¹ Gardeil, J. B., Traduction des Oeuvres médicales d'Hippocrate, sur le texte grec, d'après l'édition de Foës, Prognostic 21, 4 vols. in 8vo, [Toulouse], 1801.

² Coacae praenotiones, n. 443, Hippocratis opera, in fol. ed. Foës, p. 190, Francofurti, 1621.

³ De locis affectis, LIV, v, vol. iii, p. 204, ed. J. Froben, [1561].

⁴ De humoribus… commentarii [in Claudii Galeni opera omnia], ed. C.G. Kühn, vol. XVI, p. 447, [Lipsiae, C. Cnobloch, 1821–1833].

⁵ Galeni, Omnia quae extant, vol. II, classis 3. De symptomatum causis, lib. 3, p. 57, in fol., Basileae, [1561].

⁶ “Anasarca i. gets its name ‘through the flesh’, it is when the whole body swells up with oedema: and it flows all round: the genitals are affected for sufferers, their appetite for food is removed and fever accompanies it.” (Galeni, Omnia quae extant, in fol., Basileae, 1562, vol. I, p. 94. Galeni ascriptae definitiones medicae.)

⁷ “For Erasistratus says that the liver is painful; for he confirms that he always finds it stony when opened up: but others say that it is the colon but agree about the liver; others say it is the spleen and the liver and the colon; others say it is the peritoneum as well: others have said that the kidneys too and the matrix are the main cause of pain.” Caelii Aureliani, De morbis acutis et chronicis; morb. chron., lib. 3, cap. VIII, in 4to, Amstelodami, 1654, p. 473.

⁸ “For they grow extremely pale, become sluggish, are inactive, are fussy about their food, they are in trouble with indigestion: and when blood has been excreted, they become languid, their limbs are relaxed, even the head is made lighter and rather easily moved. But if no blood has flowed in circulation, they are troubled with headaches, their eyesight grows dim, darkness spreads over them, they suffer giddiness; then others in large numbers lapse into epilepsy, swelling up as if covered with mistiness, like those who suffer from intercutaneous dropsy.” Araetei, De causis et signis acutorum et diuturnorum morborum, ed. H. Boerhaave, in fol., Lugduni Batavorum, 1735, p. 54.

⁹ “Accordingly, it is necessary to treat dropsy anasarca sometimes both by cutting a vein and by purging.” Alexandri Tralliani, libri duodecim, lib. 9, p. 531, in 8vo, Lugduni, 1560.

¹⁰ “Whenever hardening of the kidneys occurs, it does not bring any further pain certainly: but for those who are sick, it seems as if something is hanging from an empty place in the stomach, and numbness occurs in the hips and inability to use the legs and they only pass small amounts of water and in the rest of their bodily state they are very like those suffering from intercutaneous water. In addition, some in the course of time clearly decline into dropsy, just as also happens from other hardened entrails.” Aetius, Tetrabiblos, lib. III, cap. XVII, in 4to, Basileae, 1549, p. 606.

¹¹ “Either there is a stoniness arising from a hot abscess because of the cold which turns it to stone, or heat that enlarges it: both of these are contributory causes preventing the development of maturity … And the urine is thin, small in quantity for the reason that they both draw off too little liquidity because of the weakness of their ability and the weakness of the powers of expulsion of both of them: and, deprived of digestion, it is thin; and the reason for this is a blockage: for it prevents its penetration because it is cloudy; and mostly of that which is thin: in fact sometimes blockage restrains the urine and weakness prevents its ability to dissolve. And sometimes further to this occurs agitation. And very often it leads to dropsy because of the blockage of passage of the liquidity of the blood and its return to the body.” Avicennae, In re medica, lib. III, f. 18, tract. 2, p. 858, in fol., Venetiis, 1514.

¹² “And when the ailments invade the kidneys, the liver is weakened until it reaches the point where dropsy develops, whether the kidneys are hot or cold.” Ibid., p. 852.

¹³ “And so the cause [of ascites] which is in the ability to separate, is because separation is shared between the ability to separate in the liver and the ability to draw off in the kidneys: when therefore both of them are weakened, or one of them, or a blockage has taken place in the passages, and peculiarly when there is a hard abscess in the kidneys and the liquid is not separated and the body does not receive it and the passages do not bear it, then of necessity there arises one of the methods of the occurence of dropsy ascites.” Ibid., p. 771.

