One hundred and two years ago Richard Bright1 first published his observations on the frequent coexistence of thickening of the arteries, cardiac hypertrophy and chronic renal disease. Finding no organic cause for the cardiac hypertrophy generally affecting the left ventricle, he said:
This naturally leads us to look for some less local cause, for the unusual efforts to which the heart has been impelled; and the two most ready solutions appear to be either that the altered quality of the blood affords irregular and unwanted stimulus to the organ immediately; or, that it so affects the minute and capillary circulation, as to render greater action necessary to force the blood through the distant sub-divisions of the vascular system.
Under the latter postulate Bright ascribed cardiac hypertrophy to increased peripheral resistance, which he believed was due to renal disease. It may therefore be said that he was the first to