Forty Years of Nephrosis in Childhood

This article is an attempt to relate the present-day outlook on nephrosis in childhood with the 'natural history' of the disorder as it was seen at The Hospital for Sick Children, Great Ormond Street, in the days before modern treatment was available. The first period of the study is the responsibility of one of us (D.L.) and covers the years 1917-38. During the war years in-patient care of the children attending this hospital was widely dispersed and records are not always available. With the opening up of the hospital to more than a handful of patients in 1945 and the development of a new index system the study starts again and covers up to 1956-7. This period falls into two parts: for 1945-51 it had become possible to prevent and treat infection in children with nephrosis by means of sulphonamides and antibiotics; from 1951 steroids became available, at first in limited supply for selected cases, and in 1955 freely available for all cases as required.