Enigma of contracted granular kidney: a chapter in the history of nephrology.
British successors of Richard Bright came to regard the disease which bore his name as consisting of several distinct clinical and pathological types, one of which was referred to as contracted granular kidney. The insidious nature of this form of the disease, the lack of clear-cut precipitating factors and, above all, the associated cardio-circulatory disorders gave rise to much speculation and debate. Whether the renal disease or the vascular disease was the primary and essential change was a question which sharply divided eminent Victorian physicians and gave rise to a bitter quarrel between Sir George Johnson and Sir William Gull. The anser to this conundrum, that the kidney was sometimes the cause and sometimes the consequence of circulatory disease was suggested by Mahomed's discovery of essential hypertension but confirmation had to await the invention of a clinically useful sphygmomanometer.
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University of Pittsburgh, Department of Medicine, Presbyterian-University Hospital, Pittsburgh, Pa.
D004739:England; D005921:Glomerulonephritis / Q000266:history*; D049672:History, 19th Century; D006801:Humans; D006973:Hypertension / Q000266:history*; D006977:Hypertension, Renal / Q000266:history*