The stage was set for the remarkable achievements of Richard Bright (1789-1858). Bright was born in Bristol and the family home was later at Ham Green, a few miles west of the city. (The first dialysis unit for Bristol opened at Ham Green Hospital in 1969, and the modern facility at Southmead Hospital, Bristol is today known as the Richard Bright Renal Unit.)
Stewart Cameron in the 1980s at 1, Queen Street, Bristol, Bright’s birthplace
Bright qualified in medicine in Edinburgh and then travelled extensively in Europe, particularly in Hungary, though he also found himself treating the wounded at the Battle of Waterloo in 1815.
A plaque erected in 1985 in Pecs, Hungary, 170 years after Bright visited there
Bright was appointed to Guy’s Hospital in 1820 and there began his seminal work published in his magisterial ‘Reports of Medical Cases’ in 1827 and 1831, which describe carefully observed clinical cases supported by beautiful illustrations of autopsy kidneys (most if not all painted by Bright himself).
From this work he made once and for all the game-changing connections previously missed that proteinuria and oedema were signs of kidney disease.
In gathering the data, Bright was crucially assisted by his little-remembered friend at Guy’s, the physician and chemist, John Bostock (1773-1846) [1]. As well as documenting proteinuria in Bright’s case, Bostock also noted low urine specific gravity, low urinary urea, low albumin the blood, and lipaemia. Thus by 1827 Bright and Bostock had described all the features of what we now know as nephrotic syndrome.
Bright also described in his cases ‘hardening of the pulse’ with cardiac enlargement, proposing that this may in some way be linked to the kidney disease. This of course many years before clinical measurement of arterial blood pressure was possible.
Bright 1827, discoverer of kidney diseases (historyofnephrology blog)
[1] Cameron JS. John Bostock MD FRS (1773-1846): physician and chemist in the shadow of a genius. Am J Nephrol. 1994;14(4-6):365-70.
Last Updated on January 7, 2025 by neilturn