Bright's

disease is considered by Fother gill as a secondary condition arising from a tendency toward the reversion to that pre anthropic type in which the liver performed the additional office of excreting uric acid. Acute Bright's Disease is sudden in its onset, and is a ociated with chills, headache, backache, vomiting, and edema, especially marked in the eyelids and the cheeks. The urine is scanty or even suppre ed, of a dark, smoky hue, and contains a large amount of albumin, and blood. Microscopically, blood corpuscles, renal epithelium, debris, and hyalin, epithelial, and blood-casts are found, and occasionally, also, granular casts. Occasionally the glomeruli of the kidney are the seat of the most marked changes, and to this condition the term " glomerulo-nephritis " has been given. The most frequent cause of acute Bright's disease is exposure to cold. It is often a complication of the specific fevers, especially scarlet fever. Death frequently results from uremia or cardiac failure, or the disease may a ume a chronic form. Chronic Bright's Disease embraces, as has been said, three distinct diseases of the kidney. Chronic parenchymatous nephritis, usually following an acute attack, is also known as chronic tubal and chronic desquamative nephritis, and from its size and pallor, the kidney resulting from the disease is called the " large white kidney,'''' The capsule peels off readily and leaves a smooth or very slightly granular surface. The tubules are most involved in the change; they are enlarged and distended with proliferated and swollen epithelial cells. There is some thickening of the interstitial ti ue, as a rule. This large kidney is prone to undergo degenerative changes, the protoplasm of the cells in the tubules breaking down into an amorphous debris. The kidney shrinks, and at the same time undergoes an increase in the interstitial ti ue, forming what is known as the " small white Granular contraction of the kidney is also known as chronic interstitial nephritis, and the kidney resulting is called the " small red granular kidney" the " red contracted kidney," and at times the ' ' gouty kidney ' ' or the " arteriosclerotic kidney. ' ' This kidney is usually much diminished in size and weight; the capsule is greatly thickened and adherent, so that it cannot be removed without tearing the kidney-ti ue. The renal substance is reddish, granular, with small and firm on section.