¹⁴ “And if (dropsy) were to begin in both groin and loin, an abscess would begin from the feet; then occurs flux of the stomach, bloody and long, which is not resolved and water does not come out with it. And dropsy of which the cause is hot, is accompanied by signs of heat and comes from inflammation and thirst and yellowness of colour; and bitterness of mouth: and acute dryness in the body and a decline of appetite for food, with yellow and green vomiting, and a fierce burning when urinating ultimately because of the strength of the jaundice. And if it is of the kind in which liquefaction is increased and so is expulsion to the natural passages, it is marked by a flood of yellowness and signs of liquefaction and is preceded by voiding and urinating, which is lavatorial and strong. And then begins the alchatin from parts of the groins. And in the same way all dropsy arises from acute illnesses.” Ibid., p. 773.

¹⁵ “And sometimes with dropsy occurs voiding which is bloody, and is not cut short and is not cured either; since the wateriness is not produced by looseness but rather what weakens the body is produced by looseness, and sometimes excoriation and ulceration lead on to dropsy.” Ibid., p. 800.

¹⁶ Fernel, [J.], Universa medicina, p. 510, in. fol., Coloniae Allobrogum, 1679.

¹⁷ Schenck, J., Observationum medicarum rariorum, lib. VII, in fol., Lugduni, 1644. De hydrope, lib. 3, obs. XII, p. 417.

¹⁸ “For also the kidneys do not separate the serous substance of the blood because of their blockage, sometimes because of their weakness too …” and further he says, “From the kidneys indeed occurs not only the passage of damage between themselves but it also occurs accidentally if they do not cleanse the liquidity, as a result of which much of it remains in the veins and the blood becomes watery and the serum is drained out.” Foresti, [P.], Observationum et curationum medicinalium ac chirurgicarum opera omnia, lib. XIX, obs. 28, scholium, [vol. 1], p. 371, [Rothomagi, 1653].

¹⁹ Van Helmont, [J.B.], Ortus medicinae, art. hydrops. Ignotus, in 4to, Amstelodami, 1748: “Since indeed, in the event of the stomach swelling up through a failure of urine, and so indeed it seemed that dropsy should be ascribed to neglect of the kidneys … But I have never been able to accept that the liver should be the cause of dropsy, if all dropsy could be explained through urine … wherefore for me the fault lies in the kidney rather than the liver (p. 508). A certain citizen was in pain for a long time between the false ribs and could not breathe without pain but after the suggestions of the doctors had been tried out, ultimately he died of dropsy but his liver was found to be free from harm. A treasury official from Brabant after suddenly passing blood, for a long time was treated by doctors in vain and for the same reason was subjected by his family to healing springs: on his return he began to show signs of hardness on the left side of his abdomen beneath the ribs and then the shin bone on that side became swollen. But the chief physicians and those of Louvain, although they saw that his urine was similar to healthy ones and then showed that his liver was not to blame, nevertheless did not cease from the continual use of unblocking laxatives and diuretics; indeed they dosed him with a concoction of iron salts, variously treated to combat obstructions: and in the end he died of dropsy with a huge belly. Those who had been in attendance from the hour of the passing of blood, could not say that they had been called in too late (an opportunity for an excuse). Now when his body was dissected, his liver was found to be not guilty: but the left kidney had swollen with a clot of extravenous blood (such as is in a cooked sausage) and larger than normal” (p. 510). Further on, in his animated style in speaking of this fiscal: “And in addition because the kidney is settled as maker, achiever, performer and governor of true dropsy” (p. 513).

²⁰ Rivieri, Lazari, Opera medica universa; praxeos medicae, lib. XI, cap. 6: De hydrope, p. 326, in fol., Lugduni, 1738.

²¹ Ballonii, G., Opera omnia, vol. I, p. 192, Epid. et éphémér., lib. 2, in 4to, Genevae, 1762.

²² Pisonis, N., De cognoscendis et curandis praecipue internis humani corporis morbis libri tres, vol. II, p. 220, in 4to, Lugduni Batavorum, 1736.

²³ This idea that Galen attributed dropsy to an affection of the liver had been reproduced by a number of authors; however, it is completely false: the passages of Galen cited above do not allow equivocation. What probably gave rise to the error is the mediating role that Galen theoretically accorded to the liver in the production of dropsy.

