Last update:
08-Sep-2020

Canadian physician Rowntree's crucial participation in the first in vivo haemodialysis in 1913 at the Johns Hopkins Hospital Baltimore US, under the direction of John Jacob Abel, was only one of Rowntree's several major contributions to Nephrology. He had already pioneered, aided by John T. Geraghty, a renal function test using injection of phenolsulphonephthalein (PSP) and its detection in the urine, which was used clinically for half a century. Rowntree used a dye dilution technique also to study plasma volume in normal circumstances and in patients, including those with renal disease. He moved to Minneapolis in 1915 and there worked on water overload and hyponatraemia, and on the hydrogen ion concentration in the blood using a buffer method that he set up. Then, late in the First World War, he worked in France on aviation medicine, assessing physiological and psychological suitability in potential pilots. After the war, of several choices, he accepted the chair of medicine in the prestigious Mayo Clinic, to supervise and set up new clinical research programmes. There, early on, he participated with Osborne in the first use of iodide to obtain X-ray images of functioning kidneys (the intravenous urogram, IVU), which is still in use, later studying the clotting of blood in extracorporeal circuits, described the histology of acute lupus nephritis with Norman Keith, and worked on oedema in renal and other patients. Finally, he did early work on adrenal cortex extracts and was a pioneer of the treatment of Addison's disease, hitherto fatal. During this time at the Mayo Clinic from 1921 to 1932, he used his experience from the Johns Hopkins Hospital to organise and staff eight subspecialty medical units, including one in renal medicine, all of whose contributions remain outstanding today. However, he fell out with the Mayo clinic, left in 1931 and returned to Philadelphia University, near where he had started from. During the Second World War, he served as director of a unit assessing men for service in the armed forces as well as their rehabilitation – work for which he received a Presidential citation from Harry S. Truman in 1946. Throughout his whole working life, he continued to publish steadily on clinical and research subjects, for example the more than 100 papers in the 1920s whilst at the Mayo clinic, a remarkable record for the period. His last paper appeared shortly before his death in 1959, 50 years after he had first published as a general practitioner in Camden, New Jersey.

Key words: Addison's disease, Aviation medicine, History haemodialysis, Intravenous urography, Leonard George Rowntree, Phenolsulphonephthalein injection, Renal function tests.