From the Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas. Edited version of a video transcript of internal medicine grand rounds, presented at Baylor University Medical Center on April 28, 1998. Corresponding author: John S. Fordtran, MD, Department of Internal Medicine, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, Texas 75246. 184

In 1898, Tigerstedt and Bergman published their observation that kidney extracts produce pressor effects. They characterized the substance and named it "renin." Although this was the beginning of understanding the role of the kidney in hypertension and the renin-angiotensin system, their discovery lay dormant for nearly 40 years.

In Volume 4 of the Bristol Med-Chi Journal (1886)1 we find a report of a 13 year old boy who developed abdominal pain in the right iliac fossa. He was anorexic, had vomited and was noted to be pyrexial; examination revealed tenderness localised to the right iliac fossa. Treatment was conservative with turpentine, castor oil and local poultices. When he failed to improve over the next three days...