Yesterday I mentioned Ludwig Eichna. One of his great contributions to medical pathophysiology was the delineation between congestive heart failure and a congestive state. He built on the ideas of John Peters at Yale. Peters observed that while all measurable fluid compartments in patients with CHF were expanded their kidneys acted as if volume were contracted. He then propounded the concept of effective arterial blood volume (EABV). Patients with CHF have a contracted EABV which explains their salt and water retention.
The concept of EABV was disseminated by Peters’ great student Donald Seldin of Southwestern Medical School in Dallas and in turn by Seldin’s many students who exerted (and still do) a great influence over modern nephrology.
The article below examines the difference between CHF and a congested state using acute salt-retaining glomerulonephritis as an example of the latter. Physicians often have trouble making this distinction though once the concept of EABV is firmly grasped it’s not difficult.