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Bright's disease

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Bright's disease
Diseased kidney from Richard Bright's Reports of Medical Cases Longman, London (1827–1831); Wellcome Library, London

Bright's disease is a historical classification of kidney diseases that are described in modern medicine as acute or chronic nephritis.[1] It was characterized by swelling and the presence of albumin in the urine, and was frequently accompanied by high blood pressure and heart disease.

Signs and symptoms


The symptoms and signs of Bright's disease were first described in 1827 by the English physician Richard Bright, after whom the disease was named. In his Reports of Medical Cases,[2] he described 25 cases of dropsy (edema) which he attributed to kidney disease. Symptoms and signs included: inflammation of serous membranes, haemorrhages, apoplexy, convulsions, blindness and coma.[3][4] Many of these cases were found to have albumin in their urine (detected by the spoon and candle-heat coagulation), and showed striking morbid changes of the kidneys at post-mortem.[5] The triad of dropsy, albumin in the urine and kidney disease came to be regarded as characteristic of Bright's disease.[3]

Subsequent work by Bright and others indicated an association with cardiac hypertrophy, which Bright attributed to stimulation of the heart. Frederick Akbar Mahomed showed that a rise in blood pressure could precede the appearance of albumin in the urine, and the rise in blood pressure and increased resistance to flow was believed to explain the cardiac hypertrophy.[4]

It is today known that Bright's disease is caused by a wide and diverse range of kidney diseases;[1][5][6] thus, the term Bright's disease is retained just for historical application.[7] The disease was diagnosed frequently in diabetic patients;[4] at least some of these cases would probably correspond to a modern diagnosis of diabetic nephropathy.



Bright's disease was historically treated with warm baths, blood-letting, squill, digitalis, mercuric compounds, opium, diuretics, laxatives[2][8] and dietary therapy, including abstinence from alcoholic drinks, cheese and red meat. Arnold Ehret was diagnosed with Bright's disease and pronounced incurable by 24 of Europe's most respected doctors; he designed The Mucusless Diet Healing System, which apparently cured his illness. William Howard Hay, had the illness and, it is claimed, cured himself using the Hay diet.[9]

Society and culture


List of people diagnosed with Bright's disease



  1. ^ a b Cameron, J. S. (14 October 1972). "Bright's Disease Today: The Pathogenesis and Treatment of Glomerulonephritis—I". British Medical Journal. 4 (5832): 87–90. doi:10.1136/bmj.4.5832.87. ISSN 0007-1447. PMC 1786202. PMID 4562073.
  2. ^ a b Bright, R (1827–1831). Reports of Medical Cases, Selected with a View of Illustrating the Symptoms and Cure of Diseases by a Reference to Morbid Anatomy, vol. I. London: Longmans.
  3. ^ a b Millard, Henry B. (1 January 1884). A treatise on Bright's disease of the kidneys; its pathology, diagnosis, and treatment . New York, W. Wood & Company.
  4. ^ a b c "A treatise on Bright's disease and diabetes: with especial reference to pathology and therapeutics". archive.org. Retrieved 23 July 2016.
  5. ^ a b Peitzman, Steven J. (1 January 1989). "From Dropsy to Bright's Disease to End-Stage Renal Disease". The Milbank Quarterly. 67: 16–32. doi:10.2307/3350183. JSTOR 3350183. PMID 2682170. S2CID 8806903.
  6. ^ Wolf G (2002). "Friedrich Theodor von Frerichs (1819–1885) and Bright's disease". American Journal of Nephrology. 22 (5–6): 596–602. doi:10.1159/000065291. PMID 12381966. S2CID 42309693.
  7. ^ Peitzman SJ (1989). "From dropsy to Bright's disease to end-stage renal disease". The Milbank Quarterly. 67 (Suppl 1): 16–32. doi:10.2307/3350183. JSTOR 3350183. PMID 2682170. S2CID 8806903.
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