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June 25, 1982

Urinary Concentrating Mechanism: Structure and Function

JAMA. 1982;247(24):3364-3365. doi:10.1001/jama.1982.03320490060049

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This book, written jointly by an American physiologist and a German anatomist, presents a detailed account of the structure and function of the renal medulla, with particular emphasis on the manner in which the kidney elaborates a concentrated urine. It is a scholarly book, and the authors introduce their complicated subject by likening it to a Gothic cathedral. They remind us that what, in its completed, seemingly superhuman form, fills us with wonder and admiration was in fact built over many years, section by section, by the toil of ordinary, and often profane, human laborers. Our knowledge of the countercurrent mechanism is likewise being advanced by scientists erecting an elaborate scaffolding of new information and ingenious hypotheses without being able to visualize clearly what the cathedral will look like in its complete form. But John Ruskin, by no means a stranger to cathedrals, might have also compared this book to