²⁴ Boneti, Th., Sepulchretum sive anatomia practica, lib. III, sect. XX, De cachexia, anasarca, leucophlegmastia, obs. XVI, vol. II, p. 359, in fol., Lugduni, 1700.

²⁵ Ibid., p. 362. Another case cited by Bonet (ibid., p. 354, obs. II) is less conclusive: “Citizen N gradually fell into a state of consumption and had almost the whole of his liver putrified; his bladder was empty and his gall bladder was abnormally loose and open: the kidneys were stained with a yellow colour, their parenchyma was leaden blue.” This alteration to the kidneys in my view corresponds to the third form of albuminous nephritis, but in another passage (ibid., obs. V, p. 212) where the same patient is discussed, it is not the cortical substance but the tips of the mamilla that are yellow and discoloured.

²⁶ Boneti, Sepulchretum, vol. II, p. 359.

²⁷ Plater, Felicis, Praxeos medicae, vol. III, De extuberantia, cap. 3, p. 186, in 4to, Basileae, 1736.

²⁸ Willis, T., Opera omnia, vol. II, p. 245, [Amstelaedami, 1682], De anasarca: “The watery humour which makes up anasarca, proceeds entirely or for the most part from the blood: it is produced without doubt as a result of failure or corruption of the blood, continually within a bloody mass and pours out of the ends of the arteries in too great a supply to be taken out by veins and lymph ducts, and restored and removed through the kidneys and pores of the skin and other outlets of serous liquid. From these things it follows that the material cause of this disease is watery humour and the efficient cause is blood which presumably produces the waters and deposits them in affected places.”

²⁹ Sydenham, Thomae, Opera medica, Tractatus de hydrope; vol. I, p. 334, in 4to, Genevae, 1769: “And so urine is produced sparingly because the blood serum which ought to have been excreted through the urinary passages by the law of nature is already deposited in the hollow of the abdomen and in other parts capable of taking it in.”

³⁰ Lieutaud, [J.], Historia anatomico-medica, vol. I, p. 252, [Paris, 1767], Ephem. ant. cur., vol. I, an. 9 and 10, p. 410.

³¹ Van Swieten, Gerardi, Commentaria in Hermanni Boerhaave aphorismos, § 1229, vol. IV, p. 168, in 4to, Parisiis, 1773.

³² Boerhaave, [H.], Praelectiones academicae, vol. III, p. 315, Gottingae, 1741.

³³ Morgagni, [G. B.], De sedibus, et causis morborum, epist. XXXVIII, art. 9, [Naples, 1762].

³⁴ Morgagni, [G. B.], De sedibus, et causis morborum, epist. XLII, art. 11; epist. XL, art. 21.

³⁵ Morgagni, [G. B.], De sedibus, et causis morborum, epist. XXXVIII, art. 19.

³⁶ Epist. XXXVIII, art. 28: “The particular membrane of one kidney (for I did not inspect the other one) had become quite thick and very easily followed if anyone pulled it; the canaliculi were also thicker than usual and for that reason much more obvious.”

³⁷ Hoffmann, F., Medicinae rationalis systematicae, cap. XIV, vol. III, p. 324, De hydrope, in fol., Genevae, 1761.

³⁸ Lieutaud, [J.], Historia anatomico-medica, [vol. 1], pars 1, obs. 231, obs. 458, obs. 1117, obs. 1118, obs. 1119 and obs. 1075, in 4to, Paris, 1767.

³⁹ Frank, J. P., Traité de médecine pratique, French translation by J M Goudareau, vol. IV, [Paris, 1820–1828] p. 199.

⁴⁰ Sauvages, [F. B. de], Nosologica methodica, vol. II, p. 474, in 4to, Amstelodami, 1768.

⁴¹ Pamard, fils, ‘Sur une leucophlegmasie urineuse, causée en premier lieu, par la présence d'une pierre dans la vessie, guérie par l'opération, et, en second lieu, par la crispation des filières sécrétoires des reins, guérie par les humectans’ (Journal de médecine de Roux, vol. XXIII, 1765, p. 421.)

⁴² Wrisberg, H. Aug., Commentationum, medici, physiologici anatomici, etc., p. 168, in 8vo, Gottingae, 1800.

