Excerpt from Maryland Medical Journal, Vol. 42: A Journal of Medicine and Surgery; July 1, 1899 December 30, 1899 The discovery that in many cases of general dropsy, which are associated with the secretion of an albuminous urine, a primary affection of the kidneys must be regarded as the special cause of the disease, marked an epoch in medicine. Dr. Bright's discovery and the giving of it to the world in 1827 was valuable not only because it correctly interpreted for us the meaning of previously undefined symptoms, but because it directed attention to the kidneys, to the profound influence for evil which derangements of their functions occasioned and to the importance of an early recognition of their diseased conditions. These sixty-two years have been eventful ones in adding to our knowledge of the kidney and the vital part it has to perform in the economy. The association of the name of Dr. Bright with the kidney and its diseases would be eminently proper were there only a single diseased condition in which dropsy and an albuminous urine were to be found, but because this is not the case, great as the service has been, it seems more fitting that we should honor Dr. Bright in some other way and give to the diseases of the kidney such names as will convey, at least to some extent, an idea of the conditions believed to be present in that organ. As Bright's disease may mean acute and chronic parenchymatous nephritis, acute exudative nephritis, acute productive nephritis and chronic productive nephritis, with or without exudation, it is evident that the phrase is no longer a diagnostic one, and Dr. Tyson, in the last edition of his Practice of Medicine, gives it no place in the index, and has assigned it a secondary place among the synonyms. Recent investigators have devoted much time and thought in an effort to disentangle us from the confusion into which the nomenclature of diseases of the kidneys has been thrown; it has been their aim to secure such a grouping of the subjective and objective symptoms that, when found, these shall interpret the pathological kidney conditions as truly as the signs of a pneumonia interpret the lung changes. We derive our information in regard to the kidney changes from clinical pictures and an altered composition of the urine; the first furnish us with dropsy and uremia, the second with albumen and casts. We note these four because of their importance, but especially because the interpretation of their presence is still open to question in many cases, and we thought on this account an interchange of views might be of profit to us all. We recognize in dropsy an important diagnostic sign. Before the examination of the urine was resorted to to the extent it now is the appearance of edema was often the first clinical indication of a possible disease of the kidney. Dropsy, according to those eminent physiologists, Landois and Stirling, is not always a simple process, not always an escape of the watery elements of the blood from mere overdistended or too pervious blood-vessels, but it is complex. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.