William Osler and investigation on trench nephritis.

The first alarming reports about a new disease called "trench nephritis" affecting soldiers of the British Expeditionary Forces in Flanders appeared in British medical press in 1915th. Soon, the Medical Research Council initiated a special research investigation on trench nephritis at St. Bartholomews Hospital and the results of these studies were discussed during the Royal Society of Medicine meeting in February 1916. William Osler was invited as one of the four main speakers for this presentation. He had lived in England since 1906 and served as the Regius Professor of Medicine at Oxford. At the meeting, Osler summarizes the clinical presentation of trench nephritis as a sudden appearance of swelling with rare cases of anasarca. Fever was not a common early presentation in his experience. He found rapid improvement in most of the cases during hospitalization despite "persistence of a large amount of albumin, of blood, and of cast, with increasing high blood pressure, is an unusual combination in the nephritis of civil life, yet that has been common enough in these cases". He questioned the assumption of a good prognosis in trench nephritis especially in "Cases which are lasting from twelve to fourteen weeks, the chances are that it will become subacute or chronic".

[Bright's disease is mentioned in an official Hungarian medical document in the 19th century]. / A Bright-féle vesebetegség említése egy XIX. századi magyar nyelvu, hivatalos orvosi dokumentumban.

The World Kidney Day was announced for the fifth time in 2011, that calls attention to chronic renal failure as it attains the title of endemic. Richard Bright (1789-1858), a British doctor was the first to recognize and describe the uremic state and the kidney diseases leading to it. There are many aspects that the readers should remember him about especially in connection with the World Kidney Day. During his European study tour's stage in Hungary, he was not so much interested in the country's medical and health conditions, rather in its economic and cultural life, natural history and geography. He travelled to Hungary on two occasions and recorded his experiences in a personal travel documentation illustrated with his own drawings. He finally established himself in London in 1820 and together with Thomas Addison and Thomas Hodgkin they formed the Guy's Hospital's world-famous "scientist trio". Bright described the nephritis's classical image, nowadays known as Bright's disease for the first time at the age of 38 years in 1827. A presently turned up Hungarian medical certificate from 1870 contains the Bright's disease described by Richard Bright as a written diagnosis. This 140-year-old document also confirms that we can be proud of our predecessors concerning our knowledge of kidney diseases and their application in daily use in Hungary, because in the past they were the ones who used the most advanced knowledge in their practices. One of today's greatest challenges for us is to be able to inform healthy and ill people alike properly about kidney diseases and their prevention or management. Place this in order to stem the epidemic of chronic renal failure and still pay homage to this disease's greatest scientist, Richard Bright.

The response to the trench diseases in World War I: a triumph of public health science.

The recent 90-year anniversary of the Battle of the Somme presents an opportunity to examine the public health response to the trench diseases, new conditions which arose in the trenches of World War I. Throughout history, there have been two views of epidemic disease: the configurationist and contagionist perspectives. Most doctors responding to the trench diseases, 'contingent-contagionists', combined these two conceptions of disease. Because of the difficulty of finding a causative organism and the absence of effective treatment, the majority view became that these conditions were a product of the trench environment. Configurationism, with its emphasis on environmental and social determinants, seemed to provide the most obvious approaches for tackling the trench diseases. The diseases were effectively controlled using the tools of public health science: sanitary discipline and a battery of measures, such as improving trench construction, improving the diet, providing protective kit, regular bathing and treating lice infestation. The response demonstrates the triumph of public health science over new medical technologies. It also illustrates the importance of considering all the many determinants of health and of close surveillance, discipline and partnership working to counter ill-health. Although technology, training, doctrine and health beliefs change over time, the interaction between disease and environment remains the core challenge to public health practitioners.

[Bright disease in Turin and Italy from the middle of the 19th century to the middle of the 20th century]. / La "malattia di Bright" a Torino e in Italia dalla metà dell'Ottocento alla metà del Novecento.

For many years the term nephritis was used to indicate renal diseases (in the sense of Bright s disease) in a larger sense. This review summarizes the history of the concept of glolomerulonephritis from Egyptian Medicine up to the Post-Biopsy Era, in particularly in Turin and in Italy. This study reports an epidemiology survey of Bright s disease in Italy from 1880 up to 1960. Towards the end of the 19th century Bright s disease accounted for 26 deaths/year/105 population (in comparison with more than 200 from tubercolosis) in Italy. At the beginning of the 20th century, Bright s disease was the seventh cause of death in Italy. Moreover, in Italy autopsy studies showed a higher percentage of deaths attributed to Bright s disease (5-7%) in comparison with those obtained from vital studies. In 1960, just before the beginning of renal replacement therapy, Bright s disease accounted for 15.7 deaths/year/105 population. Probably it was difficult to recognize in the real incidence of chronic renal diseases leading to death in the 1960s, and vital studies were able to furnish only approximate estimates. However, noteworthy is the fact that these values were very close to those estimated as being the annual need for renal replacement therapy (10-20/year/105 population).

[History of nephritis].

The nephritis is one of the common and detrimental diseases. This paper reviews the history of knowledge of nephritis, ancient and modern, and western and Chinese medicine, demonstrating that the continuous development of treatment of TCM and western medicine are all effective measures to combat nephritis.

Experimental nephritis: one of the earliest publications on the subject by a pioneer of Neohippocratism.

From the beginning of the 20th century, cumulative experimental work has provided considerable evidence for the possible immune mechanisms by which certain diffuse glomerular diseases develop. The first classic well-documented studies are attributed to Masugi and his research team (1933), whose experimental model involved the induction of glomerulonephritis by the administration of antikidney sera. However, 23 years earlier, in 1910, Alexander Cawadias had published a monograph on the same subject, for which he was honored with the Medal of the Paris University School of Medicine. In his study, Cawadias concluded that the mechanism of experimental nephritis was multifactorial and that the progression and the aggravation of uremic disease was caused by the production of nephrotoxins and/or antibodies against renal tissue. Cawadias referred to 'a new colloid substance', a kind of autoantibody in the context of anaphylaxis; he can be credited with foreseeing the modern era of the autosensitivity and immunology of renal diseases. Although Cawadias is well-known as a pioneer of Neohippocratism, his contribution to experimental nephritis has not been amply appreciated; he merits better recognition as one of the pathfinders in the field of renal immunopathogenesis.