|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 edema, the presence of albumin in the urine and was frequently accompanied by high blood pressure (hypertension) and evidence of 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 sign 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 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.
Bright's disease was a plot element in one of the early Dr. Kildare films (1945, Between Two Women). Sally (Marie Blake), the hospital switchboard operator, falls ill to a mysterious ailment and, fearing it is cancer, avoids treatment until Dr. Randall "Red" Adams (Van Johnson) correctly diagnoses it and operates on her kidney.
Frederick William Faber died of Bright's disease on 26 September 1863.
Ellen Axson Wilson, first wife of Woodrow Wilson, died of Bright's disease on 6 August 1914. Less than a year later, in June 1915, the condition would claim the life of one of history's greatest cricketers, Australian batsman Victor Trumper.
George-Étienne Cartier, Founding Father of the Confederation of Canada, also died of this disease on 20 May 1873. Chester Alan Arthur, 21st President of the United States, died of this disease in 1886.
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