History of Urology Forum
Scott Wiener, MD
University of California San Francisco
Presentation Authors: Scott Wiener*, David Bayne, Thomas Chi, Marshall Stoller, San Francisco, CA
Introduction: The purview of the urologist is the collecting system, while that of the nephrologist is the nephron. Jean Redman Oliver, a pathologist, born in 1889, was uniquely able to bridge this gap through meticulous dissections, hand drawn illustrations, and experiments which underpin our current understanding of renal anatomy and physiology.
Methods: A review of the works and biography of Jean Oliver.
Results: Oliver was born and raised in Northern California, the son of a physician who had crossed the Great Plains in a covered wagon. He took up his studies at Stanford in 1908 and worked part time in the histology lab of Frank McFarland. Contemporary theories of renal physiology largely ignored the role of anatomy in nephron function; it was not until 1915 that Oliver and McFarland took to performing detailed microdissections of the nephron in an effort to better define this link. Oliver advanced to Assistant in Pathology studying anti-renal antibodies prior to World War I. He then served in the American Expeditionary Forces, rising to Lieutenant-Colonel before returning as Faculty at Stanford. Oliver’s interest in heavy metal toxicity led to the first precise measurement of renal tubular diameters in 1924 and work in dye excretion in Bright’s disease was instrumental to understanding glomerular filtration and tubular transport. In 1929, Oliver became Chair in Pathology at the Long Island College of Medicine. He shortly thereafter gained notoriety for his skillful microdissections and illustrations, publishing a lengthy monograph on Bright’s disease with Stanford’s Thomas Addis. Later, during World War II, he contributed heavily to the understanding of blunt renal trauma and rhabdomyolysis in war casualties.
In 1949, Oliver gave the Ramon Guiteras Memorial Lecture entitled "When is the Kidney not a Kidney?". He believed there was an intellectual recidivism in the field of renal pathophysiology. He stressed that nephrons were a heterogeneous population, differing in length, shape, and therefore function, throughout the kidney as opposed to a homogenous filtration unit. Oliver’s opus, "Nephrons and Kidneys" marked the capstone in a remarkable career, including 25 plates in stunning detail, depicting the dissection of 18 fetal kidneys.
Conclusions: In the words of Thomas Addis, Oliver "sought with care for some measure of correlation between clinical and anatomical facts" for all his life and in the process made remarkable contributions which are now critical to our understanding of renal physiology and disease.
Source of Funding: None