⁴³ Portal, A., Observations sur la nature et le traitement de l'hydropisie, vol. I, p. 151, in 8vo, Paris, 1824.

⁴⁴ Portal, [A.], Cours d'anatomie médicale, vol. IV, [Paris, 1804], p. 77.

⁴⁵ Andral, [G.], Clinique médicale, vol. III, 1st ed., [Paris], 1826, p. 567.

⁴⁶ Barbier, J. B. G., Précis de nosologie et de thérapeutique, vol. I, p. 410, in 8vo, Paris, Oct., 1827.

⁴⁷ Barbier, op. cit., ‘Sclériasie des reins’, vol. I, p. 553.

⁴⁸ Cotunnii, [D.], De ischiade nervosa commentarius, pp. 24, 25, in 8vo, Viennae, 1770.

⁴⁹ [Traité des maladies des reins, Paris, J.-B. Baillière, 1840, vol. 2, para. 606, p. 437.]

⁵⁰ Cotugno is mistaken: it is rare that one sees albumin in the increased urine of dropsical patients, when the disease ends favourably. In dropsies with coagulable urine, the urine becomes less charged with albumin when augmented in quantity; in the others the albumin does not pass, or very rarely and always in small quantity.

⁵¹ Cotunnii, ibid., pp. 24, 25.

⁵² Fordyce, G., Elements of the practice of physic, 5th ed., p. 34, in 8vo, London, 1784.

⁵³ Cruickshank, [W.], in [John] Rollo: Cases of diabetes mellitus, chap. VI, ‘Experiments on urine and sugar’, pp. 443, 447, 448, in 8vo, London, 1798.

⁵⁴ Although one generally attributes to Cruickshank the expression “inflammatory dropsy” it is in general dropsy that he is said to have observed coagulable urine.

⁵⁵ Latham, [John], Facts and opinions concerning diabetes, p. 139, in 8vo, London, 1809.

⁵⁶ Darwin, [E.], Zoonomia, vol. I, p. 467, 3rd. ed., 8vo, London, 1801.

⁵⁷ Bulletin de la faculté de médecine de Paris, vol. I, Feb. 1806, p. 41.

⁵⁸ Watt, [R.], Cases of diabetes, consumption etc. with observations, in 8vo, Paisley, 1808.

⁵⁹ Wells, [W. C.], ‘Observations on the dropsy which succeeds scarlet fever. On the presence of red matter and serum of the blood in the urine of dropsy which has not originated in scarlet fever’, Transactions of a Society for the Improvement of Medical and Chirurgical Knowledge, vol. III, [1812], pp. 16 and 194.

⁶⁰ Brande, [W. T.], ‘An account of some changes from disease in the composition of human urine’, Transactions of a Society for the Improvement of Medical and Chirurgical Knowledge, read on 3 Feb. 1807, vol. III, [1812] p. 187.

⁶¹ Fourcroy, [A.-F.], Système des connaissances chimiques, etc., vol. x, p. 146, [Paris], 1800.

⁶² Nysten, [P. H.], Recherches de physiologie et de chimie pathologiques, p. 256, etc., in 8vo, Paris, 1811.

⁶³ “I have often noted this ‘frothy’ or yeasty appearance of the urine when it contains a significant amount of albumin. Dr. Tissot has pointed this out in his thesis, but I should say that if this characteristic leads one to suspect the presence of albumin, it is in no way a definite indication. Not only do urines that are highly charged with albumin sometimes present not even a single bubble even after several hours, but also, after a similar period, other urines, devoid of albumin and presenting no coagulum when exposed to heat and nitric acid, may present a ring of bubbles contiguous with the sides of the jar. Many such urines contain a significant quantity of animal matter in their extract. I am at the same time reminded of a certain aphorism of Hippocrates': ‘If bubbles appear on the surface of urine, there is a disease of the kidneys, which is likely to persist.’ ” (vol. VII, p. 341.)

⁶⁴ Chapotin, [C.], Topographie médicale de l'Île de France, p. 57, in 4to, Paris, 1812.

⁶⁵ Blackall, John, Observations on the nature and cure of dropsies, in 8vo, London, 1813, 2nd ed. 1814, 3rd ed. 1818, 4th ed. 1824.

