Page:The New International Encyclopædia 1st ed. v. 03.djvu/577

* BRIGHTON. 503 BRIGHT'S DISEASE. The Dome, formerly the Royal Stables, also acquired by the town, has been turned into a niagnitkcnt concert-hall. The aquarium is world- famous. There are numerous theatres and music-halls. Brighton obtained its charter of incorporation in 18.i4. It sends two members to Parliament. The town owns its excellent water-supply, as well as its electric-light plant, which yickls a large profit. Among other municipal undertak- ings are public baths, markets, and slaugliter- houses. The town has numerous parks and pub- lic race-grounds. In addition to its numerous private schools, the town has a municipal school of science and technology, and one of art. a gram- mar school, a public library, and the Dyke Road Museum, containing a fine ornithological collec- tion. Brighton has no maritime trade. It is essentially a town for recreation and sea-batliing. There are several liospitals. including one for children, a blind and a deaf-and-dumb asylum. An electric street railroad connects Brighton with Kemp Town, and an electric shore road (over- head trollcv) with Rottingdean. Population, in 1891. 11.5,873; in 1901, 123,478. Brighton was an important place in the Sixteenth Century, when it was twice ravaged by the French. The sea. however, now covers the ground where old Brighton once stood. Consult: Siekleniore, History of Brighton (Brighton. 1827): Sawyer. "Old Brighton," in Arrhwoloqicnl .Journal. Vol. XLII. (London, 1880)): "Progress of Brighton," in Municipal ./oiinial (London. 1899). BRIGHT'S DISEASE. The common name for nifihritis, or disease of the kidneys. It takes its name from Dr. Richard Bright (q.v. ), an English physician, who, in 1827, first recog- nized and described renal disease, and properly attributed to it the symptoms and the changes in the urine which it causes. The term is not distinctive, for it includes several forms of nephritis. For clinical purposes, diseases of the kidneys are classified according to the nature of the morbid process existing, whether it be congestion, degeneration, or inflammation. These processes are attended by accumulation of blood in veins and capillaries of the kidneys, changes in their blood-vessels and tissues, formation of new tissue and death of tissue, with resulting local and general symptoms and disturbances of function. We have, then, acute and chronic congestion of the kidney, acute and chronic de- generation of the kidney, acute and chronic exu- dative nephritis, acute productive nephritis, chroni<- nephritis without exudation, suppura- tive nephritis, and tubercular nephritis. There are many synonymous names for these diseases. The eau-ffs of nephritis may be as follows: (1) Prolonged exposure to cold ; ( 2 ) poisons, such as alcohol, turpentine, cantharides, lead, arsenic, mercury, as well as the toxins produced during yellow fever, scarlet fever, gout, syphilis, sup- puration, tubercle, cancer, etc.; (3) mechanical obstruction to the circulation, such as heart- disease and pleurisy with effusion. The s.i/m/J-. tom.-i of nephritis dilTer. In acute nephritis the patient may have merely slight headache, pain in the hack" and in the legs, loss of appetite and nausea, or he may have fever, ])rostration, stu- por, twitching, shortness of breath, and convul- sions. The urine generally contains alliumen and casts, and there may be dropsy of the legs. In the chronic forms of the disease the symp- toms are less severe, though shortness of breath, severe headache, anaemia, and dropsy generally predominate. In the treatment of nephritis, physicians generally recommend frequent change of scene and climate, reduction of sugars and starches and increase of fats in the diet, ab- stinence from alcoholic beverages and from to- bacco, and life in the open air. Drugs are of mueli less value. Pathology. In acute conficstion. the kidneys are swollen and darker than normal, the vessels containing an increased amount of blood. There may be flattening of the tubules from pressure and exudation into them. In acute dci/oieration the kidney is usually somewhat enlarged; it may be congested, and the cortical portion is often swollen and pale. The cells of the kidney tu- bules are swollen and granular, and show vari- ous stages of disintegration up to complete de- struction of the cells. Within the tubules are fat-globules, coagulated albumen, and granular matter, resulting from degeneration of the epi- thelium. In acute exudative inflammation the condition of the kidneys varies greatly. There may be simply congestion, with inflammatory products in the tubules. The kidney may be enlarged and congested, the cortex thick, pale, and wet. The epithelium of the tubules is apt to be swollen or flattened by the exudate, dis- integrated, and there are collections of white blood-cells scattered throughout the cortex. In the lumina of the tubules are masses of coagu- lated albumen, casts (either clear or contain- ing red or white blood-cells), and the results of cellular disintegration. In the glomeruli of the kidneys there is a thickening of the capsule epithelium and of the cells lining the capillaries, so that the outlines of the capillaries disappear. There is often an accumulation of coagulated albumen and detritus within the cavity of the glomerulus. In acute productive inflammation the kidneys are increased in size, the surface smooth, and the capsule non-adherent. An acute exudative inflammation such as hiis just been described is usually present, but added to this is an increase in the connective-tissue elements of the kidney, with consequent atrophy of the tubules. There may be extreme proliferation of the capsule-cells of the glomeruli. The kidneys remain permanently damaged organs. In chronic congestion the kidney is somewhat enlarged, heavy, hard, of dark-red color, the surface smooth, and the capsule nonadherent. The epithelial cells of the tubules may be swol- len, and in the glomeruli the capillaries are dis- tended, and there is more or less thickening of their walls. In chronic degeneration, due to heart-disease, the kidneys are usually lar^' and white, the cortex being thickened. The epi- thelium of the tubules is swollen and granular, and in the glomeruli the capsule-cells are dis- tended and their walls thickened. In the de- generation which occurs in wasting di.seases, the changes in the glomeruli are apt to be ab- sent, while in senile degencnition the kidney may be either large and white, or small, red, and atroi)hicd, with changes in the epithelium of the tubules, but no change in the glomeruli. In chronic diffuse inflammation u'-ith exudation, or chronic parenchymatous inflammation, the ap[>earance of the kidney varies greatly. It is usually enlarged, more rarelv it is of normal