|Diseased kidney from Richard Bright's Reports of Medical Cases Longman, London (1827–1831). Wellcome Library, London|
|Classification and external resources|
Bright's disease is a historical classification of kidney diseases that would be described in modern medicine as acute or chronic nephritis. It was characterized by swelling, 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, he described 25 cases of dropsy (edema) which he attributed to kidney disease. Symptoms and signs included: inflammation of serous membranes, hemorrhages, apoplexy, convulsions, blindness and coma. 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 autopsy. The triad of dropsy, albumin in the urine and kidney disease came to be regarded as characteristic of Bright's disease.
Subsequent work by Bright and others indicated an association with cardiac hypertrophy, which was attributed by Bright to stimulation of the heart. Subsequent work by 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.
It is now known that Bright's disease is due to a wide range of diverse kidney diseases; thus, the term Bright's disease is retained strictly for historical application. The disease was diagnosed frequently in patients with diabetes; 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, 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, MD had the illness and, it is claimed, cured himself using the Hay diet.
Historical accounts attributing deaths to Bright's disease
Frederick William Faber died on 26 September 1863.
American tennis pioneer Mary Ewing Outerbridge died at the age of 34, on May 3, 1886.
The poet Emily Dickinson died May 15, 1886.
Woodsman Louis "French Louie" Seymour died on February 28, 1915.
John Bunny, an American actor and one of the first comic stars of the early motion picture era, died on April 26, 1915.
Australian cricketer Victor Trumper died at age 37, in June 1915.
Charles Sumner Sedgwick, a prominent architect based in Minneapolis, Minnesota, died in 1922.
Baseball Hall of Famer Ross Youngs died on October 22, 1927.
Master of Science Fiction Horror, Howard Phillips “H. P.” Lovecraft, died from a combination of cancer and Bright’s Disease on March 15, 1937, at the age of 46.
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