected and recorded an expanding body of information on therapeutics and put it to use for the daily medical care of ordinary folks. Armenian medicine developed around the church and monasteries, which flourished during episodic periods of peace in an otherwise tumultuous and warring region. However, unlike the monastic medicine that developed in Europe, Armenian medicine maintained the rationality it had acquired from Greek medicine, and never resorted to magic, myth or amulets. Nor did it acquire or import saints. Armenian medicine is a classic example of the evolving art of therapeutics, whose record is preserved in extant manuscripts, saved over the centuries in monasteries, and now preserved in accessible collections.

Historical development of the renal histopathology services in Malaysia

Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its first renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently filtered out to the private sector as more histopathologists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, fibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation.

[The classics of Italian nephrology. 'Functional semiology of the kidney' by Giovanni Gigli (1913-1988) and Sergio Giovannetti (1924-2000)]

The monograph Semeiologia funzionale del rene (Functional semiology of the kidney) by Giovanni Gigli (1913-1988) and Sergio Giovanetti (1924-2000), published in 1953, was the first systematic survey on the subject to appear in Italy. Besides the classical renal function tests (urinalysis, BUN measurement, urea clearance), the book recounts the many new techniques that were introduced into clinical practice in that period as a result of the great advances in the field of renal physiology (e.g., glomerular filtration rate, renal plasma and blood flow, tubular water reabsorption, maximum tubular excretion and reabsorption capacity, filtration fraction). In addition, it describes the utility and pitfalls of such tests in a wide spectrum of kidney diseases, but especially in different types of glomerulonephritis, of which the two authors had collected a personal cohort of 48 patients. Today, the monograph by Gigli and Giovannetti shows the difficulties and uncertainties encountered in the evaluation of kidney diseases in a period in which renal biopsy was yet to become the widely used technique it is today.

[The classics of Italian Nephrology: an interview with Professor Alberto Amerio, one of Italy's first nephrologists. 2005. Interview by A. Losito]

A. Losito reports the interview he made to professor Alberto Amerio in Bari for the 50 years of the Italiana Society of Nephrology. Professor Amerio was one of the first Italian doctors interested in renal disease. Witness of the birth of the Society was also the first academic in Italy to be appointed Professor of Nephrology. With his move from Turin to Bari he also transferred a specific knowledge acquired as visiting felloz to excellece centres in France. His witness is a reference mark on the birth and the development of Italian nephrology.

Diseases of the kidney in medieval Persia the--Hidayat of Al-Akawayni

The centralization of socioeconomic resources following the rise of the Islamic empire in the 7th century nurtured an initial gathering and translation into Arabic of extant medical texts in Greek, Syriac, Hindu and Chinese. As Arabic became the lingua franca of scholarship, there followed a second period of assimilation, original observations, commentary and systematization of medical knowledge in Arabic texts, which became the basis of revival and learned medicine in the West in the 12th century. However, not all medical texts of the period were written in Arabic. As central power eroded, provincial principalities arose, and regional cultures flourished, medical texts began to be written in local dialects, particularly in Persia. Notable amongst those and probably the oldest is the Hidayat al-Muallimin fi-al-Tibb (Learner's; guide to medicine) written by Abubakr al-Akawayni al-Bokhari in the closing decades of the 10th century. Written in Farsi and dedicated to his son and other students of medicine, the Hidayat is a relatively short and simplified pandect of medicine at the time and provides a glimpse of the teaching of medicine of the period. The present article is a translation of the sections of the Hidayat related to the kidney and urinary tract and their diseases. These early writings provide insight into the care of patients with kidney disease during the Middle Ages in general, and in Persia in particular.

Lessons in medical humanism: the case of Montaigne

Michel de Montaigne, the great French humanist and inventor of the personal essay, suffered from frequent and severe renal colic. He wrote about his illness in his travel journal and in his last and greatest essay, "Of Experience." In his illness narratives, Montaigne integrated disease and suffering into his life and art. He humanized rather than conquered his disease. A mature humanism replaced his youthful Stoic philosophy of detachment and disengagement and provides a worthy model for our own medical humanism.

Sir Robert Christison (1797-1882): the man, his times, and his contributions to nephrology

Sir Robert Christison was a professor of Medicine in Edinburgh for 50 years, and twice President of the Royal College of Physicians there. Despite this, few modern descriptions and assessments of either him or his work have been published. In particular, his major work in the field of renal disease, which allows him to be considered one of the fathers of nephrology, has been almost completely forgotten, even in Scotland. In this paper, Christison and his work in renal disease are described, trying to place his sometimes apparently paradoxial views and actions as a physician in the context of a man who lived across major changes in medicine.

[The classics of Italian nephrology: the monograph ''Le nefropatie'' (Renal diseases) 1880-1946]

This paper, the first of the new feature ''The Classics of Italian Nephrology'', describes the monograph published in 1940 ''Le nefropatie. Manuale per i medici e studenti'' (Renal Diseases. Handbook for Doctors and Students). It was written by Adolfo Ferrata (1880-1946), who is remembered today for his important contributions to the advancement of hematology. The book, which has more than 400 pages and many illustrations, especially of pathologic anatomy, is the product of teamwork involving several pupils and coworkers of Ferrata. It describes all aspects of medical renal diseases known at the time, and from an historical viewpoint represents an interesting testimony of the nephrological practice in Italy in the 1940s.