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      Ippolito Albertini and Michael Albertus: Disparate Old and Innovative Theories on Dropsy and Edema

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      American Journal of Nephrology

      S. Karger AG

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          Abstract

          The concept of edema and dropsy as a part of heart and renal failure developed in the 17th and 18th centuries with the observations of Albertini, who realized that two clinical entities were derived from the blood rather than the tissues. Albertus, who lived in the same period, was the last physician to interpret fluid accumulation according to the old, scholastic and dogmatic procedures of medicine. The fundamental concepts of Albertus held little in addition to the classification and categories of the physicians of the Middle Ages. Bloody congestions were distinguished from stagnation: the former have the purpose of reducing superfluites of blood and occurred in plethoric patients. Plethora in turn is caused by the ancient villain, inculpated since Hippocrates and Galen: suppressed hemorrhoids, suppressed menstrual evacuation and cutaneous eruption driven inward. Because of its suppression, transfer of blood occurs toward the chest, which impedes thoracic expansion and contraction, then asthma and dyspnea occur. On the contrary, Albertini with his clinical and autoptic observations and pronouncements filled in the anatomical and clinical picture of fluid accumulation and created the rudiments of diagnostic criteria. Edema, dropsy, asthma, dyspnea were, according to Albertini, the signs and symptoms of heart and renal failure. Albertini was the first to point out that dyspnea is apt to arise with special rapidity when a lesion occurs in the left atrial chamber and ventricle and by implication the mitral valve. In modern physiopathological terms, he discovered the picture of pulmonary edema. To this important discovery, he added a number of extremely important comments: changes in the respiratory organs are secondary to changes in the cardiovascular system; edema that is accompanied by dyspnea also affects the viscera, most especially the lungs, and finally dropsy of the lungs must be differentiated anatomically and clinically from dropsy of the chest (hydrothorax). In other words, he depicted the anatomical and clinical picture of congestive heart failure in modern terms.

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          Author and article information

          Journal
          AJN
          Am J Nephrol
          10.1159/issn.0250-8095
          American Journal of Nephrology
          S. Karger AG
          978-3-8055-7424-2
          978-3-318-00852-4
          0250-8095
          1421-9670
          2002
          July 2002
          27 June 2002
          : 22
          : 2-3
          : 220-224
          Affiliations
          Department of Internal Medicine – Nephrology and Dialysis, Teaching Hospital of Foligno, Italy
          Article
          63765 Am J Nephrol 2002;22:220–224
          10.1159/000063765
          12097744
          © 2002 S. Karger AG, Basel

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          Page count
          Figures: 2, References: 14, Pages: 5
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/63765
          Categories
          Origins of Nephrology – The Modern Era

          Cardiovascular Medicine, Nephrology

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