The Roscoe R. Robinson History of Nephrology Collection
Richard Bright, M.D. 1789-1858 Father of Nephrology
Bright's Scientific Work
Richard Bright appeared on the medical scene at an intriguing time. Medicine was shaking off the bonds of tradition; ancient authorities, age-old theories and practices were being seriously questioned.The humoral theory was losing ground; blood-letting was falling into disrepute.The almost forgotten Hippocratic idea that diesase was due to some natural cause was reappearing, and the cause was being sought.
Auenbrugger in the eighteenth century and Laennec in the early 19th century had started to correlate the physical findings of the chest with the underlying pathology. Bright was to do the same with some kidney diseases. Physicians were thinking for themselves, not blindly following the ancient dogmas.
Richard Bright could easily have qualified for the title of gentleman and scholar, for he was both. His early writings of his travels in Iceland and Hungary, on geology and natural history showed that he possessed a lively curiosity, an excellent power of careful observation, and an ability to write clear, concise material. Bright started at Guy's in 1820 spending six hours a day lecturing on the wards and in pathology. He soon noted the connection of organic changes in the structure of the kidney "and the secretion of albuminous urine, more or less coagulable on the application of heat" in a dropsical patient. In the three years, 1825-1827, he saw twenty-three cases which showed albumin in the urine; over one-half died, and all showed disease in the kidneys. These and other finding were published in 1827 by Longman Ries of London, Reports of Medical Cases Selected with a View of Illustrating the Symptoms and Cure of Diseases by a Reference to Morbid Anatomy. It was this book that first described "Bright's disease," and initiated his rise to fame as the father of Nephrology.
In the spring of 1842, the authorities at Guy's set aside two clinical wards of twenty-one beds each for six months for Dr. Bright to carry on intensive study of renal disease; there were included in this area a small clinical laboratory, a consulting room, and office. This was the first clinical experimental unit established in England. The results were reported in Guy's Reports for 1843 by Bright's associates, G.H. Barlow and G.O. Rees.
Richard Bright's research interests included not only renal disease, but also pulmonary diseases, various fevers, abdominal tumors, heart disease, liver, pancreas, and duodenum. He and Thomas Addison lectured at Guy's on the "Theory and Practice of Medicine" for twenty years, and in 1839 published the first volume of Elements of the Practice of Medicine. The second volume was never published. Bright was Gulstonian Lecturer in 1833, and in 1837 delivered the Lumleian Lectures on disorders of the brain. He was a multi-talented man who very definitely earned the memorial which was erected to him at St. James's Church Piccadilly. This tribute reads: He contributed to medical science many discoveries and works of great value, And died while in the full practice of his profession, After a life of warm affection, unsullied purity, and great usefulness. Dr. Richard Bright was truly the right man, in the right place, at the right time.