The Scientific Revolution—The Kidney and Nephrology in and about the Seventeenth Century (Part 1)

Abstract

In the history of the evolution of the medical sciences, it is in the 17th century that the conscious, deliberate, and systematic study of the workings of the human body began. It was a product of the radical changing attitudes of this insurgent century when mathematical reasoning and mechanistic philosophy replaced the teleological outlook of earlier times. It was then that meticulous observation, reproducible quantification, experimental validation, and mathematical exactitude in the quest for truths launched the Scientific Revolution. The effect on medicine was a transformative change from a descriptive to an explanatory body of knowledge during the course of which rigorous anatomical dissections were used for the mechanical explanation of organ function, when morbid changes observed at postmortem began to be related to clinical features of disease, and when the secretive analytical methods of alchemy began to be refined for the study of chemical changes in living matter. Essentially what began with meticulous observations of anatomical features begat physiology and laid the foundations of pathology and chemistry. As a result, studies of organ structure, function, and changes in disease in general, and of the kidney in particular, were clarified and progressed at a rate never achieved theretofore.

Introductory Chapter: Modern Diagnostics with the Ancient History

“…Andreas Vesalius, the Belgian anatomist, and Roman Bartolomeo Eustachio working separately at more or less the same time, based their discoveries on direct observations of humans' and dogs' kidneys. Their meticulous work allowed them to correct many of the mistakes of their predecessors (and still, they had different results regarding some of the anatomical features of analyzed kidneys, e.g., the position of the right and left one in the human body) when it comes to the anatomy of the kidney [11]. Where Vesalius and Eustachio were quite ignorant of the function of the kidney itself [12], Neapolitan physicist and mathematician Giovanni Borelli was vitally interested in mechanisms explaining the mechanics of the body, among them kidney functioning, stating that the kidneys play the role of sieve filtering blood and excreting the elements which need to be eliminated [11].…”

“…Their meticulous work allowed them to correct many of the mistakes of their predecessors (and still, they had different results regarding some of the anatomical features of analyzed kidneys, e.g., the position of the right and left one in the human body) when it comes to the anatomy of the kidney [11]. Where Vesalius and Eustachio were quite ignorant of the function of the kidney itself [12], Neapolitan physicist and mathematician Giovanni Borelli was vitally interested in mechanisms explaining the mechanics of the body, among them kidney functioning, stating that the kidneys play the role of sieve filtering blood and excreting the elements which need to be eliminated [11]. Marcello Malpighi and Lorenzo Bellini, other renowned physicians, who were additionally armed with magnifying lenses and microscopes, were able to perform even more detailed observations of renal structure and function, especially Malpighians' body of the kidney [13].…”

“…Marcello Malpighi and Lorenzo Bellini, other renowned physicians, who were additionally armed with magnifying lenses and microscopes, were able to perform even more detailed observations of renal structure and function, especially Malpighians' body of the kidney [13]. Bellini, Borello, and Malpighi though, even with all the advances in their observations, still believed that urine is created in purely mechanistic or hydraulic ways [11,14]. The concept of ultrafiltration as the means of urine formation was first described by Archibald Pitcairne, even though it was properly termed almost 150 years later [11].…”

“…Bellini, Borello, and Malpighi though, even with all the advances in their observations, still believed that urine is created in purely mechanistic or hydraulic ways [11,14]. The concept of ultrafiltration as the means of urine formation was first described by Archibald Pitcairne, even though it was properly termed almost 150 years later [11]. The final touches to the kidney anatomy and function were added by William Bowman, who, armed with a microscope far better than Malpighi's and Bellini's described the existence of Bowman capsule surrounding the Malpighi's body.…”

Beginnings—The Kidney and Nephrology in Ancient Mesopotamian Culture

“…In preparing previous articles in this series on the medical history of the kidney a question that kept recurring was when and how did it all begin? Exploring the issue of beginnings assumed primacy while preparing the last article in the series on the Scientific Revolution, when it became increasingly evident that it is only after the 17th century that scientific medicine in general, and the study of the kidney in particular, actually began; most of what had preceded it was mainly a gradually expanding empiric body of knowledge that to a great extent was repetitive and transmitted authoritatively in what was the dogmatic medicine of the past (1). With that in mind, and without delving into a planned second part article on the Scientific Revolution, I decided to further explore the question of beginnings.…”