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The first alarming reports about a new disease called "trench nephritis" affecting soldiers of the British Expeditionary Forces in Flanders appeared in British medical press in 1915th. Soon, the Medical Research Council initiated a special research investigation on trench nephritis at St. Bartholomews Hospital and the results of these studies were discussed during the Royal Society of Medicine meeting in February 1916. William Osler was invited as one of the four main speakers for this presentation. He had lived in England since 1906 and served as the Regius Professor of Medicine at Oxford. At the meeting, Osler summarizes the clinical presentation of trench nephritis as a sudden appearance of swelling with rare cases of anasarca. Fever was not a common early presentation in his experience. He found rapid improvement in most of the cases during hospitalization despite "persistence of a large amount of albumin, of blood, and of cast, with increasing high blood pressure, is an unusual combination in the nephritis of civil life, yet that has been common enough in these cases". He questioned the assumption of a good prognosis in trench nephritis especially in "Cases which are lasting from twelve to fourteen weeks, the chances are that it will become subacute or chronic".

The recent 90-year anniversary of the Battle of the Somme presents an opportunity to examine the public health response to the trench diseases, new conditions which arose in the trenches of World War I. Throughout history, there have been two views of epidemic disease: the configurationist and contagionist perspectives. Most doctors responding to the trench diseases, 'contingent-contagionists', combined these two conceptions of disease. Because of the difficulty of finding a causative organism and the absence of effective treatment, the majority view became that these conditions were a product of the trench environment. Configurationism, with its emphasis on environmental and social determinants, seemed to provide the most obvious approaches for tackling the trench diseases. The diseases were effectively controlled using the tools of public health science: sanitary discipline and a battery of measures, such as improving trench construction, improving the diet, providing protective kit, regular bathing and treating lice infestation. The response demonstrates the triumph of public health science over new medical technologies. It also illustrates the importance of considering all the many determinants of health and of close surveillance, discipline and partnership working to counter ill-health. Although technology, training, doctrine and health beliefs change over time, the interaction between disease and environment remains the core challenge to public health practitioners.

The nephritis is one of the common and detrimental diseases. This paper reviews the history of knowledge of nephritis, ancient and modern, and western and Chinese medicine, demonstrating that the continuous development of treatment of TCM and western medicine are all effective measures to combat nephritis.

From the beginning of the 20th century, cumulative experimental work has provided considerable evidence for the possible immune mechanisms by which certain diffuse glomerular diseases develop. The first classic well-documented studies are attributed to Masugi and his research team (1933), whose experimental model involved the induction of glomerulonephritis by the administration of antikidney sera. However, 23 years earlier, in 1910, Alexander Cawadias had published a monograph on the same subject, for which he was honored with the Medal of the Paris University School of Medicine. In his study, Cawadias concluded that the mechanism of experimental nephritis was multifactorial and that the progression and the aggravation of uremic disease was caused by the production of nephrotoxins and/or antibodies against renal tissue. Cawadias referred to 'a new colloid substance', a kind of autoantibody in the context of anaphylaxis; he can be credited with foreseeing the modern era of the autosensitivity and immunology of renal diseases. Although Cawadias is well-known as a pioneer of Neohippocratism, his contribution to experimental nephritis has not been amply appreciated; he merits better recognition as one of the pathfinders in the field of renal immunopathogenesis.

An epidemic of nephritis occurred among soldiers in World War I, predominantly those in the trenches. Characterized by the sudden onset of albuminuria, hypertension, edema, and dyspnea, atypical features such as bronchitis, an evanescent course, low early mortality, and frequent relapses distinguished it from poststreptococcal glomerulonephritis. Pathologic features included glomerular ischemia, capillary thrombi, endocapillary proliferation, and frequently epithelial crescents, suggesting an underlying vasculitis. The cause was not established, but a postinfectious, possibly postviral, etiology seems most plausible. Trench nephritis was the major nephrologic problem of World War I, accounting for 5% of medical admissions and more than 10% of military hospital bed occupancy at that time.