Croonian Lecture: A new conception of the glomerular function

Abstract

I have chosen as the subject of this lecture the physiology of the kidney, and more particularly the mode of action of one part of it, namely the glomerulus. In 1906, at the meeting of the British Medical Association in Toronto, I brought forward a new conception of the action of this very characteristic portion of the renal apparatus, and since that time have been accumulating a considerable mass of evidence by the light of which my theory can be criticised. Very shortly after the discovery of the main details of the structure of the kidney, Ludwig, basing his ideas upon the then known structure, put forward his well-known theory that the glomerulus was a filter, and since that time all discussions upon renal activity have centred round this theory because it offered an explanation of the mode of action of one part of the mechanism upon hydrodynamic principles. The necessary corollary following from this assumption of filtration is that a considerable degree of absorption must be effected as the dilute filtrate travels down the tubule, and how excessively great this must be was first pointed out by Heidenhain.