The following is excerpted from Framing Disease: Studies in Cultural History, edited by Charles E. Rosenberg and Janet Golden (Rutgers University Press, 1992). Included are Dr. Rosenberg's introduction and a chapter by Steven J. Peitzman that traces understanding of end-stage renal disease, starting with the pathologic studies by Richard Bright early in the nineteenth century and continuing to the present era of renal dialysis and transplantation.