Bright's Disease - Brights Disease

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).

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 a nd 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.

Treatment

Bright's disease was historically 'treated' with warm baths, abstinence from alcohol, cheese and red meat, blood-letting, squill, digitalis, mercuric compounds, opium, diuretics, and laxatives. Most of these treatments are in fact harmful to the patient. The disease was diagnosed frequently in diabetic patients. Arnold Ehret was diagnosed with Bright's disease and pronounced incurable by 24 of Europe's most respected doctors. He finally designed the The Mucusless Diet Healing System and cured himself. William Howard Hay, MD suffered from the illness and it is claimed cured himself using the Hay diet.

Historical accounts

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.

In chapter 11 of Dashiell Hammett's 1929 novel Red Harvest, a minor character, Myrtle Jennison, is "in the hospital ... dying of Bright's disease or something."

Ellen Wilson, first wife of Woodrow Wilson, died of Bright's disease on 6 August 1914.

References