The Bright's disease?!

[j.r-ahde]

Hello you all!

So, we know, that CE had Bright's disease, a form of uremia.

Any more details to tell about this disease?!

All the best
Jukka

[Magpie]

Hi Jukka!

My understanding is that the term "Bright's Disease" at that time was used as a catch-all term for a wide range of kidney ailments, particularly those (falsely) associated with alcoholism.

[Frank]

Maybe this article will help. It is by William Gull himself and Dr Sutton.

http://www.pubmedcentral.nih.gov/art...?artid=2296565

I have not read it yet, but it is contemporary and may give an hint what they then thaught what Bright's disease was.

[halomanuk]

Also this is in 'laymans' terms on Wiki :

'Bright's disease is a historical classification of kidney diseases that would be described in modern medicine as acute or chronic nephritis. The term is no longer used, as diseases are now classified according to their more fully understood causes.

It is typically denoted by the presence of serum albumin (blood plasma protein) in the urine, and frequently accompanied by edema (tissue particulate).

These common symptoms of kidney disease were first described in 1827 by noted English physician Richard Bright. It is now known that the symptoms accompany various morbid kidney conditions . Thus, the term Bright's disease is retained strictly for historical application.

The symptoms are usually severe. Back pain, vomiting and fever commonly signal an attack. Edema, varying in degree from slight puffiness of the face to an accumulation of fluid sufficient to distend the whole body, and sometimes severely restrict breathing, is very common. Urine is reduced in quantity, is of dark, smoky or bloody color, and has higher levels of albumin (albuminuria). Under the microscope, blood corpuscles and urinary casts are found in abundance.

This state of acute inflammation may severely limit normal daily activities, and if left unchecked, may lead to one of the chronic forms of Bright's disease. In many cases though, the inflammation is reduced, marked by increased urine output and the gradual disappearance of its albumen and other abnormal by-products. A reduction in edema and a rapid recovery of strength usually follows.

Acute Bright's disease was treated with local depletion, warm baths, diuretics, and laxatives. There was no successful treatment for chronic Bright's disease, though dietary modifications were sometimes suggested.'

[DVV]

Hi Jukka,

I think the best clarification on the subject has been provided by Evans and Rumbelow ("JtR. Scotland yard investigates", p 168 and 170).

Some sentences:

"There is a popular misconception that Eddowes was suffering from a kidney condition known as Bright's disease, but there is actually no evidence to show that she did. The person responsible for starting the myth is Henry Smith of the City police."

"Bright's disease, named after Richard Bright (1789-1858) of Guy's Hospital does not exist as a named illness today ; the modern equivalent would be glomerulonephritis, which has many variants. (...) This having been said, it was not an uncommon illness in 1888."

Amitiés,
David

[Jon Guy]

Hello

Dr William Sedgwick Saunders, who was involved in the CE postmortem said that the remaining right kidney was "perfectly normal in it`s structure and healthy, and by parity of reasoning you would not get much disease in the left."

Eddowes did not have Brights disease.

Inspector J.G. Littlechild did die from problems associated with Brights Disease.

[perrymason]

The visual inspection of the kidney that remained in Catherine Eddowes cited specific characterizations of that organ....all in keeping with a form of Nephritis....of which Brights Disease is one category.

Kate Eddowes had Nephritis....that much was clear. Maybe not Brights Disease, but it was obviously not a healthy kidney left in her.

Which would raise the question.... did the killer know what a healthy organ looked like as compared with a unhealthy one? If so, and if he intended to eat it as From Hell suggested he did.....then my guess is he didnt know what healthy organs looked like.

If he never had any interest in eating it...then I dont know if the visual defects would matter anyway.

Best regards.

[Jon Guy]

Kate Eddowes had Nephritis....that much was clear. Maybe not Brights Disease, but it was obviously not a healthy kidney left in her.

Where is your source for that prognosis ?

I am interested as I just provided a quote that stated that her remaining kidney was healthy.

