754 THE URINARY TRACT. 



not infrequently death, could be produced, leading pathologists have retained 

 the designation "Morbus Brightii," and distinguished it from nephritis. 

 Thus, C. Eokitansky* separates nephritis from Bright's disease. P. Eayer,t 

 and subsequently B. Beinhardt,1: described Bright'^ disease as a diffuse exu- 

 dation into the renal tissue. Frerichs likewise regarded the designation 

 "inflammation of the kidney "as insufficient, and retained the customary 

 name of " Bright's disease." Virchow || was the first to speak of a catarrh of 

 the urinary tubules, and to know that the catarrh could increase to croup 

 that is to say, to the formation of a fibrinous exudation in the urinary tubules. 

 According to him, croup of the urinary tubules is a severer degree of catarrhal 

 inflammation. As a third form he adopts " parenchymatous inflammation" 

 of the kidney, which depends essentially on a change in the epithelial cells. 

 In his opinion, catarrhal, croupous, and parenchymatous inflammation can 

 attack the kidney simultaneously, and for this condition he wishes to retain 

 the name of " Bright's disease." Herewith, the way was prepared for the 

 idea that Bright's disease is an inflammatory process, and this view was sub- 

 sequently adopted by the following authors : S. Eosenstein,1f who speaks of a 

 catarrhal and of a diffuse nephritis ; furthermore, William Aitken l and J. 

 Hughes Bennett. 2 Aitken distinguishes two varieties of inflammation of the 

 kidney, in Virchow's sense, namely, the interstitial, in which, principally, 

 the connective-tissue stroma is diseased, and the parenchymatous, in which 

 the urinary tubules are mainly affected. T. Grainger Stewart 3 divides this 

 disease into an inflammatory, an amyloid, and a cirrhotic form. Ed. Eind- 

 fleisch 4 declares premature the attempts of Eayer, Foerster, and others to 

 draw sharp lines between a simple albuminous, a parenchymatous, an inter- 

 stitial, and a croupous nephritis. He speaks of a desquarnative catarrh, of an 

 acute parenchymatous nephritis, under which latter head he distinguishes 

 between a circumscribed purulent, and a diffuse, non-purulent form. In 

 addition, he speaks of a combination of parenchymatous and interstitial 

 nephritis. C. Heitzmann 5 asserts that the picture of Morbus Brightii drawn 

 by Eokitansky includes two different forms, namely, croupous and intersti- 

 tial nephritis. According to him, the characteristic anatomical feature of 

 interstitial nephritis is the striation of the more or less swollen cortical sub- 

 stance ; while the characteristic feature of croupous nephritis depends on the 

 diffuse infiltration, superadded to the inflammatory swelling and redness. C. 

 Bartels B divides the diffuse diseases of the kidney into hypersemia, ischemia, 

 parenchymatous inflammation, interstitial inflammation, and amyloid degen- 

 eration. 



This much is clear at the present day, that the designation " Bright's 

 disease" must be dropped as being altogether unscientific. Virchow's 



' Handlmch der Pathol. Anatomie," 1861, 3 Aufl. 

 t 'Traite des Maladies des Reins," Paris, 1840. 

 t ' Anualen des Charite Krankenh., Berlin, 1850. 



2 'Die Bright'schen Nierenkrankheiten und Hire Behaudluug," Braunschweig, 1851. 

 || ' Ueber parencli. Entziind." Virchow's Arcliiv, 1852. 

 II ' Die Pathol. und Therap. der Nierenkrankheiten," Berlin, 1870. 



1 ' Science and Practice of Medicine," London, 1863. 



2 ' Principles and Practice of Medicine," Edinburgh, 1865. 



3 'A Practical Treatise on Bright's Diseases of the Kidneys," Edinburgh, 1871. 



4 'Lehrbuch der Pathologischen Gewebelehre," 3 Aufl., Leipzig, 1873. 



5 Ueber Tuberkelbildung. Wiener Med. Jahrb., 1874. 



6 " Krankheiten des Harnapparates in /ierassen's Handbuch der spec. Pathol. und 

 Therap." Leipzig, 1871. 



