(Developments in Nephrology. Vol. 33.) Edited by Carl M. Kjellstrand and John B. Dossetor. 235 pp., illustrated. Boston, Kluwer Academic, 1992. $108.50. ISBN 0-7923-1625-8.
In 1960, kidney doctors lost their innocence. Prioritizing,rationing, and exclusion, before 1960, were words alien to thelexicon of renal medicine. Before that year, except for patientstreated by Alwall in Lund, Sweden, and Merrill in Boston, whoapplied hemodialysis to acute renal failure, the diagnosis ofuremia meant death in days or weeks. Proposals for repetitivehemodialysis in patients with uremia were termed "unethical"and "cruel" and were considered needlessly stressful for patientand family in protracting the inevitable. I recall being taughtthe use of magnesium sulfate and chloral hydrate injectionsto mute agonal uremic seizures. Physicians . . . [Full Text of this Article]
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