⁶⁶ “A correct guide to it (venae-section) may be found in the firmness, copiousness, and early appearance of coagulum in the urine.” Blackall, op. cit., [1813], p. 281.

⁶⁷ Crampton, [J.], ‘Clinical report on dropsies’, Transactions of the Association of Fellows and Licentiates of the King's and Queen's College of Physicians in Ireland, vol. II, 1818, p. 140.

⁶⁸ Abercrombie, [J.], ‘Observations on certain dropsical affections which are successfully treated by blood-letting’, Edin. med. surg. Journ., vol. XIV, [1818], p. 163.

⁶⁹ Scudamore, [C.], A treatise on the nature and cure of gout and gravel, etc., 4th ed., pp. 313ff, in 8vo, London, 1823.

⁷⁰ Prout, [W.], Inquiry into the nature and treatment of gravel, calculus, and other diseases connected with a deranged operation of the urinary organs, in 8vo, London, 1821, 2nd. ed. revised, 1825.

⁷¹ [Gregory, J.C., ‘On diseased states of the kidney connected during life with albuminous urine’], Edin. med. surg. Journ., vol. XXXVII, [1832] p. 67, obs. LXVII.

⁷² Howship, [J.], A practical treatise on the symptoms, causes, etc., of the most important complaints that affect the secretion and excretion of the urine, pp. 70ff, in 8vo, London, 1823.

⁷³ Bright, R., ‘Diseased kidney in dropsy’, Reports of medical cases, in 4to, London, 1827, [pp. 3, 4, 67].

⁷⁴ Bright, Richard, Reports of medical cases, London, 1827, pp. 67ff.

⁷⁵ Bright, Reports of medical cases, p. 80. Cyclopaedia of practical medicine, art. Urine [vol. 4, London, 1835].

⁷⁶ Christison, Robert, ‘Observations on the variety of dropsy which depends on diseased kidney’, Edin. med surg. Journ., vol. XXXII, 1829, p. 262.

⁷⁷ Gregory, J. C., ‘On diseased states of the kidney connected during life with albuminous urine’, Edin. med. surg. Journ., vol. XXXVI, 1831, p. 315; ibid., vol. XXXVII, [1832] p. 54.

⁷⁸ [Christison, Robert], On granular degeneration of the kidnies, in 8vo, Edinburgh, 1839.

⁷⁹ Edin. med. surg. Journ., vols. XXXVI–XXXVII [1831–1832].

⁸⁰ Lond. med. Gazette, vol. VII, Feb. 1831, p. 385; Dublin Journal of Medical Science, [vol. 6], no. 16, 1835, pp. 72–74; Archives générales de médecine, second series, vol. VI, 1834, p. 559.

⁸¹ Dublin Journal of Medical Science, [vol. 6, 1835], no. 16; Archives générales de médecine, second series, vol. VI, 1834, p. 559.

⁸² Spittal, R., Dissertatio de quodam vitio renum, quod urinae mitatio particularis comitatur, Edinburgh, 1832.

⁸³ Craigie, [D.], ‘Report on the cases treated during the course of clinical lectures, delivered at the Royal Infirmary in the session 1832–1833’, Edin. med. surg. Journ., vol. XLI, [1834], p. 120.

⁸⁴ [Barlow, E., ‘On dropsy, with coagulable urine’], Midland Medical and Surgical Reporter, [p. 255], May 1832.

⁸⁵ Elliotson, [J.], ‘Reports of cases, etc.’ [‘Announcement of cases – Dropsy’], Lond. med. Gazette, vol. VII, [1831], p. 315.

⁸⁶ Darwall, [J.], in Cyclopaedia of practical medicine, art., Dropsy, [vol. 1, London], 1833, p. 641.

⁸⁷ [Traité des maladies des reins, Paris, J.-B. Baillière, 1840, vol. 2, para. 562, p. 277.]

⁸⁸ Copland, [J.], A dictionary of practical medicine, art., Dropsy, in 8vo, London, 1833.

⁸⁹ Gazette méd. de Paris, 1833, p. 27.

⁹⁰ Hamilton, [G.], ‘On the epidemic scarlatina and dropsical affection which prevailed in Edinburgh during the autumn of 1832’, Edin. med. surg. Journ., vol. XXXIX, [1833], p. 140; ‘Cases’ (ibid. vol. XLIII, [1834] p. 303); ‘On the treatment of scarlatina anginosa’ (ibid. vol. XLVII, [1837], p. 141).

