Bright's disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.

It is typically denoted by the presence of serum 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 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.