[Christine]

If the Lusk kidney had Bright's disease/nephritis, wouldn't determining whether Eddowes right kidney also had Bright's disease be a priority? How could Henry Smith be mistaken about such an important point?

Did anyone ever get the two kidneys side by side and look at them? The press reports seem to imply this, but is there a better source?

Bright's disease is nephritis--inflammation of the kidney. It just means that the kidney was visibly inflamed. If anything Bright's disease would be the broader term, as it also refers to glomerulonephritis, which is inflammation of the little tubes in the kidney, and something they may not have been able to see in an autopsy. Normally they would diagnose it by cloudy or bloody urine. Nowadays they would describe it as infection, or any of the many diseases that might cause a kidney to be inflamed. The only thing we can really conclude about her health is that her kidney was visibly inflamed. Unless P.C. Smith was mistaken, in which case we don't even know that.

[halomanuk]

Unless P.C. Smith was mistaken, in which case we don't even know that.

Ooh i wouldn't let him hear you call him that Christine.
Lft Col Sir Henry Smith if you please.

[Jon Guy]

I don`t know whether they kept internal organs but Eddowes was buried on the 8th Oct and the Lusk kidney arrived on the 16th Oct.


..but, Dr Brown was reported as saying that the remaining kidney was "pale, bloodless, with slight congestion of the base of the pyramids". This obviously contradicts Dr Saunders who said the kidney was healthy. According to Philip Sugden, these symptoms, according to Nick Warren, unquestionably do indicate Brights Disease.

[Christine]

Ooh i wouldn't let him hear you call him that Christine.
Lft Col Sir Henry Smith if you please.

Whoops! Oh well, I was quoting Christopher-Michael DiGrazia's dissertation on the kidney so I have a weak excuse.

[perrymason]

Where is your source for that prognosis ?

I am interested as I just provided a quote that stated that her remaining kidney was healthy.

Thats a fair question John, and I dont recall specifically....it was with comments made after the Lusk section had begun its "tour" of medical experts...that much Im sure of. Ill see if I can find the quote.

I cant only remember that Brown stated the stomach contents were preserved at the Inquest, and that there was testimony on the analysis of those contents,...Im not sure that the remarks I'm recalling were made in reference to a comparison of the sample with the preserved remaining kidney, if thats what you thought I meant.

I think the only relevance the issue could have is if the condition or one like it was thought seen in the sample...of which we know the data was analyzed by many experts....thus relating specifically to the findings in the autopsy...which the details of only come out in snippets by comments made at later dates.

As you know this is not a new question...and I think the only real basis for the analysis was to match the sample to the findings of the remaining organ found still in her. If the sample had suggestion of Brights Disease, but the kidney left inside did not show that....we wouldnt be having these debates today.

A sample of a kidney affected with Nephritis could not have come from a woman without that condition, no debate needed.

All the best Jon.

[Sam Flynn]

Maybe this article will help. It is by William Gull himself and Dr Sutton.

http://www.pubmedcentral.nih.gov/art...?artid=2296565

Thanks, Frank. Interestingly, there's not one mention in that article - helpfully entitled "The Anatomy of Bright's Disease" - that mentions paleness, bloodlessness, or slight congestion at the base of the pyramids. The anatomical changes described in that paper are firmly at the microscopic level, whereas the paleness, congestion etc refers to the appearance of the kidney at a gross anatomical level.

On this point, the body had been exsanguinated to a significant extent - so perhaps it's not surprising that the remaining kidney was pale and bloodless. As to the congestion - it was only "slight". Quite how this morphs into an "advanced stage of Bright's Disease" (which Major Smith, the source of this story, would have us believe) I really don't know.

[Sam Flynn]

Thats a fair question John, and I dont recall specifically....it was with comments made after the Lusk section had begun its "tour" of medical experts...

That a "tour" of the medical experts happened is only down to Major Smith's story, Mike. The same story that claimed that a further examination of the kidney remaining in the body took place... this could only have happened if it had been exhumed (for which no record exists - not even Major Smith claims as much), because Eddowes had been buried several days before Lusk received the offending article in the mail.