⁹¹ Burrows, [G.], ‘Physiological and pathological observations on the blood and urine’, Lec. II, Lond. med. Gazette, vol. XIV, [1834] p. 555.

⁹² Anderson, John, ‘Observations on renal dropsy’, Lond. med. Gazette, vol. xv, [1835] pp. 855 and 903.

⁹³ Osborne, [J.], On dropsies, connected with suppressed perspiration, and coagulable urine, London, 1835.

⁹⁴ Seymour, E., ‘The nature and treatment of dropsy, considered especially in reference to the diseases of the internal organs of the body which most commonly produce it’, The Medico-Chirurgical Review, [n.s. vol. 26, 1836–37, pp. 1–24.].

⁹⁵ Dublin Journal of Medical Science, vol. xv, March 1839, p. 185, no. XLIII.

⁹⁶ Mateer, W., ‘On the coagulability of urine as a diagnostic and therapeutic sign of dropsy’, Edin. med. surg. Journ., vol. XLVII, 1837, p. 68.

⁹⁷ “By and by the urine becomes towards the turn of the fever, albuminous; thus showing that the kidneys are called into excited action, and roused from their state of anaemia. At the same time, too, the general febrile excitement is lowered. After the kidneys have for some time excreted albumen, this suddenly disappears, and uric acid and the urate salts are formed in its place, and in this way the crisis per urinas is effected.” (ibid., p. 93.)

⁹⁸ Willis, Robert, Urinary diseases and their treatment, p. 150, in 8vo, London, 1838.

⁹⁹ Tissot, E., De l'hydropisie, causée par l'affection granuleuse des reins, in 4to, Paris, 1833.

¹⁰⁰ Sabatier, [J. C.], ‘Considérations, et observations sur l'hydropisie symtomatique d'une lésion spéciale des reins’, Archives générales de médecine, second series, vol. V, 1834, p. 333.

¹⁰¹ Monassot, [J.], Etude sur la granulation des reins, in 4to, Paris, 1835.

¹⁰² Gaz. méd. de Paris, 1834, p. 553.

¹⁰³ Gaz. méd. de Paris, 1834, p. 105; Gaz. des hôpitaux, 1834, p. 102; Gaz. des hôpitaux, 1835, p. 521.

¹⁰⁴ Ibid.

¹⁰⁵ Desir, A., De la présence de l'albumine dans l'urine, considérée comme phénomène et comme signe dans les maladies, in 4to, Paris, 1835.

¹⁰⁶ [Traité des maladies des reins, Paris, J.-B. Baillière, 1840, vol. 2, para. 502, p. 99.]

¹⁰⁷ Forget, [C. P.], ‘Lettre sur l'albuminurie (maladie de Bright), adressée à M. le Dr. Rayer’, Gaz. méd. de Paris, 1837, p. 609.

¹⁰⁸ Genest, [J.-L.], ‘Etat actuel des connaissances sur la maladie des reins désignée sous les dénominations de maladie de Bright, affection granuleuse des reins, néphrite albumineuse’, Gaz. méd. de Paris, 1836, p. 449.

¹⁰⁹ Bouillaud, [J. B.], Clinique médicale de l'hôpital de la Charité, vol. II, p. 270, vol. III, pp. 190, 197, 287, etc., in 8vo, Paris, 1837.

¹¹⁰ Guillemin, [V.-V.], Essai sur la maladie de Bright, in 4to, Strasbourg, Feb. 1837.

¹¹¹ Bureau, [J. V.], De la néphrite albumineuse ou maladie de Bright, affection granuleuse des reins, in 4to, Paris, 1837.

¹¹² Martin Solon, F., De l'albuminurie ou hydropisie causée par une maladie des reins, etc., in 8vo, Paris, 1838.

