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This still leaves large amounts of water and waste materials to be taken away by the kidney. Probably most of you think of the kidney as the sewage disposal bed of the body. It is that, giving off impure water daily in amounts anywhere from several pints normally to many quarts in certain diseases. It is so much more, however, that an eminent scientist friend of mine starts his discussion of it with “a word of praise for that admirable organ, the kidney.”
It is carefully placed in a well-protected position up against the heavy muscles about the spine, overhung by the lower ribs, and with the “innards,” or viscera, in front. Therefore, it is not often accidentally injured, as are the spleen, intestines, and bladder. Short of being struck by a bullet, it is rarely seriously enough injured to require removal.
This talk so far has been about “the” kidney, for although it is unusual not to have two, a description of one will fit them both. As a matter of fact, there are really about two million. Inside the tough capsule of the kidney are enormous numbers of “nephrons,” which is just Greek for kidneys. Each one of these is complete in itself, doing its full share of the work.
Over a century ago, Sir William Bowman, using a microscope and a needle, dissected one of these nephrons. Each begins with a glomerulus. This is a minute coil of blood vessels, surrounded by a sack called Bowman’s capsule. So Bowman’s name goes ringing down the halls of fame with Alexander the Great, Napoleon, and Hitler. Unfortunately, the high pitch of men like him is rarely perceived by human ears.
At these glomeruli, fluid and waste products are filtered out from the blood, and flow from Bowman’s capsule into a fine tube remarkably twisted and coiled like our intestines. Finally the contents of these millions of tubes are passed as urine.
All these tubes discharge into a sac called the pelvis of the kidney which is on the inner side towards the spine. There is no way of describing the shape of the kidney except by saying that it is kidney shaped, or like a kidney bean. Certainly there are numerous ponds here and there in the country called Kidney Ponds because of their shape. Everybody knows where the kidneys are located as shown by the “kidney blows” of pugilists and the success of patent medicine dealers in selling kidney pills to people with lame backs. Sick kidneys may cause many symptoms, but back pains are the least important of these.
Usually the kidney cannot be felt by the examiner except on the right side of a thin woman. This kidney always lies lower because of the big liver and sometimes it moves around so freely that it is called a “floating kidney.” We used to stitch it up in place but I think that is rarely done now. If the patient accumulates some fat, that will usually keep it where it belongs. The blood supply of the kidney is profuse, for the blood has to be worked over thoroughly and frequently for the removal of impurities. The renal artery is a short large vessel leading from the aorta right to the kidney; therefore, there is little obstruction to the passage of the arterial blood to it and, hence, the blood pressure remains high there. About a quart of blood goes to the kidney every minute.
Practically all of the blood goes to the little glomeruli. I believe that it is generally accepted now that the glomerulus acts as a filter and extracts from the blood water and other products and does not take out the protein of the blood. There are a number of ingredients in the blood that have to be delicately adjusted, such as sodium, potassium, magnesium, calcium, phosphates, etc. All this is an intricate, important, chemical balance, which the kidneys maintain by reabsorbing through the walls of their little tubes just the right amount of these materials to serve the body’s needs, and discard the rest along with the harmful waste products.
You do not need to be told that certain things increase the flow of urine – chief among these is the drinking of large quantities of water. Caffeine and alcohol also are diuretics. (A diuretic is our medical term for a substance which increases the flow of urine.) It is notorious that beer drinking causes increased urination due to the intake of great bulk of water combined with the effect of alcohol.

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