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June 24, 1905


JAMA. 1905;XLIV(25):1979-1982. doi:10.1001/jama.1905.92500520007001b

THE MODERN CONCEPTION OF BRIGHT'S DISEASE.  The determining feature of Bright's disease is high arterial tension, with resulting cardiovascular changes. The latter lead to nutritional disorders in various parts of the body, and particularly in those organs that are supplied by end-arteries, viz., the kidneys, retina and brain.The old idea that in Bright's disease the kidneys are always primarily involved, and that as a result of renal inadequacy certain toxic products are retained that produce the cardiovascular changes and the eye and brain symptoms, is untenable, for many cases of Bright's disease occur in which the kidneys are not involved until very late in the course of the disease, long after cardiac hypertrophy, retinitis, albuminurica and brain symptoms have appeared.True, there are many infections and intoxications of an acute character in which the kidneys are primarily affected. Most of these nephritides, however, run their course without any involvement of the heart, the arteries, the retina or the brain.

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