By J. Stewart Cameron
This e-book tells the extreme tale of ways the functionality of the 1st- and up to now virtually the one- human organ was once changed through a computer, and the ''artificial kidney'' entered clinical and public folk-lore. a realistic articial kidney, or dialyser, got here by means of advances in technological know-how by way of the purchase of latest artificial fabrics which made the appliance of those rules attainable. but it used to be the commitment and patience of a couple of proficient pioneers who pressed forward opposed to expert oppostion to be successful, first within the therapy of transitority, recoverable kidney failure, after which everlasting renal shut-down which made it successful. the obvious excessive rate and constrained availability of this way of remedy instantly raised moral questiond which had by no means been puzzled sooner than, centering round fairness of entry to therapy, whilst and if remedy can be denied, and- worst of all- the agonising selection of while, as soon as confirmed, it may be stopped. Spiralling expenditures because the precise variety of individuals with kidney failure turned obvious raised significant political and fiscal questions, which have been addressed in several international locations in several methods which mirrored- but additionally helped switch- styles of the way remedy is supplied. In constructed international locations, the matter can be solved by means of allocating a disproportionate amount of cash to the therapy of fairly few kidney sufferers, yet within the constructing international the price of therapy nonetheless limits its availability, because it does all varieties of smooth future health care. however, this day nearly 1000000 humans world-wide are maintained alive following terminal kidney failure, thirds of them through a variety of varieties of dialysis and the rest bearing kidney transplants, quite often positioned after a interval on dialysis. the tale can be the sum of the customarily heroic lives of those thousands of sufferers, some of whom have this day been maintained alive and energetic for greater than 35 years, and plenty of of whom suffered recognized, but additionally unforeseen problems because of their remedy.
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Additional info for A History of the Treatment of Renal Failure by Dialysis
Three volumes and atlas. 21. Piorry PA. Traité de Médecine pratique, Vol. III, Chapter XII, nos 4430–40. Ballière, Paris, 1847. For a biography of Piorry, see: Sakula A. Pierre Adolph Piorry (1794–1879): pioneer of percussion and pleximetry. Thorax 1979; 34: 575–81 (his most famous work was on respiratory diseases). 22. Picard J. De la présence de l’urée dans le sang. Thesis, Strasbourg, 1856. Cited in Richet [1,3]. 23. Frerichs T. Die Bright’sche Nierenkrankheit und deren Behandlung. Vieweg & Sohn, Braunschweig, 1851.
From this mass urea was extracted by alcohol in so pure a condition as to appear in crystalline tufts upon the evaporation of the alcohol. 27 28 A HISTORY OF THE TREATMENT OF RENAL FAILURE BY DIALYSIS Fig. 4 One of Graham’s many dialysis apparatuses. This one is based on a simple hoop, with the membrane separating two solutions. ) The history of dialysis is but one of many areas of medicine demonstrating the application of science to a clinical problem. One can assert with confidence that the basic science underlying clinical dialysis was virtually completed with Graham and Piorry’s work around 1850–1860, together with its molecular and mathematical refinement by the Dutchman Jacobus Henricus Van’t Hoff (1852–1911) in 1887 .
1. Paris, 1733: 37. 9. Rouelle le Cadet H. Observations sur l’urine humaine et sur celle de vache et de cheval comparées ensemble. J Med Chir etc. 1773; 60: 451–68. 10. Fourcroy AF, Vauquelin N. Mémoire pour servir à l’histoire naturelle chimique et médicale de l’urine humaine. Mém Insitut 1797; 2: 431 (4 Avril). 11. Fourcroy AF, Vauquelin N. Premier mémoire pour servir à l’histoire naturelle, chimique et médicale, de l’urine humaine contenant quelques faits nouveaux sur son analyse et son altérations spontanée.
A History of the Treatment of Renal Failure by Dialysis by J. Stewart Cameron