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December 3, 1927


JAMA. 1927;89(23):1968-1969. doi:10.1001/jama.1927.02690230052014

Certain types of disorder induced by renal insufficiency are usually designated as uremia. It is unfortunate that this name has received such widespread, continued acceptance; for it inevitably brings to mind a feature of the malady that has thereby attained undue prominence and probably retarded the discovery of the fundamental etiology of the more important symptoms. The knowledge that urea accumulates in the blood when the excretory function of the kidneys is suppressed is more than a century old.1 According to Foster,2 the classic discovery of Prévost and Dumas led Bright's associates, Prout and Babbington, to test the blood of patients having chronic interstitial nephritis. An increase of urea was detected—hence the name uremia. The additional, prejudicial, feature was that Bright believed urea to be a very toxic substance and the cause of some of the severe nervous disorders noted in the later stages of certain cases of