relevance of proteinuria to tubular degeneration, which Addis considered "the central mystery of the disease."

The book Glomerular Nephritis: Diagnosis and Treatment (1948, 4) is a synthesis of over thirty years of work by Addis and his co-workers at Stanford's Clinic for Renal Diseases. His colleague Arthur Bloomfield felt that the book would "perhaps interpret the man to his followers better than anything else he has done." To those who had been close to Addis's work over the years, little in the book would be particularly new. Many of its conclusions were based on papers published in the preceding years. However, Addis clearly felt that he had finally accumulated enough data and clinical experience to present a case for the broader clinical adoption of the diagnostic and therapeutic methods he had perfected over decades. "For no matter how well supported by reason and buttressed by fact a new method of treatment may be, there is no sure foundation for clinical action other than clinical experience."

The book has a strongly philosophical tone and thus also serves as a vehicle for an exposition of Addis's philosophy of clinical medicine and scientific research. In addition, Richard W. Lippman has stated that, "The thread of his concern with political philosophy is to be found in all his writing in later years, most notably in the book 'Glomerular Nephritis'." Although perhaps only implicit in its formulation, Addis's political and social philosophy can clearly be recognized in the book, especially in his description of the social organization of work at the clinic. Another remarkable feature of this work is its literary grace and power. It is a masterpiece of both critical reasoning and pathos. Belding Scribner, a former student in Addis's lab and one of the founders of hemodialysis, has said that to this day the syllabus given to the new nephrology fellows in his division starts with the last chapter of Addis's book.

The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement