Tuesday, July 29, 2008

Dropsy

I would highly recommend the following book for renal fellows everywhere: "Dropsy, Dialysis, Transplant: A Short History of Failing Kidneys", by Steven Peitzman. I am presently reading it during my trips on the "T" while commuting into Mass General Hospital in the wee hours of the morn.

What is "dropsy"? Dropsy--still used to describe ailments which affect marine animals such as fish or frogs (see left)--was the ancient word for edema, or total body sodium excess. Like the word "edema", dropsy does not make any distinctions between its many causes: heart failure, cirrhosis, kidney disease, etc. But the British physician Richard Bright (1789-1858) in his landmark autopsy studies noted that a particular subset of patients with dropsy had a characteristic type of scarring of the kidney which was also associated with the appearance of albumin in the urine, which he could detect by placing a flame under a urine specimen. We now know this as "nephrotic syndrome", even though "Bright's Disease" is considered by many as the first "named disease" which was named after its discoverer.

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