¹¹³ In a great number of passages, Dr. Martin Solon describes the symptoms, the lesions and the effects of the remedies which prove the inflammatory characteristics of the disease. In Obs. III he says that “the lengthy duration of the loin pain experienced by this patient makes one think that his slight albuminuria was caused by a renal irritation accompanied only by hyperaemia, but which would have been followed by sub-acute nephritis and possibly by degeneration, had one not halted the disease process.” In another (Obs. VII) he says that “In place of a simple hyperaemia, it is evident that an inflammation of the renal tissue has developed in this patient: there is no other inflammation. Anasarca and ascites clearly appear to be caused by the sole influence of a morbid condition of the kidneys. This has prompted us to place this observation among the cases of acute albuminuria or acute dropsy caused by disease of the kidneys. Antiphlogistics and rest have shown the most favourable results in such inflammation and its effects up to the present time. The rapid termination of all these events has given us hope that morbid processes will not develop in the kidneys and that there will be no recurrence of dropsy.” Dr. Martin Solon expresses more or less the same opinion in other passages (Obs. XVII). “In fact, we see,” he says, “this decline immediately leads to loin pain, undoubtedly caused by hyperaemia, then inflammation of the kidneys. We see this disease as aggravated by excessive work, the ingestion of cold drinks, then the anasarca manifests itself and the albuminuria becomes evident. This case, therefore, can be counted amongst those in which the kidneys are the point of departure and the principal site of the disease.” And later (Obs. XXIII) he says, “The renal degeneration in this case is evidently independent of all other lesions, the state of the heart could not have any influence on it. Should it be attributed to a latent nephritis determined by the decline in the patient? The successive incidences which followed this decline and the absence which followed the absence of all other causes lead one to think so. It is also possible that, burdened by the function of its congenital underdevelopment, this kidney would more easily become the site of over-irritation, which, whilst remaining latent, has none the less been capable of altering its nutrition; nevertheless, in this patient, as in some others, one is tempted to consider that a sub-inflammatory process had led to the development of the observed disorder.” And further on (Obs. XXIV), “Was the anatomical condition observed in this woman due to an old inflammation of these organs? The pain experienced for so long in the lumbar region makes it a possibility.” And finally (Obs. XXV), “the lively pains suffered in the lumbar region before the appearance of complete oedema suggest that, in this patient, the renal degeneration had reached an inflammatory state during the lying-in period.” And elsewhere he says, “In the first state there is renal hyperaemia, sub-inflammation, and latent inflammation, in the other, alteration of the nutrition, organic degeneration and development of incidental products” (op. cit., pp. 275 and 276). Is it not clear that Dr. Martin Solon, in these passages, as in several others, appears to share the opinion previously set out by several of my students, that the kidney is inflamed in the first period of the disease? Only the expressions that he uses, such as “sub-inflammation” and “latent inflammation” prove that he regards this type of inflammation as completely distinct from simple nephritis, which is incontestable. In another passage he insists even more strongly on the dissimilarity of the disease from ordinary inflammation. “Even though the patient has in no way experienced pain in the lumbar region, one recognizes however, on examination, that the kidneys have been the site of a considerable hyperaemia and possibly of the commencement of inflammation which is indicated by the colour and greater friability of the organic tissue. However, this will not be such as to produce an inflammation as to determine hypertrophy of the tissue, that hyperaemia will seem to be destined in this disease, as one does not observe the normal consequences of an inflammatory process” (op. cit., p. 133). With regard to incidental occurrences (tubercles, cancerous matter, etc.), Dr. Martin Solon is wrong I believe to indicate them as an ending, as a form of Bright's disease; they are completely different.

¹¹⁴ Meeting of 8 October 1839 of l'Académie royale de médecine: “Dr. Martin Solon thinks that Dr. Rayer's expression is wrong for several reasons: 1. There are several cases of ordinary nephritis in which the urine shows itself to be albuminous, 2. Bright's disease is not a nephritis and one must be determined to find inflammation all over in order to see one of the kidney alterations described under this name.” (L'Expérience, vol. v, [1839], p. 241).

¹¹⁵ Op. cit., p. 246.

¹¹⁶ L'Expérience, vol. I, p. 60, in 8vo, 1837.

¹¹⁷ Valentin, G., ‘Examen microscopique des granulations des reins’, L'Expérience, vol. I, [1837], p. 366. Extract from Repertorium für Anatomie und Physiologie, 2nd vol., 2nd cahier, 1837, p. 290.

¹¹⁸ Gluge, Gottlieb, Anatomisch-mikroscopische Untersuchungen zur allgemeinen und speziellen Pathologie, first cahier [Minden], 1839.

¹¹⁹ Corfe, G., A popular treatise on the kidney, in 8vo, London, 1839.