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Bright's disease

Bright's disease is a historical classification of kidney diseases that would be described in modern medicine as acute or chronic nephritis. The term is no longer used, as diseases are now classified according to their more fully-understood etiologies. more...

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It is typically denoted by the presence of albumin (blood plasma) in the urine, and frequently accompanied by edema (tissue particulate).

These associated symptoms in connection with kidney disease were first described in 1827 by noted English physician Dr. Richard Bright. Since that time, 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. Thus, the term Bright's disease, which is retained in medical nomenclature in honor of Dr. Bright, must be understood as having a strictly historical application.

The symptoms are usually of a severe nature. Back pain, vomiting and fever commonly signal an attack. Edema, varying in degree from slight puffiness of the face to an accumulation of fluid sufficient to distend the whole body, and sometimes severely restrict breathing, is a very common ailment. The urine is reduced in quantity, is of dark, smoky or bloody color, and exhibits to chemical reaction the presence of a large amount of albumin, while, under the microscope, blood corpuscles and casts, as above mentioned, are found in abundance.

This state of acute inflammation may severely limit normal daily activities, and if left unchecked, may lead to one of the chronic forms of Bright's disease. In many cases though, the inflammation is reduced, marked by increased urine output and the gradual disappearance of its albumen and other abnormal by-products. A reduction in edema and a rapid recovery of strength usually follows.

Acute Bright's disease was treated with local depletion, warm baths, diuretics, and laxatives. There was no successful treatment for chronic Bright's disease, though dietary modifications were sometimes suggested.

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Ninety years ago: September, 1913
From Medicine and Health Rhode Island, 9/1/03

An Editorial lambasted the Providence Journal for advertising quack remedies: "While they fill their editorial pages with righteous indignation regarding the impure milk supply, the failure to safeguard the public by proper precautions against tuberculous [sic] and tainted meats, and the contamination of potable waters, they admit to their advertising columns ...praise of nostrums proven to be false in their claims, which are a menace to health and an actual cause of death. We do not exaggerate when we say that death following the excessive use of tonic drugs and like nostrums, or dependent upon the fact that reliance on their supposed virtues has prevented or delayed more efficiency measures, occurs twenty times to every one which may be ascribed to the common drinking cup, to contaminated milk...or tuberculous beef, and, indeed, to all the rest of the possible sources of infection which receive so much attention in this day of preventive medicine." The Editorial cited one page advertising a remedy for Bright's Disease, proclaiming a man of prominence in the community as "cured," while on the opposite page the Journal printed his obituary. Other remedies included Dean's Kidney Pills, Warner's Safe Cure, Monyan's Kidney Pills, Mothersill's Seasick Remedy, Kilmer's Swamp Root, Mercolized Wax, Artikamnia, and Hensen's Corn Salve (advertised as "Pink Pills for Pale People").

Harvey Winans Burnett, in "Dispensary Management of Infantile Malnutrition," discussed the difficult feeding cases seen at the outpatient department of Rhode Island Hospital. "Our histories always relate that often as many as 4 or 5 different kinds of proprietary foods have been used in connection with cow's milk, condensed milk appearing on many of the lists, and too often do we find a case...a baby two months previously has been deliberately taken from the full breasts of its healthy mother because "'the doctor said my milk did not agree with the baby, and nothing has agreed with it since.'"

Surgeon Robert A. Bachman, USS Delaware, in "Venereal Prophylaxis - Past and Present," traced the history of treatments for syphilis and gonorrhea. The Army in 1906 developed a system of prophylaxis: "Dr. Raymond made up a package ...an eye-dropper with argyrol solution, intended to combat gonorrhea; later he added calomel ointment. The scheme was too complicated to be successful from a practical point of view." The Navy "gave an exposed man on his return to the ship next morning...antigonoccic injections followed by inunctions of calomel ointment... Modified slightly...it was officially adopted in the Navy in 1908 and Army in 1909." Data from 1910-11 showed "the dispensing system of prophylaxis is not a decided success." Also, the United States Army, like the British Army, did not pay men while they were incapacitated with venereal disease - a measure that encouraged compliance with prophylaxis.

Copyright Rhode Island Medical Society Sep 2003
Provided by ProQuest Information and Learning Company. All rights Reserved

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