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Bright's Disease

1911 Encyclopedia Britannica

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A term in medicine applied to a class of diseases of the kidneys (acute and chronic nephritis) which have as their most prominent symptom the presence of albumen in the urine, and frequently also the coexistence of dropsy.

These associated symptoms in connexion with kidney disease were first described in 1827 by Dr Richard Bright (1789-1858). Since that period it has been established that the symptoms, instead of being, as was formerly supposed, the result of one form of disease of the kidneys, may be dependent on various morbid conditions of those organs (see Kidney Diseases). Hence the term Bright's disease, which is retained in medical nomenclature in honour of Dr Bright, must be understood as having a generic application.

The symptoms are usually of a severe character. Pain in the back, vomiting and febrile disturbance commonly usher in the attack. Dropsy, varying in degree from slight puffiness of the face to an accumulation of fluid sufficient to distend the whole body, and to occasion serious embarrassment to respiration, is a very common accompaniment. The urine is reduced in quantity, is of dark, smoky or bloody colour, and exhibits to chemical reaction the presence of a large amount of albumen, while, under the microscope, blood corpuscles and casts, as above mentioned, are found in abundance.

This state of acute inflammation may by its severity destroy life, or, short of this, may by continuance result in the establishment of one of the chronic forms of Bright's disease. On the other hand an arrest of the inflammatory action frequently occurs, and this is marked by the increased amount of the urine, and the gradual disappearance of its albumen and other abnormal constituents; as also by the subsidence of the dropsy and the rapid recovery of strength.

In the treatment of acute Bright's disease, good results are often obtained from local depletion, from warm baths and from the careful employment of diuretics and purgatives. Chronic Bright's disease is much less amenable to treatment, but by efforts to maintain the strength and improve the quality of the blood by strong nourishment, and at the same time by guarding against the risks of complications, life may often be prolonged in comparative comfort, and even a certain measure of improvement be experienced.